Can you take paracetamol and ibuprofen together?

If one painkiller isn't quite doing the job, it's natural to wonder whether you can take another. The good news is that for most adults, paracetamol and ibuprofen can be taken together. They work in different ways, so taking both can give better relief than either one on its own.

Here's what you need to know to do it safely.

How paracetamol and ibuprofen work

Paracetamol is a painkiller that also brings down a high temperature. It's gentle on the stomach and suitable for most people, including pregnant women.

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID). As well as easing pain and fever, it reduces swelling and inflammation, which makes it useful for things like back pain, sprains, toothache and period pain.

Because they're different types of medicine, one doesn't add to the other's dose. That's why they can be combined, as long as you stick to the right dose of each.

How to take them together

Adults can either take both at the same time, or alternate between them (for example, paracetamol, then ibuprofen a couple of hours later). Alternating can help if your pain tends to come back before your next dose is due.

Whichever you choose, keep to the usual adult doses below and don't take more of either medicine than the packet says.

Paracetamol: usual adult dose

• 1 or 2 tablets (500mg each) at a time.
• Leave at least 4 hours between doses.
• No more than 8 tablets (4g) in 24 hours.
• If you weigh under 50kg, or have liver problems, you may need a lower dose. Ask a pharmacist.

Ibuprofen: usual adult dose

• 1 or 2 tablets (200mg each) every 4 to 6 hours.
• No more than 6 tablets (1,200mg) in 24 hours, unless a doctor tells you otherwise.
• Take it with or just after food or a drink of milk, to protect your stomach.
• Use the lowest dose that works, for the shortest time.

Tip: write down the time of each dose, especially if you're alternating. It's easy to lose track when you're feeling unwell.

Watch out for hidden paracetamol

Many cold and flu remedies already contain paracetamol, and some contain ibuprofen too. Taking them alongside separate painkillers is one of the most common ways people take too much by accident. Always check the ingredients on every medicine you're taking.

Taking too much paracetamol can cause serious liver damage, even if you feel fine at first. If you think you've taken too much, get urgent advice from NHS 111 or go to A&E straight away. Don't wait for symptoms.

Who should avoid ibuprofen

Ibuprofen isn't suitable for everyone. Speak to a pharmacist or GP before taking it if you:

• have had a stomach ulcer or bleeding in your stomach
• have asthma that's made worse by ibuprofen, aspirin or similar medicines
• have heart, kidney or liver problems, or high blood pressure
• are pregnant, especially from 20 weeks, or trying to get pregnant
• take blood thinners, steroids or certain antidepressants
• already take another anti-inflammatory, such as aspirin or naproxen
• are aged 65 or over

Paracetamol is usually the better choice in these situations.

What about children?

Children's paracetamol and ibuprofen come as liquids and melt-in-the-mouth tablets, with doses based on age. Don't give children both medicines at the same time unless a doctor or pharmacist has advised it. If your child is still uncomfortable before their next dose is due, a pharmacist can tell you whether to alternate. Never give aspirin to children under 16.

When to get help

Painkillers are for short-term relief. Speak to a pharmacist or GP if:

• you need painkillers for more than a few days
• your pain is severe, getting worse or keeps coming back
• you have a high temperature that won't come down
• you get side effects such as stomach pain, black poo or vomiting blood (get urgent help for these)

The short answer

For most adults, yes: paracetamol and ibuprofen can be taken together or alternated. Stick to the right dose of each, check other medicines for hidden paracetamol, and ask a pharmacist if you're unsure whether ibuprofen is right for you.