Nurofen is one of the most recognizable pain relief brands in the world. But when you open your medicine cabinet, you’ll often see other options sitting right next to it: paracetamol, naproxen, aspirin, even topical gels. So what’s the real difference? And more importantly, which one should you reach for when your head hurts, your back aches, or your period cramps hit hard?
Nurofen’s active ingredient is ibuprofen - a nonsteroidal anti-inflammatory drug (NSAID). It doesn’t just mask pain. It cuts inflammation at the source. That’s why it works so well for sprains, arthritis, or menstrual pain. But ibuprofen isn’t the only player. Other painkillers have different strengths, risks, and ideal uses. Choosing the wrong one can mean less relief… or worse, side effects you didn’t expect.
How Nurofen (ibuprofen) actually works
Ibuprofen blocks enzymes called COX-1 and COX-2. These enzymes make prostaglandins - chemicals your body releases when injured or inflamed. Prostaglandins cause pain, swelling, and fever. By stopping their production, ibuprofen reduces all three. That’s why it’s more effective than plain paracetamol for swelling-related pain, like a swollen ankle or inflamed gums.
But here’s the catch: COX-1 also protects your stomach lining. When ibuprofen blocks it, you risk stomach upset, ulcers, or bleeding - especially if you take it on an empty stomach or use it long-term. That’s why Nurofen’s packaging warns against using it for more than 10 days without seeing a doctor.
For most healthy adults, a standard dose of 200 mg every 6-8 hours (no more than 1,200 mg in 24 hours) is safe. But if you’re over 65, have kidney issues, or take blood thinners, even that much can be risky.
Paracetamol (acetaminophen): The gentler option
If you’ve ever taken Tylenol or Panadol, you’ve used paracetamol. It’s the most common painkiller in the world. And unlike ibuprofen, it doesn’t touch inflammation. It works mainly in the brain to lower pain signals and reduce fever.
That makes it ideal for headaches, mild arthritis, or fevers - especially if you can’t take NSAIDs. People with stomach ulcers, asthma triggered by NSAIDs, or kidney disease often switch to paracetamol because it’s easier on the body.
But here’s the danger: paracetamol has a razor-thin safety margin. Taking just 10-15 extra tablets in one day can cause severe liver damage - sometimes fatal. The maximum daily dose for adults is 4,000 mg. But if you drink alcohol regularly, that number drops to 2,000 mg. Many cold and flu meds also contain paracetamol, so it’s easy to accidentally overdose.
Bottom line: Paracetamol is safer for your stomach and kidneys, but harder on your liver. Use it if you need fever control or mild pain without inflammation. Skip it if you drink alcohol daily or have liver disease.
Naproxen: The long-lasting alternative
Naproxen (sold as Aleve or Naprosyn) is another NSAID - like ibuprofen, but slower and longer-lasting. One tablet can work for up to 12 hours. That’s why it’s often recommended for chronic conditions like osteoarthritis or gout.
Studies show naproxen may carry a slightly lower risk of heart attack than ibuprofen, especially at higher doses. That’s why some doctors prefer it for people with heart disease risk factors. But it’s still an NSAID. It can cause stomach bleeding, kidney damage, and high blood pressure just like ibuprofen.
For acute pain like a toothache or muscle strain, naproxen might be overkill. But for all-day joint pain, it’s a solid pick. The standard dose is 220 mg every 8-12 hours. Don’t take it longer than 10 days without medical advice.
Aspirin: Not just for heart health
Aspirin is the oldest painkiller on this list. It’s an NSAID too, but it has one unique trick: it permanently blocks platelets from clumping. That’s why low-dose aspirin (75-100 mg daily) is used to prevent heart attacks and strokes.
For pain relief, you need a higher dose - usually 300-600 mg every 4-6 hours. But here’s the problem: aspirin increases bleeding risk more than ibuprofen or naproxen. It’s not safe for children under 16 due to Reye’s syndrome. It’s also risky if you have peptic ulcers, gout, or are pregnant.
Most people don’t use aspirin for routine headaches anymore. But if you’ve been prescribed low-dose aspirin for heart protection, don’t stop it without talking to your doctor - even if you’re taking ibuprofen for pain. Ibuprofen can interfere with aspirin’s heart-protective effect.
Topical pain relievers: Localized relief without the gut risk
What if you don’t want to swallow anything? Topical gels and patches can deliver pain relief directly to the skin. Products like Voltaren Gel (diclofenac) or Bengay (menthol + camphor) work well for sore muscles, arthritis in the knees or hands, or minor sprains.
They bypass the digestive system entirely. That means far less risk of stomach upset or internal bleeding. But they’re not strong enough for full-body pain like migraines or period cramps. And they won’t reduce fever.
These are great as a supplement to oral meds - or as the first line of defense for localized pain. Just don’t use them on broken skin, and avoid combining them with heat wraps or heating pads. That can cause burns.
Who should avoid NSAIDs entirely?
Not everyone can take ibuprofen, naproxen, or aspirin. Avoid NSAIDs if you:
- Have a history of stomach ulcers or GI bleeding
- Have kidney disease or are on dialysis
- Have uncontrolled high blood pressure
- Are pregnant after 20 weeks (NSAIDs can affect fetal circulation)
- Have asthma worsened by painkillers
- Take blood thinners like warfarin or apixaban
- Are over 65 with multiple health conditions
If any of these apply to you, paracetamol is usually the safest starting point. But even then - check with your doctor or pharmacist. Some conditions require completely different treatments.
When to switch from Nurofen to something else
Here’s a simple rule: if Nurofen doesn’t help after two doses (about 12 hours), don’t keep taking more. You’re not getting stronger relief - you’re just increasing your risk.
Switch to paracetamol if:
- Your pain is mild and not linked to swelling
- You have stomach sensitivity
- You need something safe for short-term fever
Switch to naproxen if:
- Your pain lasts all day
- You have chronic joint pain
- You’re looking for longer-lasting relief
Try a topical gel if:
- Your pain is in one spot - knee, shoulder, wrist
- You want to avoid pills
- You’re already taking other medications that interact with NSAIDs
And if nothing works after 48 hours? See a doctor. Persistent pain isn’t normal. It could be a sign of something deeper - like an infection, nerve issue, or autoimmune condition.
Real-life examples: What works for what
Case 1: Sarah, 32, has a migraine. She takes Nurofen, but it only takes the edge off. She switches to paracetamol with caffeine (like Excedrin) - and gets full relief. Why? Migraines respond better to central pain relief than inflammation reduction.
Case 2: Raj, 58, has osteoarthritis in his knee. He used to take Nurofen daily. But his stomach started burning. His doctor switched him to naproxen once a day, plus a topical diclofenac gel. His pain is better, and his stomach is fine.
Case 3: Maria, 28, has period cramps. She used to take two Nurofen tablets every 6 hours. She started getting dizzy and nauseous. She switched to paracetamol with a heating pad. The cramps didn’t vanish, but the nausea did. She now uses a low-dose NSAID only on her heaviest days.
There’s no universal best painkiller. What works for one person can backfire for another.
What to look for on the label
Always check the active ingredient - not the brand name. Nurofen, Advil, Motrin, and generic ibuprofen all contain the same drug. But dosages vary. Some products combine ibuprofen with caffeine or antihistamines.
Look for:
- Active ingredient (e.g., ibuprofen 200 mg)
- Dosage instructions (how many pills, how often)
- Maximum daily dose
- Warnings (e.g., "Do not use if you have kidney disease")
- Expiration date
Never assume "natural" or "herbal" pain relievers are safer. Some can interact with prescription meds or cause liver damage. Stick to regulated pharmaceuticals unless your doctor approves otherwise.
Final tip: Don’t mix painkillers without checking
Many people think taking ibuprofen and paracetamol together is fine - and often it is. But only if you space them out. Don’t take them at the same time. Use one, wait 4-6 hours, then try the other. Keep a log of what you took and when.
And never combine NSAIDs. Taking ibuprofen and naproxen together doesn’t give you double the pain relief - it doubles your risk of bleeding and kidney damage.
Is Nurofen stronger than paracetamol?
Nurofen (ibuprofen) is stronger for pain caused by inflammation - like swollen joints, sprains, or period cramps. Paracetamol is better for fever and mild, non-inflammatory pain like headaches. Neither is universally "stronger." It depends on the cause of your pain.
Can I take Nurofen and paracetamol together?
Yes, you can take them together safely, but not at the same time. Space them 4-6 hours apart. For example, take ibuprofen at 8 a.m., paracetamol at 2 p.m., then ibuprofen again at 8 p.m. This gives you continuous relief without overdosing on either.
What’s the safest painkiller for long-term use?
No oral painkiller is truly safe for long-term daily use. But if you must take something regularly, paracetamol at the lowest effective dose (usually 650-1,000 mg up to four times a day) is the least risky for most people - as long as you don’t drink alcohol. Always talk to your doctor before using any painkiller daily for more than a few weeks.
Why does Nurofen sometimes make me feel sick?
Ibuprofen reduces protective stomach lining chemicals, which can lead to nausea, heartburn, or even ulcers. Taking it with food helps. If you feel sick often, switch to paracetamol or ask your doctor about a stomach-protecting medication like omeprazole.
Are there natural alternatives to Nurofen?
Some people find relief from turmeric, ginger, or omega-3s for mild inflammation. But these aren’t proven replacements for NSAIDs in moderate to severe pain. They work slowly, inconsistently, and may interact with blood thinners. Don’t use them instead of prescribed pain relief without medical advice.
What should I do if Nurofen doesn’t work?
If Nurofen doesn’t help after two doses (about 12 hours), stop taking it. Try paracetamol or a topical gel. If pain continues past 48 hours, or gets worse, see a doctor. Persistent pain could signal an infection, nerve issue, or other condition that needs different treatment.
If you're managing chronic pain, keep a simple log: what you took, when, how much, and how you felt 30 minutes later. Over time, you’ll spot patterns. You might discover that paracetamol works better for your headaches, while naproxen handles your back pain. The right painkiller isn’t about brand names - it’s about matching the drug to your body and your pain.