Paracetamol, aspirin or ibuprofen? The right way to use common painkillers

From headaches to period cramps, painkillers are everywhere-but doctors warn against popping the wrong one without knowing the risks

“Headache again? Should I just pop a pill?”

 

If you’ve ever sat through a long lecture or a meeting (that could have been an email) with a throbbing head or battled period cramps in the middle of exams or office hours, chances are your hand reached out for that familiar strip of paracetamol, ibuprofen, or maybe even aspirin. After all, they are cheap, available at every pharmacy, and seem harmless.

But are you sure you know which one works best for your situation—or what hidden risks they carry?

According to Dr Rohit Deshpande, internal medicine department, Lilavati Hospital, Mumbai, self-medicating can mask symptoms of serious illnesses and delay proper treatment. That’s why it’s important to understand why, when, and how to take over-the-counter painkillers instead of popping them like candies.

 

Why do so many people self-medicate, and what’s the risk?

Because painkillers are available over the counter, most of us pop them without thinking twice. But Dr Deshpande warned this can be risky. Ignoring dosage, duration, or existing health conditions may cause liver damage (paracetamol), stomach ulcers and bleeding (ibuprofen, aspirin), kidney damage, or dangerous drug interactions.

Paracetamol overdose: why is it so dangerous?

Paracetamol is seen as the “safest” painkiller, but its therapeutic window is narrow, meaning the difference between a safe dose and a toxic dose is tiny. Dr Deshpande explained:

 

“Even a slight excess over the safe dose can lead to acute liver failure. The scary part is that early signs like nausea or mild discomfort may go unnoticed until it’s too late.”

 

That is why doctors stress never exceeding the prescribed limit—and being extra careful with cold or flu medicines that already contain paracetamol.

Can you get addicted to painkillers?

Unlike opioids, paracetamol, ibuprofen, and aspirin are not addictive. But if you are taking painkillers too often for headaches, they may actually worsen the problem. Many also fall into a psychological dependence trap, feeling they cannot function without their daily pill.

Headaches or period pain—should you be reaching for pills?

For recurring headaches, Dr Deshpande suggested checking for underlying issues like migraines, sinus problems, or even eye strain. For menstrual cramps, simple remedies such as heat therapy, exercise, or dietary tweaks can often help. NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen may work in some cases, but regular self-medication is not the answer.

Which painkiller should you choose, and when?

Here’s the quick guide Dr Deshpande offered:

• Paracetamol: Best for fever, mild pain, and safe use in sensitive patients (with stomach, kidney, or blood pressure issues)
• Ibuprofen: Better for inflammation-related pain like arthritis, injuries, or muscle aches
• Aspirin: Rarely used for pain now, but gold standard in low doses for heart protection

Is it safe to mix these medicines?

Sometimes doctors recommend alternating paracetamol and ibuprofen for strong pain relief. But combining ibuprofen and aspirin is a red flag, as it can cancel out aspirin’s heart benefits and raise the risk of ulcers, bleeding, and kidney strain.

 

“Don’t mix painkillers without medical advice,” said Jeevan Kasara, Director & CEO, Steris Healthcare, a Jaipur-based pharma company.

 

What should you check before popping a pill?

 

Dr Deshpande gives a simple checklist:

• Do you have liver disease, kidney problems, ulcers, or bleeding disorders? (If yes, avoid certain painkillers.)
• Are you already on medication like blood thinners or blood pressure drugs?
• Are you sticking to the right dose and duration?
• What if you feel side effects?

If you notice stomach pain, nausea, unusual bleeding, or dark stools, stop immediately and call a doctor, warned Kasara. With a paracetamol overdose, early medical attention can be life-saving, since antidotes only work if given quickly.

Do alcohol and painkillers mix?

Bad idea. Kasara warned that adding alcohol and paracetamol increases liver risk, and adding alcohol and ibuprofen or aspirin leads to higher stomach bleeding risk. If you are drinking socially, avoid doubling up with painkillers.

Are these still the go-to painkillers today?

Despite new alternatives, experts agree that paracetamol, ibuprofen, and aspirin are still the cornerstones of pain relief. They are effective, affordable, and time-tested. But guidelines are evolving—for example, low-dose aspirin is no longer routinely recommended to prevent heart attacks in healthy older adults due to bleeding risks.

So, what’s the smart way to use painkillers?

• Stick to the minimum effective dose for the shortest time possible
• Do not double-dose unknowingly—check labels of cold and flu combinations
• Use lifestyle fixes where possible such as hydration, sleep, ergonomics, heat therapy to manage pain
• When in doubt, talk to your doctor instead of relying on self-medication

Dr Deshpande reiterated that painkillers can be lifesavers on tough days as quick relief, but they cannot become your daily fix. Your body (and liver, kidneys, and stomach) will thank you for being mindful. 

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This content is for informational purposes only and is not a substitute for professional medical advice.