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Paracetamol vs Ibuprofen: which painkiller should you reach for?

The short answer

For everyday headache or fever, start with paracetamol — it is gentler on the stomach and safe in pregnancy. Reach for ibuprofen when there is swelling or inflammation behind the pain, like a sprain, toothache, or period pain, and take it with food.

Walk into any chemist in Nigeria with a headache and you will be offered one of these two. They are not interchangeable. Paracetamol brings down fever and dulls pain but does nothing for inflammation. Ibuprofen is an NSAID — it attacks the inflammation itself, which is why it works better for a swollen ankle or an aching tooth.

The price difference is small; the safety difference is not. Paracetamol taken correctly is one of the safest medicines there is (the danger is overdose — many cold remedies already contain it, so doses add up quietly). Ibuprofen is harder on the stomach lining and the kidneys, and anyone with an ulcer, kidney trouble, or in the last three months of pregnancy should leave it alone.

Side by side

ParacetamolIbuprofen
Works on inflammationNoYes — its main advantage
Stomach friendlinessGentle; fine on an empty stomachCan irritate; always take with food
PregnancyConsidered safe at normal dosesAvoid, especially the last trimester
Main dangerOverdose — hidden in many cold/flu remediesUlcers, kidney strain with long use
Typical usesFever, headache, malaria-related achesSprains, toothache, period pain, arthritis
Drug classNon-opioid analgesic and antipyreticNon-steroidal anti-inflammatory drug (NSAID)
Typical price₦300–₦6,900 online (median ₦1,050, July 2026)₦350–₦8,050 online (median ₦1,070, July 2026)
NAFDAC registrations90 active Greenbook listings57 active Greenbook listings
Common brandsPanadol Extra, BoskaBrufen, Nurofen

Prices are sampled from licensed Nigerian online pharmacies and span brands and pack sizes — indicative only. Registration counts are from our copy of the NAFDAC Greenbook (July 2026); listings can lag renewals.

Reach for Paracetamol when…

  • It's a fever or a simple headache
  • You're pregnant or breastfeeding
  • You have an ulcer, heartburn history, or kidney problems
  • You're also taking a cold remedy (check it doesn't already contain paracetamol before adding more)

Reach for Ibuprofen when…

  • The pain comes with swelling — sprain, toothache, injury
  • It's period pain (ibuprofen consistently beats paracetamol here)
  • Arthritis or joint flare-ups
  • You can take it with food and your stomach and kidneys are healthy

Frequently asked questions

Educational comparison, not a prescription. Both medicines have full guides covering dosage, side effects, and warnings — talk to a pharmacist or doctor before switching. Updated July 2026.