When to take ibuprofen or paracetamol?

Surely at times we have doubted whether it is better to take ibuprofen or paracetamol before a certain pain or discomfort. That is why we are going to tell you some curiosity that you would like to know. For example, do you know that paracetamol is a powerful liver toxin taken at high doses? And do you know that if you have any gastric pathology you should avoid excessive consumption of anti-inflammatories?

What is paracetamol and ibuprofen?

paracetamol: is an analgesic and antipyretic and is indicated for:

• Control fever.
• Menstrual pain or dimenorrhea
• Toothache or dental pain
• muscle pain
• Headache
• arthromyalgias typical of the flu

ibuprofen: It is a non-steroidal anti-inflammatory drug (NSAID) with analgesic, antipyretic, anti-inflammatory and reversible antiplatelet action and is indicated for:

• Treatment of acute or chronic pain of any cause (rheumatic, infectious, dental, arthritic, growth ...).
• Control fever.

Recommended dosage

paracetamol: it will depend on the age of the patient:

• For babies and children small will depend on the weight so we will adjust the dose and recommend the administration in drops for it. If it is a baby and does not tolerate ingestion, we have the option of a rectal suppository.
• If he child is older but he is not yet an adult, we have presentations of medium doses, between 250 mg and 325 mg.
• For the Adults the recommended dose can be 500 mg, 650 mg and 1 gram.

ibuprofen: it will depend on the age of the patient:

• For babies and toddlers It will depend on the weight so we will adjust the dose that is usually administered in the form of syrup.
• For the Adults doses may be higher.

Contraindications and adverse effects

paracetamol: Like the rest of drugs, it is not exempt from adverse effects, among which we can mention liver toxicity due to overdose or prolonged use.

• We will use it with caution in patients with alcoholism, liver failure and anemia.
• In the case of pregnancy and lactation, it is considered a category B drug, according to the FDA (Food and Drug Administration), so its use is accepted during pregnancy as long as there is a justifying cause, therefore, it is also compatible with breastfeeding.
• Other adverse effects are skin rash and urticaria, alteration of blood cells and hypotension, all of which occur rarely.

ibuprofen: it is contraindicated in case of heart, liver or kidney failure and gastric pathology.

• asthmatic patients should pay special attention as it can exacerbate symptoms.
• For pregnant women, it is considered a category B-C drug (during the first and second trimesters) and it would be category D for the third trimester (contraindicated).
• Regarding the adverse effects, some of them would be: arterial hypertension, bronchospasm, gastric heartburn, heart failure, etc.
• It interacts with other drugs such as oral anticoagulants, antihypertensives, other NSAIDs, methotrexate, lithium, corticosteroids ...

In case of overdose

paracetamol: During the first hours vomiting, dizziness, drowsiness, loss of appetite and abdominal pain may appear. From the second or third day, the most serious effects appear, related to liver involvement, which can lead to a state of coma and death. That is why you must. To confirm paracetamol overdose, a blood concentration determination must be made at least four hours after ingestion. In case of intoxication we must use the specific antidote which is acetylcysteine ​​and it is administered intravenously. It is very effective and its administration is recommended during the first eight hours after intoxication.

ibuprofen: symptoms such as vertigo, abdominal pain, nausea, vomiting, drowsiness, headache or hypotension will appear. Therefore, when detected, a symptomatic treatment will be carried out, since there is no specific antidote.

What to drink paracetamol or ibuprofen?

You already have a photo of the two drugs and of the. Practically similar in indication, however, we must be very clear that:

• In case of fever or malaise general with generalized pain of mild intensity or pain of another cause (also mild) we are going to stick to the use of paracetamol, ideally every eight hours, although we can use it promptly every 6 if we cannot control the symptoms until the next dose.
• In case of uncontrolled fever with paracetamol, generalized pain of medium intensity of any cause (dental, joint, throat or ear, gynecological, rheumatic ...) or chronic processes with exacerbation of pain, we will choose the ibuprofen.

You may also need a combined treatment with paracetamol or ibuprofen alternately every four hours in acute situations of fever and generalized pain (typical case of influenza). As soon as we have the symptoms and if their intensity is controlled, we will stop treatment with ibuprofen and continue with paracetamol.

As is evident, in case of allergy or contraindication of paracetamol or ibuprofen we will opt for another combination such as metamizole + paracetamol (in case of high fever) or metamizole + ibuprofen (in case of stubborn pain such as renal colic, for example). Important: we will never combine two NSAIDs at the same time since the risk of gastric injury will be high.

In any case, I recommend you before taking any medication.

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Family Medicine Specialist