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Paracetamol vs. Ibuprofen Choosing the Right Painkiller in Prehospital Care

30 Sep 2023

Prehospital professionals often find themselves at the forefront of medical emergencies, tasked with making rapid decisions to alleviate patients’ pain and discomfort. Two common over-the-counter pain relievers they frequently encounter are Paracetamol vs. Ibuprofen. While both medications are effective at managing pain and reducing fever, they have distinct differences that paramedics need to be aware of to make informed choices for their patients. In this blog, we’ll explore the differences between paracetamol and ibuprofen to help professionals make the right decision in the field. 


Mechanism of Action: Paracetamol works primarily in the central nervous system and is believed to reduce the production of prostaglandins, which are chemicals involved in pain and fever. Its exact mechanism isn’t fully understood.

Pain Relief: Paracetamol is generally considered a mild to moderate pain reliever. It’s effective for conditions like headaches, toothaches, and mild muscle aches.

Fever Reduction: It is effective at reducing fever and is often used in paediatric cases for this purpose.

Anti-Inflammatory: Paracetamol is not an anti-inflammatory medication, so it does not reduce inflammation associated with conditions like sprains.

Gastrointestinal Tolerance: Paracetamol is usually gentler on the stomach compared to ibuprofen and is less likely to cause stomach irritation or bleeding.

Caution: Excessive use of paracetamol or overdose can lead to severe liver damage. Caution should be taken about the total dose and potential for interactions with other medications.


Mechanism of Action: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that works by reducing the production of prostaglandins, which cause inflammation, pain, and fever.

Pain Relief: Ibuprofen is known for its strong pain-relieving properties and is effective for conditions involving inflammation, such as joint pain, sprains, and menstrual cramps.

Fever Reduction: Like paracetamol, ibuprofen also reduces fever effectively.

Anti-Inflammatory: Ibuprofen is an anti-inflammatory medication, making it suitable for conditions characterised by swelling and inflammation.

Gastrointestinal Tolerance: Ibuprofen can irritate the stomach lining and may lead to gastrointestinal discomfort or ulcers if used excessively or for extended periods.

Caution: Caution when administering ibuprofen to patients with a history of stomach ulcers, bleeding disorders, or allergies to NSAIDs should be taken.

Choosing the Right Medication

Professionals should consider the patient’s specific condition and medical history when deciding between paracetamol and ibuprofen. If the patient has a fever without significant inflammation, paracetamol may be the preferred choice. Conversely, if the patient is experiencing pain associated with inflammation or injuries, ibuprofen’s anti-inflammatory properties may offer better relief

Additionally, professionals should always check for potential drug interactions, allergies, and contraindications before administering any medication.

In conclusion, both paracetamol and ibuprofen have their roles in prehospital care. Understanding their differences and knowing when to use each medication is crucial for prehospital professionals in providing the best care for their patients. Proper assessment, patient history, and consideration of the specific condition will guide professionals in making the right choice between these two commonly used pain relievers.