Is Acetaminophen, Ibuprofen, or Aspirin Best for Headaches?

There are a couple of over-the-counter drugs you can take if you suffer from occasional tension headaches, including acetaminophen (Tylenol and other brands), ibuprofen (Advil, Motrin, and others), and aspirin.

How do you decide among the three? And is one more effective than the others? 

With acetaminophen, taking too much can damage the liver, so it’s important to take the minimum effective dosage. It’s safest to limit it to 3,000 mg and never exceed 4,000 mg in a day. Don’t take acetaminophen if you drink three or more alcoholic drinks per day. That’s because doing so can severely damage your liver.

People with a history of gastrointestinal symptoms should be cautious when taking NSAIDs. These medications might cause stomach discomfort, such as nausea and dyspepsia, Dafer says. 

With ibuprofen, you should know that long-term use at high dosages (more than 2,400 mg per day) may cause an increased risk of cardiovascular events, Natbony says. That’s why people who have recently had a heart attack are advised to avoid ibuprofen.

As for aspirin, you shouldn’t give it to infants or children because of the risk of Reye’s syndrome, a rare but serious illness that causes brain swelling and liver damage, Natbony says. Instead, consider children’s acetaminophen. 

If you’re 65 or older, avoid taking aspirin as a pain reliever. Even at low doses, if taken over time, there’s an increased risk of serious side effects. A 2023 study found that taking low dosages of aspirin (about 75 to 100 mg, although the study looked at 100 mg) on a daily long-term basis might increase the overall risk of intracranial bleeding (bleeding within the skull) for older people prone to falls and head trauma. 

Finally, don’t take any of these medications for more than 10 days in a row. Doing so can increase the risk of side effects. If your pain persists past this point, it’s time to see your healthcare provider and consider other treatments.