Can you take paracetamol and ibuprofen together?
Advice for patients

Taking paracetamol and ibuprofen together

Paracetamol is on of the most popular drugs prescribed drugs in UK. It is also one one of the most commonly purchased drugs over the counter to help to relief mild to moderate pain for example headache, tooth ache and to help with symptoms of cold, such as high temperature. Ibuprofen is indicated to help to control similar symptoms. Additionally due to it’s anti-inflammatory properties, ibuprofen is taken to reduce swelling and inflammation. Can paracetamol and ibuprofen be taken together?

NHS recommends that anyone who is 16 or over can take ibuprofen and paracetamol together at the same time. This differs from recommendations for children.

Can children take paracetamol and ibuprofen together at the same time?

NHS (with advice from NICE) does not recommend giving paracetamol and ibuprofen together at the same time unless recommended by a healthcare professional.

You can try the second medication instead, if for example your child is still in ‘distress’ after giving them a dose of paracetamol. A dose of ibuprofen could be given before the next dose of paracetamol.

Both drugs should not be given routinely alternately.

Why giving paracetamol and ibuprofen at the same time is not recommended

NHS recommendation come from NICE guidelines on management of fever under 5s.

NICE guidelines used a systemic review which assessed the safety and efficacy of combining paracetamol and ibuprofen together. Few clinical studies shown that both dual and alternating dosage may be more effective in reducing of children’s fever comparing to use of a single drug alone. These studies did not include ages of children. Use of single drug was recommended as insufficient information exists to recommend use of both drugs at the same time. No serious side effects were reported in any of the included studies (NICE, 2013).

Paracetamol and ibuprofen: combination product

Nuromol: paracetamol and ibuprofen together in one product

Combination product containing paracetamol and ibuprofen can be purchased from the pharmacy. Nuromol contains 200mg and 500mg of paracetamol. There is some evidence suggesting Nuromol is more effective in reducing pain than taking paracetamol and ibuprofen at the same time.

References:

NICE (2013). 4-year surveillance (2017) – Fever in under 5s: assessment and initial management (2013) NICE guideline CG160.  Available at: https://www.nice.org.uk/guidance/cg160/evidence/appendix-a-summary-of-new-evidence-from-surveillance-pdf-4429528382 Accessed on 10/03/2019

I am a community pharmacist working in UK. I blog about drugs, health and pharmacy.

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