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Aspirin vs Ibuprofen: Understanding the Basics

What is Aspirin?

Aspirin, also called acetylsalicylic acid (ASA), belongs to a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). It is a type of NSAID called acetylated salicylates. Brand names include Bayer Aspirin, Ecotrin, and others.

What is Ibuprofen?

Ibuprofen is also a nonsteroidal anti-inflammatory drug (NSAID). It is a type of NSAID called propionic acids. A few brand names include Advil, Motrin, and Midol.

Mechanism of Action

Ibuprofen and aspirin work in the same way, by decreasing the body’s ability to produce prostaglandins. Prostaglandins are natural chemicals in the body that cause pain, fever, and inflammation (redness, swelling, pain).

Key Differences Between Aspirin and Ibuprofen

Aspirin and ibuprofen are both NSAIDs that are used to treat pain and inflammation. However, there are some key differences between them:

Uses: Both aspirin and ibuprofen are used to treat pain, inflammation, and fever. But aspirin is also used to prevent heart attack and stroke in people at a high risk of these cardiovascular events. 

Recommended Age: Aspirin and products containing aspirin as the active ingredient are not recommended for use in children under the age of 18 years due to the risk of a serious condition called Reye syndrome. Ibuprofen is approved for use in children 6 months of age and older. 

Side Effects (Stomach Upset): Aspirin is generally more irritating to the stomach and more likely to cause stomach upset compared to ibuprofen. However, the risk of stomach-related side effects with ibuprofen increases with higher doses, longer duration of use, taking the medicine on an empty stomach, and alcohol intake. Damage to the stomach lining by NSAIDs is more likely in people who have a history of stomach ulcers.

Blood Thinning Effects: Aspirin is a blood thinner while ibuprofen is not. Daily low-dose aspirin is used to prevent cardiovascular events like heart attack and stroke due to its protective effect (blood thinning or antiplatelet effects). However, ibuprofen does have a mild effect on blood clotting and can increase the risk of bleeding. Therefore, you should not take ibuprofen if you are on anticoagulants (blood thinning drugs).

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When to Take Aspirin

Recommended uses for prescription-strength aspirin include treating pain, redness, swelling, stiffness, and inflammation related to:

• Rheumatoid arthritis

• Osteoarthritis

• Systemic lupus erythematosus (SLE)

• Other rheumatologic conditions 

Nonprescription aspirin is used to treat:

• Fever 

• Mild to moderate pain (arthritis pain, headaches, toothaches, muscle aches, menstrual cramps)

In addition, aspirin is used to prevent heart attack and stroke and lower the risk of death from cardiovascular events in people with:

• Angina (chest pain)

• History of heart attack 

• History of ischemic stroke 

• History of mini-strokes (transient ischemic attacks or TIAs)

When to Take Ibuprofen 

Recommended uses for prescription-strength ibuprofen include treating pain, tenderness, redness, swelling, stiffness, and inflammation related to:

• Rheumatoid arthritis

• Osteoarthritis 

• Mild to moderate menstrual pain

Nonprescription ibuprofen is used to treat:

• Fever 

• Minor aches and pains (mild arthritis pain, headaches, muscle aches, backaches, toothaches, menstrual pains, common colds)

Fever

Both ibuprofen and aspirin are fever reducers. However, ibuprofen is usually preferred as it is better tolerated. Also, ibuprofen is safe for use in babies 6 months of age and older. Aspirin should not be given to anyone under the age of 18 years without medical supervision.

Headaches

Both aspirin and ibuprofen can provide headache relief, and you can take either medication based on your personal preference. High-dose aspirin can be particularly effective for severe headache or migraine. However, you should avoid taking over-the-counter NSAIDs such as aspirin and ibuprofen more than a couple of times a week. Talk to your healthcare provider if you are having trouble managing your headaches on OTC pain medications.

Backache

Both ibuprofen and aspirin have a pain relieving effect on back pain. If you have chronic back pain, you should talk to your pharmacist or healthcare provider for effective long-term pain management options, including non-pharmacological methods.

Minor Pain

Ibuprofen is usually preferred over aspirin for pain caused by menstrual cramps, toothache, and muscle pains because it is better at reducing pain and is also generally better tolerated.

Arthritis

Ibuprofen is generally preferred over aspirin to manage pain and inflammation related to chronic conditions such as arthritis. This is because the risk of gastrointestinal side effects is higher with aspirin and the risk increases with a longer duration of use.

Pain Caused by Soft Tissue Injuries

Studies in professional athletes suggest that ibuprofen works better than aspirin in relieving pain caused by soft tissue injuries, in terms of reducing both the intensity and duration of the pain.

Safety and Side Effects

Is Aspirin or Ibuprofen Safer?

Aspirin and ibuprofen are generally safe when used as prescribed or as directed on the product package. However, there are some safety considerations to keep in mind:

• Do not take ibuprofen if you’ve recently had a heart attack. Taking ibuprofen and other NSAIDs (other than aspirin) can increase your risk of heart attack and stroke.

• Do not take aspirin or ibuprofen without consulting your doctor if you’re pregnant. These pain medications can harm the unborn baby if they’re taken at 20 weeks of pregnancy or later. Low-dose aspirin (81 mg) may be used in pregnant women to lower the risk of blood clots in those with artificial heart valves.

• Avoid aspirin in children younger than 18 years of age due to a risk of Reye’s syndrome, a serious condition that causes brain swelling and liver damage.

• Talk to your doctor about other over-the-counter medications for pain and fever, such as acetaminophen (Tylenol), which are less likely to cause stomach problems compared to taking aspirin or ibuprofen.

• Check with your doctor before taking aspirin or ibuprofen if you have a history of stomach ulcers, kidney problems, liver disease, heart disease, or bleeding disorders.

Common Side Effects of Aspirin

• Stomach pain

• Nausea

• Vomiting

• Heartburn

Common Side Effects of Ibuprofen

• Gas 

• Bloating

• Constipation

• Dizziness

• Tinnitus (ringing in the ears)

• Nervousness

Interactions and Precautions

Can I Take Aspirin and Ibuprofen Together?

Do not take aspirin and ibuprofen together without talking to your healthcare provider. Aspirin and ibuprofen belong to the same group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). Taking ibuprofen and aspirin together can increase the risk of adverse effects such as kidney injury and stomach pain leading to peptic ulcers.

Research suggests that ibuprofen (Motrin, Advil, and others) can block the heart-protecting effects of aspirin. If you take aspirin for your heart, acetaminophen (Tylenol) may be the better choice drug to treat pain and fever. If you want to take ibuprofen for aches and pains while on low-dose aspirin for your heart, experts recommend that you take the aspirin first every day.

Possible Drug Interactions 

Taking aspirin and ibuprofen with certain other medications can affect how the medicines work. Drug interactions can also increase the risk of serious side effects. Your doctor may change the doses of your medicines, switch you to a different medication, and/or monitor you carefully for adverse effects if there are known interactions between aspirin, ibuprofen, and other medicines. Give your doctor a full list of your prescription drugs, over-the-counter medications, dietary supplements, and herbal remedies. Possible drug interactions include:

• Carbonic anhydrase inhibitors such as acetazolamide (Diamox)

• Angiotensin-converting enzyme (ACE) inhibitors 

• Beta-blockers

• Diuretics (water pills)

• Anticoagulants (blood thinners) 

• Diabetes medications 

• Arthritis and gout medications

• Other NSAIDs

• Certain antiepileptic drugs 

• Oral steroids

• Antidepressants targeting serotonin such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)

When to Avoid Both Aspirin and Ibuprofen

Aspirin and ibuprofen may not be safe for people with certain underlying medical conditions. Before taking these pain medications, tell your doctor if you have any of these health conditions: 

• Recent heart attack

• Heart disease

• Heart failure

• Risk factors for heart disease (smoking, high cholesterol, high blood pressure)

• Recent or planned coronary artery bypass graft (CABG or heart bypass surgery)

• Ulcers, bleeding, or perforation in the gastrointestinal tract (stomach or intestines)

• Bleeding disorders

• Asthma

• Frequent stuffy or runny nose

• Nasal polyps

• Lupus

• Liver disease

• Kidney disease

• Pregnancy

Alternatives to Aspirin and Ibuprofen for Pain Relief

Acetaminophen (Tylenol) is a non-NSAID pain reliever and can be used to treat fever and common aches and pains. Acetaminophen affects the body’s ability to form prostaglandins as well as how the central nervous system will signal pain and how the body senses pain, but scientists don’t fully understand its mechanism of action. 

Acetaminophen does not cause stomach irritation and is a good choice for people with stomach issues. 

However, acetaminophen does not have anti-inflammatory effects. Meaning, while acetaminophen can relieve pain caused by inflammation it does not control the inflammation itself. Therefore, if an inflammatory condition is causing pain (osteoarthritis, rheumatoid arthritis), ibuprofen might work better.

Also, acetaminophen can cause liver damage at high doses (more than 4000 mg in 24 hours). Make sure you take no more than the recommended dose of acetaminophen. Check the label carefully for all over-the-counter fever and pain remedies because many of them contain acetaminophen, and taking multiple products together can lead to an overdose of acetaminophen and a risk of liver injury.

Comparing Pain Relievers

A meta-analysis examined the effectiveness of higher versus lower doses of aspirin, ibuprofen, and paracetamol in pain relief. Results showed a consistent, modest benefit of higher doses, with about 10% more patients experiencing significant pain relief at higher doses. However, only 22% of the studies evaluated showed a significant difference. Therefore, while higher doses may provide better pain relief, safety concerns, especially in long-term use, should guide dosing decisions. 

Studies have also shown that, in general, acetaminophen and ibuprofen are better tolerated with fewer significant adverse events compared to aspirin.

Other studies have shown that ibuprofen (7.5 mg/kg per dose) is a superior fever reducer to aspirin (10 mg/kg/dose) and paracetamol (10 mg/kg per dose) in young children between the ages of 6 months and 2 years with fever. Remember, however, it is not safe to give aspirin to children younger than 18 years without a doctor’s supervision.

Frequently Asked Questions

Is Aspirin Anti-Inflammatory?

Yes, aspirin works as an anti-inflammatory. It belongs to a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). 

What Is The Healthiest Pain Reliever To Take?

Acetaminophen is generally considered the healthiest and safest over-the-counter medication to reduce pain and fever. It is safe for children. It is also less likely to cause stomach irritation compared to NSAIDs like aspirin and ibuprofen. 

However, acetaminophen (Tylenol) is not an anti-inflammatory and is less effective if you want to reduce swelling and redness. Also, high doses of acetaminophen can cause liver injury, and this pain medicine may not be safe for people with liver disease. 

Final Recommendations: Is It Better to Take Aspirin or Ibuprofen to Relieve Pain?

In general, ibuprofen works better to relieve pain. It is also less likely to cause stomach irritation compared to aspirin. However, aspirin may be the safer choice for people with a history of cardiovascular disease. You can also talk to your healthcare provider about other NSAIDs such as naproxen (Aleve, Naprosyn) and consider non-NSAID pain medicines such as acetaminophen (Tylenol).