Best Over-the-Counter Medicine for Headaches: Ibuprofen vs. Acetaminophen

One of the questions I hear most often as a pharmacist is:“Should I take ibuprofen or Tylenol for my headache?”

Both medications are effective, but they work differently — and choosing the right one depends on the type of headache you’re dealing with, your health history, and how strong the pain is. In some situations, a combination of both, at lower doses, can even work better than either one alone.

Let’s break this down simply.

How They Work

Ibuprofen (Advil®, Motrin®)

Ibuprofen is an NSAID (nonsteroidal anti-inflammatory drug). It reduces pain, fever, and inflammation.It’s especially useful when your headache involves:

• Muscle tension

• Sinus pressure or congestion

• Neck strain

• Any type of swelling or soreness

Acetaminophen (Tylenol®)

Acetaminophen works mainly in the brain to reduce pain and fever.It does not reduce inflammation.It’s gentle on the stomach and is often safer for people with:

• Acid reflux

• Ulcers

• High blood pressure

• Sensitive stomachs

Combination Therapy

Taking both together at appropriate doses can be more effective for strong headaches or migraines than taking a higher dose of just one.

A common pharmacist-recommended example:

• Ibuprofen 200 mg + Acetaminophen 325 mg

This can provide faster, more powerful relief while helping minimize stomach irritation (from ibuprofen) or liver stress (from acetaminophen).

How Long They Last

• Ibuprofen: 4–6 hours

• Naproxen (Aleve®): 8–12 hours (longer-acting NSAID)

• Acetaminophen: 4–6 hours (or up to 8 hours with extended-release)

Choosing the Right Option

Choose Ibuprofen if:

• Your headache involves tension, tight muscles, or sinus pressure

• You feel soreness or inflammation

• You have no history of stomach ulcers, kidney issues, or NSAID sensitivity

Choose Acetaminophen if:

• You have a sensitive stomach

• You take blood pressure medication

• You need something safe and steady for general headache pain

• You want to avoid NSAIDs

Consider a Combination if:

• The headache is stronger than usual

• You get migraines

• One medication alone isn’t enough

Combination therapy is a common and safe strategy when dosed properly.

Safety Tips from Your Pharmacist

Acetaminophen

• Max daily dose for most adults: 3,000 mg

• Watch for hidden acetaminophen in cold/flu products

• Avoid extra doses if you drink alcohol heavily or have liver issues

Ibuprofen/Naproxen

• Always take with food

• Avoid if you’ve had ulcers, kidney disease, or uncontrolled high blood pressure

• Stay hydrated to protect your kidneys

Combination Use

• Safe when used correctly

• Track your total doses over 24 hours

• Stick to recommended spacing and limits

Final Word

Both medicines deserve a place in your home medicine cabinet.

• Ibuprofen: Best when inflammation or tension is part of the headache

• Acetaminophen: Better for sensitive stomachs and people who should avoid NSAIDs

• Combination: A powerful, balanced approach for tougher headaches or migraines

If you asked me this question at the pharmacy counter, this is exactly how I’d explain it — simple, clear, and tailored to how headaches really behave in everyday life.

For trusted product options, visit the Pharmacist-Approved Pain Relief Guide at PharmOTC+