Paracetamol and ibuprofen both relieve pain and bring down fever, but they work in different ways. Choosing the right one avoids side effects and makes the treatment work better.
The difference in one sentence
Paracetamol is a painkiller and fever-reducer: it takes away pain and lowers fever. Ibuprofen does the same, and is also anti-inflammatory: it reduces swelling and redness in tissue.
That difference decides which one to reach for, almost every time.
When to choose paracetamol
It’s the first choice whenever inflammation isn’t part of the problem:
- Headache and mild migraine
- Fever with no other symptoms
- Sore throat
- General malaise from a cold or flu
- Joint pain from osteoarthritis without an inflammatory flare-up
It’s also the painkiller of choice if you have stomach problems, take anticoagulants, have high blood pressure, asthma or kidney disease, and during pregnancy and breastfeeding.
When to choose ibuprofen
When the problem involves inflammation:
- Sprains, bruises and knocks
- Muscle pain and tendinitis
- Toothache and dental abscesses
- Period pain
- Earache
- Lower back pain and sciatica
Usual adult doses
For healthy adults, without a prescription, for a few days at most:
| Medicine | Dose per intake | Interval | Maximum per day |
|---|---|---|---|
| Paracetamol | 500–650 mg | every 6–8 h | 3 g |
| Ibuprofen | 400 mg | every 8 h | 1,200 mg |
Two important details:
1 g paracetamol tablets have required a prescription in Spain since 2018 and shouldn’t be taken without one. The 3 g daily ceiling is the recommended limit for self-medication; going over it consistently damages the liver.
Ibuprofen should be taken with or right after food, with a full glass of water. The 600 mg dose also requires a prescription: for mild to moderate pain, 400 mg is usually enough and carries less risk to the stomach.
Precautions with ibuprofen
Ibuprofen belongs to the NSAID (non-steroidal anti-inflammatory drug) family and shares its risks. Check with a pharmacist or doctor before taking it if:
- You have, or have had, an ulcer, gastritis or reflux
- You take anticoagulants, corticosteroids or SSRI antidepressants
- You have high blood pressure, heart failure or kidney problems
- You have asthma — it can trigger bronchospasm in some people
- You are pregnant — it’s discouraged throughout pregnancy and contraindicated from week 20 onwards
The most common mistake: doubling up without realising it
Many over-the-counter cold and flu remedies already contain paracetamol. If you take a cold sachet and then a headache tablet on top, you can go over the maximum dose without noticing. Always check the active ingredients before combining two products.
Alternating paracetamol and ibuprofen every 4 hours is sometimes recommended for high fever that won’t come down, but it should be guided by a healthcare professional and not continued for long.
When to stop self-medicating
See a doctor if:
- Fever goes above 39°C or lasts more than three days
- Pain doesn’t improve after 3–5 days of treatment
- You get severe stomach pain, black stools, or vomiting blood
- There’s neck stiffness, confusion or difficulty breathing
- It’s a baby under 3 months old with a fever
This information is general guidance only. It does not replace a consultation with your doctor or pharmacist. Sources: AEMPS — Spanish Agency of Medicines and Medical Devices, CIMA technical data sheets.