Ask Your Pharmacist

October 04, 2023

Is acetaminophen or ibuprofen better for a dull headache? 


There are many different types of headaches such as tension headaches, migraines, cluster headaches and rebound headaches caused by overuse of pain medication. Tension headaches are the most common and cause a dull, aching pain that can feel like a band squeezing your head.  

Some people will feel tenderness on their scalp, neck and shoulders and may feel stressed, depressed or anxious. The pain will typically last from 30 minutes to several hours but can last for days and range from a minor discomfort to debilitating pain.  

Tension headaches can be triggered by stress, anxiety, poor posture or muscle tension in the neck and shoulders. Common things such as not getting enough sleep, skipping a meal, clenching your jaw, working too much or drinking alcohol are enough to bring on a tension headache. 

When it comes to choosing between acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) it is important to remember they work differently and depending on your medications and medical conditions they might not be appropriate for you. 

Acetaminophen is hard on your liver if taken for too long or at too high of a dose and should be avoided if you have liver disease or cirrhosis. Ibuprofen, on the other hand, carries a risk of stomach ulcers, high blood pressure, and kidney failure and may tighten the airways of people with asthma. You should avoid ibuprofen if you have bleeding problems, kidney disease, heart disease or are more than 20 weeks pregnant.  

Always talk to your pharmacist before taking any over-the-counter medications as they will assess your allergies, current medications and medical conditions to guide you to the safest choice. Many cold, flu and sinus medications already contain pain relievers so it is important to tell the pharmacist about non-prescription medications as well as they may need to adjust your dose. 

Both acetaminophen and ibuprofen are suitable options to relieve tension headaches. There is no straightforward winner because different people will respond differently to the medications. It is reasonable to try both and see which one works best for you.  

If you find you are not getting sufficient relief, acetaminophen is also available in combination with caffeine. Some people find caffeine causes headaches, but others find it helps as it increases the absorption of acetaminophen resulting in an increase in its pain-relieving effects. Keep in mind, that caffeine may cause you to feel dizzy, nervous, irritable or jittery and may make it difficult for you to fall asleep if taken at bedtime.  

Acetaminophen and ibuprofen can also be taken at the exact same time, but many people find separating them by a few hours maximizes pain relief, as they are not wearing off around the same time when separated. It is important not to regularly use these medications to treat headaches more than a couple of times a week as it may cause rebound headaches. If you get stuck in this cycle it becomes difficult to tell if it is a tension headache caused by your triggers or a rebound headache caused by the medication.  

Many simple lifestyle changes can also help you to manage and prevent headaches. Maintaining a regular sleep schedule by going to bed and getting up at the same time each day can help. Eating regular meals without skipping any, especially breakfast and drinking enough water to keep yourself properly hydrated which is about two litres per day.  

You can improve your posture when standing by holding your shoulders back and head level, and pulling in your abdomen and buttocks. When sitting thighs should be parallel to the ground and do not let your head slump forward. You can reduce stress by planning and organizing your day ahead of time and by practicing stress management techniques such as yoga, meditation, massage therapy or by taking a hot shower. 

If you find you are having headaches more than twice a week, or less often if your quality of life is being disrupted, it is time to talk to your doctor or nurse practitioner. Keeping a journal for a few weeks before the appointment and taking note of headache duration, intensity, location and any possible headache triggers is a great tool to bring along with you. If appropriate, you may be prescribed a medication to help reduce the frequency or severity of your headaches.  

Erin Thompson (BSc, BScPharm) is a graduate of Dalhousie University and a community pharmacist practicing at Shoppers Drug Mart in Quispamsis N.B. Her opinions expressed in this newspaper are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment. Send your questions to 


The Ask Your Pharmacist column appears in New Brunswick newspapers for educational and informational purposes only. These opinions are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment. If you have a question you’d like to see answered, you can send it to