Quick answer — which should you use?
Paracetamol is generally the first choice for pain and fever in most situations. It is gentler on the stomach, safe during pregnancy, and suitable for people with asthma. Ibuprofen is more effective when inflammation is involved — such as sprains, strains, toothache, period pain, or arthritis — because it reduces both pain and swelling. However, ibuprofen should be avoided by people with stomach ulcers, kidney problems, asthma triggered by anti-inflammatories, or during the third trimester of pregnancy.
In a first aid context, paracetamol is the safer option when you are unsure of the person’s medical history. First aiders holding HLTAID011 Provide First Aid are trained to assist with medication — but only when the casualty has been prescribed the medication or it is an over-the-counter product they would normally take. First aiders do not diagnose or prescribe.
How paracetamol works
Paracetamol (known as acetaminophen in the US) is an analgesic and antipyretic — it relieves pain and reduces fever. The exact mechanism is not fully understood, but it is believed to work by inhibiting the production of prostaglandins in the central nervous system. Unlike ibuprofen, paracetamol does not have significant anti-inflammatory properties at standard doses.
When paracetamol is the better choice
- General headache — effective and gentle on the stomach
- Fever — first-line treatment for reducing temperature in adults and children
- Post-surgical pain — commonly recommended as it does not increase bleeding risk
- Pregnancy — considered safe throughout pregnancy at recommended doses (ibuprofen is not)
- People with asthma — does not trigger asthma symptoms (some asthmatics are sensitive to ibuprofen)
- People with stomach ulcers or gastritis — does not irritate the stomach lining
- Children under 3 months — paracetamol is recommended; ibuprofen is only approved from 3 months of age
- Elderly patients on blood thinners — paracetamol does not interact with anticoagulants the way ibuprofen can
Paracetamol dosage for adults
| Detail | Adult dosage |
|---|---|
| Standard dose | 500 mg – 1,000 mg (1–2 tablets) |
| Frequency | Every 4–6 hours as needed |
| Maximum daily dose | 4,000 mg (4 g) in 24 hours |
| Onset of action | 30–60 minutes |
| Duration of effect | 4–6 hours |
The maximum daily dose is critically important. Paracetamol overdose is the leading cause of acute liver failure in Australia. Many cold and flu products contain hidden paracetamol — always check the active ingredients of all medications being taken to avoid accidentally exceeding 4 g per day.
How ibuprofen works
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID). It works by blocking the enzyme cyclooxygenase (COX), which reduces the production of prostaglandins — chemicals that cause pain, inflammation, and fever. Because it targets inflammation directly, ibuprofen is more effective than paracetamol for injuries and conditions involving swelling.
When ibuprofen is the better choice
- Sprains and strains — reduces both pain and the swelling that causes stiffness (note: the RICER method should be applied first for acute soft tissue injuries)
- Toothache and dental pain — ibuprofen is generally more effective than paracetamol for dental pain due to the inflammatory component
- Period pain (dysmenorrhoea) — ibuprofen targets the prostaglandins that cause uterine cramping
- Arthritis and joint pain — the anti-inflammatory effect addresses the root cause, not just the symptom
- Back pain — particularly when muscle inflammation or spasm is involved
- Sports injuries — post-event pain management after applying appropriate first aid
- Sore throat with swelling — reduces tonsillar inflammation alongside pain
- Sinusitis — addresses sinus inflammation and pressure headache simultaneously
Ibuprofen dosage for adults
| Detail | Adult dosage |
|---|---|
| Standard dose | 200 mg – 400 mg (1–2 tablets) |
| Frequency | Every 6–8 hours as needed |
| Maximum daily dose | 1,200 mg (over-the-counter) / 2,400 mg (prescribed) |
| Onset of action | 20–30 minutes |
| Duration of effect | 6–8 hours |
| Take with | Food or milk to reduce stomach irritation |
Always take ibuprofen with food or a glass of milk. Taking it on an empty stomach increases the risk of gastric irritation and ulceration.
Side-by-side comparison
| Feature | Paracetamol | Ibuprofen |
|---|---|---|
| Drug class | Analgesic / antipyretic | NSAID (anti-inflammatory) |
| Reduces pain | Yes | Yes |
| Reduces fever | Yes | Yes |
| Reduces inflammation | Minimal | Yes — primary advantage |
| Onset | 30–60 minutes | 20–30 minutes |
| Duration | 4–6 hours | 6–8 hours |
| Take with food? | Not required | Yes — always with food |
| Safe in pregnancy | Yes (all trimesters) | No (especially third trimester) |
| Safe with asthma | Yes | Caution — may trigger symptoms |
| Stomach risk | Low | Higher — can cause ulcers |
| Liver risk | Higher in overdose | Lower |
| Kidney risk | Lower | Higher — avoid in kidney disease |
| Interacts with blood thinners | Minimal | Yes — increases bleeding risk |
| Brand names (Australia) | Panadol, Panamax, Herron | Nurofen, Advil, Brufen |
Can you take paracetamol and ibuprofen together?
Yes. In Australia, taking paracetamol and ibuprofen together or alternating between them is a widely recommended strategy for managing moderate to severe pain. Because they work through different mechanisms, combining them can provide better pain relief than either drug alone.
The approach for adults:
- Take paracetamol (1,000 mg) first
- Two to three hours later, take ibuprofen (400 mg) with food
- Continue alternating every 3–4 hours, respecting the maximum daily dose of each drug independently
- Never exceed 4,000 mg paracetamol or 1,200 mg ibuprofen (OTC) in 24 hours
This alternating approach is commonly recommended by Australian GPs and pharmacists for post-dental pain, sports injuries, and post-operative recovery. However, it is not a substitute for medical advice — if pain requires regular combined medication for more than a few days, see a doctor.
When to avoid each medication
Avoid paracetamol if:
- You have severe liver disease or liver failure
- You are already taking other products containing paracetamol (check cold/flu products, codeine combinations)
- You consume more than 3 standard alcoholic drinks per day (increased liver toxicity risk)
- You weigh under 50 kg (dose should be reduced)
Avoid ibuprofen if:
- You have a history of stomach ulcers, gastritis, or gastrointestinal bleeding
- You have kidney disease or impaired kidney function
- You are in the third trimester of pregnancy
- You have aspirin-sensitive asthma
- You are taking blood thinners (warfarin, aspirin, or other anticoagulants)
- You are dehydrated — NSAIDs can worsen kidney function in dehydrated patients
- You have heart failure or uncontrolled high blood pressure
- You have had a recent heart attack or stroke
Paracetamol and ibuprofen in first aid
In a workplace first aid context, trained first aiders may assist a casualty with pain relief medication under specific conditions. Under HLTAID011 Provide First Aid, the guidelines are:
- A first aider may assist someone to take their own prescribed medication or an over-the-counter product they would normally take
- A first aider does not diagnose conditions or prescribe medications
- Always ask about allergies, existing medications, and medical conditions before assisting with any medication
- Record what was given, the dose, the time, and the person’s response
- If in doubt, do not give medication — wait for paramedics
Understanding the difference between paracetamol and ibuprofen helps first aiders make better-informed decisions when assisting casualties. For example, a first aider responding to a workplace injury involving a sprained ankle (managed with the RICER method) would know that ibuprofen may be more appropriate than paracetamol due to the inflammatory component — but would only assist if the casualty confirms they normally take ibuprofen and have no contraindications.
Common Australian brand names
It is useful to recognise the brand names, as many people refer to their medication by brand rather than active ingredient:
Paracetamol brands
Panadol, Panamax, Herron Paracetamol, Chemists’ Own Paracetamol, Dymadon, Lemsip (contains paracetamol), Codral (contains paracetamol), Panadeine (paracetamol + codeine).
Ibuprofen brands
Nurofen, Advil, Brufen, Herron Blue, Rafen, ACT-3, Chemists’ Own Ibuprofen.
Combination products to watch
Nuromol (ibuprofen + paracetamol), Mersyndol (paracetamol + codeine + doxylamine), Panadeine Forte (paracetamol + codeine). These combination products increase the risk of accidentally exceeding the maximum daily dose of one or both active ingredients.
Learn medication awareness in first aid training
Understanding when and how to assist with medication is part of the HLTAID011 Provide First Aid course ($95, 4 hours, same-day certificate). The course covers medication awareness alongside CPR, DRSABCD, wound management, burns, fractures, and anaphylaxis (including EpiPen administration).
IRFA delivers HLTAID011 at four North Brisbane venues:
Redcliffe Peninsula — Redcliffe RSL
Irene Street, Redcliffe QLD 4020.
North Lakes — Community Centre
10 The Corso, North Lakes QLD 4509.
Virginia / Northgate — Northgate Hall
34 Ridge Street, Virginia QLD 4014.
Caboolture — Caboolture Hub
4 Hasking Street, Caboolture QLD 4510.
Same-day certificates. Paramedic trainers. Sessions 7 days a week. RTO 32154. View all North Brisbane courses →
Frequently asked questions
Is paracetamol or ibuprofen better for headaches?
Paracetamol is generally sufficient for tension headaches. Ibuprofen may be more effective for headaches with an inflammatory component, such as sinus headaches or migraines. Both are considered first-line options for general headache relief.
Can you take paracetamol and ibuprofen at the same time?
Yes. They work through different mechanisms and can be taken together or alternated for better pain relief. Respect the maximum daily dose of each drug independently: 4,000 mg paracetamol and 1,200 mg ibuprofen (over-the-counter) in 24 hours.
Which is better for a toothache?
Ibuprofen is generally more effective for dental pain because toothache involves inflammation of the pulp or gum tissue. Many dentists recommend alternating ibuprofen with paracetamol for post-extraction or severe dental pain.
Which is safer for children?
Both are safe for children at age-appropriate doses. Paracetamol can be given from birth; ibuprofen is approved from 3 months of age and 5 kg body weight. Always use children’s formulations and dose by weight, not age. Do not give aspirin to children under 16.
Is ibuprofen bad for your stomach?
Ibuprofen can irritate the stomach lining and increase the risk of ulcers if used frequently or on an empty stomach. Always take it with food or milk. If you have a history of stomach problems, paracetamol is the safer choice. Short-term use at recommended doses carries a low risk for most people.
Which is better after a sports injury?
Ibuprofen is typically preferred for the first 48–72 hours after a sports injury because it addresses both pain and inflammation. Apply the RICER method (Rest, Ice, Compression, Elevation, Referral) first, then consider ibuprofen with food for pain management. After 72 hours, paracetamol may be sufficient as inflammation subsides.
