Paracetamol, Ibuprofen or Diclofenac — Which Painkiller Should You Take and When?

Most Nigerians have taken one of these three painkillers — but many do not know the difference. Taking the wrong one for your situation can make things worse.

Pain is one of the most common reasons Nigerians visit a pharmacy or chemist. Headache, toothache, period pain, back pain, joint pain, fever — and the first thing most people reach for is a painkiller. But which one should you actually take?

Paracetamol, ibuprofen, and diclofenac are the three most commonly used painkillers in Nigeria. They all reduce pain, but they work differently, they are suited for different types of pain, and they have different risks. This post will break it all down for you in simple language.

Quick Answer

Paracetamol = mild pain and fever, safest option for most people. Ibuprofen = pain with inflammation (swelling, joint pain, period pain). Diclofenac = stronger inflammation and joint/muscle pain. Never mix these without a pharmacist's guidance.

Paracetamol — The Safe Everyday Painkiller

Paracetamol (also known as acetaminophen) is the most widely used painkiller in the world. In Nigeria you will find it in brands like Panadol, Emzor Paracetamol, and many generic versions. It works by blocking pain signals in the brain and also brings down fever.

Best for:

• Headaches and migraines
• Fever (including malaria fever before your medication kicks in)
• Mild to moderate pain anywhere in the body
• Toothache (temporary relief)
• Children — it is the safest painkiller for children and infants
• Pregnant women — it is the only painkiller generally considered safe in pregnancy

Standard adult dose:

500mg to 1000mg (1–2 tablets) every 4 to 6 hours. Do not exceed 4,000mg (8 tablets of 500mg) in 24 hours.

⚠️ Warning: Paracetamol is safe when taken correctly, but overdose causes severe liver damage. Do not take more than the recommended dose. Do not mix paracetamol tablets with other medicines that already contain paracetamol (like many cold and flu sachets) — you might accidentally overdose without realising it.

You can find paracetamol and other pain relief medications in our Pain Relief Medications section.

Ibuprofen — For Pain With Swelling and Inflammation

Ibuprofen belongs to a class of drugs called NSAIDs (Non-Steroidal Anti-Inflammatory Drugs). This means it does not just relieve pain — it also reduces inflammation (swelling) in the body. This makes it more powerful than paracetamol for certain types of pain.

Best for:

• Period pain (menstrual cramps) — ibuprofen is significantly better than paracetamol for period pain because it reduces the inflammation causing the cramps
• Dental pain (toothache)
• Muscle and joint pain
• Swelling from minor injuries
• Back pain
• Fever

Standard adult dose:

200mg to 400mg every 4 to 6 hours with food. Do not exceed 1,200mg in 24 hours without a doctor's instruction.

⚠️ Who should NOT take ibuprofen:

• People with stomach ulcers or a history of gastric problems
• People with kidney disease
• People with heart disease or high blood pressure (unless a doctor says it is safe)
• Pregnant women — especially in the last 3 months of pregnancy
• Children under 3 months of age

Always take ibuprofen with food to protect your stomach.

Diclofenac — The Stronger Anti-Inflammatory

Diclofenac is also an NSAID like ibuprofen, but it is generally stronger and works better for more intense pain involving inflammation — especially joint pain, arthritis, and back pain. You can find it as tablets (Voltaren, Cataflam, and generics), gel, or injection.

Best for:

• Arthritis and joint pain
• Back pain and sciatica (nerve pain in the back and leg)
• Sports injuries
• Post-surgical pain (under doctor supervision)
• Severe period pain when ibuprofen is not strong enough
• Kidney stone or gallstone pain (as a suppository or injection, in a clinical setting)

⚠️ Who should NOT take diclofenac: Same restrictions as ibuprofen, but even more so. People with heart disease, kidney problems, or stomach ulcers should be especially careful. Diclofenac carries a slightly higher cardiovascular risk than ibuprofen and should not be taken for long periods without a doctor's monitoring.

Quick Comparison Table

Can You Take Paracetamol and Ibuprofen Together?

Yes — and this is actually a medically recommended strategy for moderate pain. Because paracetamol and ibuprofen work through completely different mechanisms in the body, they can be taken together safely. Some doctors and pharmacists call this "combination analgesia" or "multimodal pain relief."

The way it usually works is: take paracetamol first, then 2 hours later take ibuprofen, then 2 hours later take paracetamol again, and so on — this way there is always one painkiller active in your body without exceeding the daily dose of either drug. Do not do this without first speaking to a pharmacist, especially if you have any medical conditions.

You should never take ibuprofen and diclofenac together — they are both NSAIDs and combining them greatly increases the risk of stomach ulcers and kidney damage.

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Shop Pain Relief Ask Our Pharmacist

❓ My child has a fever. Which painkiller should I give?

Give paracetamol syrup or tablets (based on their weight). This is the safest option for children. Ibuprofen can also be used for children over 3 months who weigh at least 5kg, but never give aspirin to a child — it can cause a dangerous condition called Reye's syndrome. Always check the dose on the packet based on your child's weight, not their age.

❓ I have a stomach ulcer. What painkiller is safe for me?

Paracetamol is the safest choice if you have a stomach ulcer. Ibuprofen and diclofenac are NSAIDs that irritate the stomach lining and can make ulcers worse or cause dangerous bleeding. If you need a stronger painkiller, speak to your doctor — they may prescribe an NSAID along with a stomach-protecting drug like omeprazole.

❓ Why does paracetamol not seem to work for my period pain?

Period pain (dysmenorrhea) is caused largely by inflammatory chemicals called prostaglandins. Paracetamol does not block prostaglandins — ibuprofen does. This is why ibuprofen works much better for period pain. Take 400mg of ibuprofen with food as soon as your period starts, before the pain gets severe, for best results.

⚕️ Disclaimer: This article is for educational purposes only. It does not replace the advice of a doctor or pharmacist. If you have a medical condition, are pregnant, or take other medications, always consult a healthcare professional before taking any painkiller.