Understanding Pain Medications: Aspirin, Ibuprofen, and Acetaminophen 

When you’re dealing with pain, fever, or inflammation, reaching for an over-the-counter pain medication is often the first step. But with so many options—aspirin, ibuprofen, and acetaminophen—how do you know which one is right for you? 

At Covenant Health, we believe that understanding your medications is just as important as taking them. Informed choices lead to better health outcomes. Keep reading to learn the differences, use cases, and safety considerations of these three common pain relievers. 

Understanding the Basics of Pain Medicine

Each of these medications works differently in the body, and knowing how they function can help you choose wisely. 

Aspirin 

Aspirin is one of the oldest medications still in use today. It belongs to a class of drugs called NSAIDs—non-steroidal anti-inflammatory drugs—and it works by reducing substances in the body that cause pain, fever, and inflammation. Interestingly, aspirin also has blood-thinning properties, which is why it’s often recommended in low doses to help prevent heart attacks and strokes.  

Use for: 

• Mild to moderate pain 
• Lowering the risk of heart attack or stroke (low-dose therapy) 

Avoid if: 

• You have bleeding disorders or ulcers 
• You are under age 18 with viral illness (risk of Reye’s syndrome) 
• You’re allergic to NSAIDs 

If your doctor has recommended low-dose therapy for heart health (not for pain relief), it’s important to take it exactly as prescribed. This isn’t about pain relief—it’s about preventing serious cardiovascular events. 

Ibuprofen 

Ibuprofen, commonly known as Advil, Motrin, or Midol, is another NSAID. It is a bit more targeted for inflammation. It’s commonly used for muscle pain, menstrual cramps, and joint discomfort. Unlike aspirin, it doesn’t have the same blood-thinning effect, but it can still irritate the stomach lining if taken on an empty stomach or in high doses.  

Use for: 

• Muscle cramps, sprains, and strains 
• Reducing inflammation (e.g. arthritis) 
• Menstrual cramps 
• Dental pain 
• Fever 

Avoid if: 

• You have kidney disease 
• You are pregnant 
• You are taking blood pressure medication or blood thinners 

Acetaminophen 

Acetaminophen (Tylenol) is not an NSAID. It’s a pain reliever and fever reducer that works in the brain to block pain signals. It’s gentler on the stomach and often recommended for people who can’t tolerate NSAIDs—but it does come with its own risks, particularly to the liver.  

Use for: 

• Headaches 
• Fever 
• Minor aches and pains 
• Pain during pregnancy (as directed by your physician) 

Avoid if: 

• You have liver disease 
• You consume alcohol regularly 
• You are taking other medications that contain acetaminophen 

Important Safety Considerations 

While these medications are available without a prescription, they’re not without risks. Here are a few key notes to keep in mind: 

• Never exceed the recommended dose. More is not better—it can be dangerous. 
• Avoid mixing medications unless your provider says it’s safe. For example, taking ibuprofen and aspirin together can reduce the effectiveness of aspirin’s heart-protective benefits. 
• Watch for hidden ingredients. Many cold and flu remedies contain acetaminophen, which can lead to accidental overdose. 
• Take NSAIDs with food to reduce the risk of stomach irritation. 
• Limit alcohol when taking acetaminophen to protect your liver. 

Who Should Be Extra Cautious? 

Children should never take aspirin when recovering from viral illnesses due to the risk of Reye’s syndrome—a rare but serious condition. Older adults may be more sensitive to NSAIDs and should consult their provider before regular use. People with liver disease, kidney problems, or bleeding disorders should be especially cautious and may need alternative treatments. 

Pregnant individuals are generally advised to avoid NSAIDs, particularly in the third trimester, and should consult their OB-GYN before taking any medication. 

When Pain Persists, We’re Here to Help 

“Over the counter pain medications with typical use can be safe for most people. However, it’s important to know when to avoid them,” Alicia Brooks, MD and medical director of primary care at Covenant Health advises. “When in doubt, run it by your primary care clinician, especially if you also take prescription medications or have any chronic conditions.”  

Over-the-counter medications can be incredibly helpful, but they’re not a cure-all. If you’re experiencing persistent pain, recurring headaches, or symptoms that don’t improve with treatment, talk to a healthcare provider. 

At Covenant Health, our primary care team is here to guide you through your options and help you find safe, effective relief. Whether it’s reviewing your medications, managing chronic pain, or addressing underlying conditions, we’re committed to your well-being. 

Schedule your primary care visit today.  

This blog post is intended for educational purposes only and should not replace professional medical advice. Always consult your healthcare provider before starting or changing any medication.