Ibuprofen vs acetaminophen: Both deemed safe for acute pain management

Short-term safety does not significantly differ between ibuprofen and acetaminophen in paediatric and acute pain patients, a study has shown.

The databases of PubMed, Scopus, and Web of Science were searched from inception to May 2026 for randomized controlled trials (RCTs) that reported safety outcomes in patients aged 0‒18 years. The investigators then conducted the review in accordance with the PRISMA 2020 guidelines. They also conducted random-effects meta-analyses and assessed the risk of bias.

Fifteen studies, involving a total of 2,847 patients, were identified, covering postoperative pain, musculoskeletal trauma, orthodontic pain, and emergency department settings. Follow-up ranged from single-dose assessments to 12 months. Of the studies, three (n=937 participants) contributed to the primary meta-analysis of any adverse event (AE).

Ibuprofen did not contribute to a statistically significant difference in the risk of any AE when compared with acetaminophen (risk ratio, 0.80, 95 percent confidence interval, 0.36‒1.79; I², 2.9 percent). Serious renal or hepatic AEs were also not reported.

“Available RCT evidence did not show a clear difference in short-term safety between ibuprofen and acetaminophen, [but] the certainty of the evidence is limited,” the investigators said.

“Patient factors and clinical context should guide drug choice. Larger RCTs with standardized safety reporting are needed,” they added.