Aspirin, Paracetamol & Ibuprofen: What's The Difference?


Aspirin, paracetamol, ibuprofen - they are a staple of all home medicine cabinets.  The brand names of the drugs including, Nurofen, Panadol and Disprin are as well known as pretty much any consumer product on the market.  Despite this name recognition, do we really know the difference between the three most common painkillers?

The UK’s total paracetamol consumption

We take so many of the pills that rates of consumption are measured in the tonnes rather than by the pill. Given how ubiquitous they are, exact figures are not easy to come by.  However it is estimated that in the UK we consume something like 6,300 tonnes of paracetamol each year.  The figure for aspirin and ibuprofen will be similar.  However you cut it, that’s a lot of pills.

We clearly have an appetite for the medication, but a 2010 study would suggest we aren’t clear on what separates the products.  It found that nearly 50% of people did not know the difference between ibuprofen or paracetamol.  This is concerning as while these drugs are available without prescription, they can all have negative effects if consumed against guidelines.  

To try and shed some light we’ve produced a simple guide, setting out the key differences between the three main painkillers, what they do and how they do it.  As with any drug, read the label and consult your doctor if you have any questions or if symptoms persist.  Also be aware the information below is for people looking for help with pain relief.  If you’ve been prescribed these drugs, our basic guidelines may not apply. 


What is Aspirin and how is it different from other NSAIDS?

In its original form aspirin has been around for thousands of years.  The underlying substance, salicylic acid, exists in any number of plants including beans, peas and, most abundantly, in willow bark.  In this form people have been aware of its medicinal properties, and consuming it, for millennia.  It wasn’t until 1829 that the underlying compound was identified by French scientists, and then the 1890s that the most common, and safe, formulation of aspirin, acetylsalicylic acid, was isolated and produced synthetically. 


How does Aspirin work?

Aspirin is in a family of drugs known as NSAIDs or Non-Steroidal Anti-Inflammatory Drugs.  They work by blocking the release of chemicals called prostaglandins, which intensify electrical ‘pain’ signals from damaged tissue to the brain. Block these chemicals and you block the pain, or at least some of it.


What does Aspirin do?

In addition to the treatment of pain, aspirin is used to control fever, reduce inflammation and - when prescribed by a doctor - to prevent heart attacks and strokes.  There is also some evidence that aspirin may prevent certain types of cancer.  Aspirin can be taken with paracetamol but not with ibuprofen. With some exceptions it is generally not recommended to take aspirin in the later stages of pregnancy. 


If you choose to believe: Aspirin and the Soviet Union

Aspirin played a key role in the Russian revolution and the creation of what we now know to be the Soviet Union.  The story is that in the early 20th century Grigori Rasputin, the infamous ‘Mad Monk’, cemented his position in the inner circle of the Russian court by healing Alexei, the only son of the tzar of Russia, Nicholas II.  It is just possible that this healing came about by Rasputin insisting that Alexei be treated by herbal remedies only, thereby removing aspirin from his medications, and inadvertently curing him of his stomach bleeding, a potential side effect of the drug.  In his position of power Rasputin went on to become the lightening rod for all that was wrong with the Russian imperial state, thereby catalysing the Russian revolution.  


What is Paracetamol?

Compared to aspirin, paracetamol is a relative newcomer on the painkilling scene.  It was identified in the 19th century as a potential replacement for aspirin when natural sources of the drug became scarce. But it wasn’t until the mid-20th century that the drug became widely available in its current form.


How does Paracetamol work?

No one is quite sure how paracetamol works. Like aspirin, paracetamol is thought to block the chemical messengers that transmit pain messages to the brain.  Exactly how it does this is a bit of a mystery.  It is possible that the drug works on the receptors of pain messages in the brain rather than the transmitters of pain messages in damaged flesh.


What does Paracetamol do? 

Paracetamol reduces both pain and fever, however it does not have anti-inflammatory properties.  According to the medical authorities paracetamol can be taken in pregnancy and while breastfeeding.  Taken in excess the drug can be dangerous to the liver.  Paracetamol can be taken with aspirin or ibuprofen. 


Precursors to Paracetamol

 If you choose to believe:  Various precursors to paracetamol were produced in the 19th century.  These formulations were in the same chemical family as paracetamol and had the same analgesic effects, however they had serious side effects, so were quickly dropped.  One of the effects was a tendency to turn people an alarming shade of blue. 


What is Ibuprofen?

Ibuprofen is a Non-Steroidal Anti-Inflammatory Drug, like aspirin.  It was discovered in the 1960s by research pharmacists working for Boots looking for a treatment for rheumatoid arthritis.   After a successful introduction as a prescribed medicine ibuprofen was put on the general sale list in 1996. 


How does Ibuprofen work?

Ibuprofen works in much the same way as aspirin in that it inhibits the production of chemicals in damaged flesh that amplify pain signals to the brain.  However ibuprofen does not have the same adverse gastrointestinal side-effects as aspirin, something it was specifically designed to eliminate. 


What does Ibuprofen do?

The drug is highly effective at reducing pain, inflammation and fever.  Like aspirin it is not generally recommended to take ibuprofen when pregnant.  Ibuprofen can be taken with paracetamol but not aspirin. 


If you choose to believe: Ibuprofen and Hangovers

If you choose to believe:  Hangovers rarely produce much of any merit, except perhaps ibuprofen.  According to Dr Stewart Adams, one of the scientists credited with discovering the drug, he took his own newly discovered medicine after a heavy night out with friends and just before giving an important speech.  The drug cured his hangover and, by doing so, convinced him it worked. 


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