If you have serious pain, you probably need both of them.

Don't forget ye olde aspirin. It has a cheat mechanic: https://en.wikipedia.org/wiki/Salicylate_poisoning

You take too much and it can give you a fever, which might entice you to take more aspirin. Nasty.

Obligatory Reye's mention:

https://www.uspharmacist.com/article/reyes-syndrome-a-rare-b...

and my own editorializing -- this is not just a problem for little kids. As various articles explain, if you've had flu-like symptoms (from whatever cause) you should be wary of aspirin. Will one standard dosage kill you? Unlikely. But if you've got better options, particularly pre-loading NAC before Tylenol, why not consider them first?

Further reading:

https://www.nhs.uk/medicines/low-dose-aspirin/who-can-and-ca...

And for those of you with kids: https://www.nhs.uk/conditions/kawasaki-disease/

Of course it's not all bad. There's even some discussion of anti-cancer potential. How might this work? One hypothesis: https://www.nature.com/articles/srep45184

This topic is a bit personal for me and I'm glad it's getting some attention here. Bravo, hackers.

Without resorting to research or statistical inference engines, based only on the average knowledge explained by my colleague OP, I will say that paracetamol is also toxic in continuous doses (people with chronic pain who resort to the medication for daily use) and has drug interactions with other agents (such as alcohol). Aspirin and Ibropufen are great but really do have a risk of ulcers. As for the thrombo-prophylactic issue, it is very poorly explained and I completely disagree. My readings to date have shown that both have a very slight rebound effect on the formation of thrombi and the main problem is the release of thrombi that have already formed, prior to the use of the medication.

What about low dose aspirin?

there is an antidote for paracetamol: ACC (Acetylcysteine)

why they don't make pills with ibuprofen + nac?

Interesting, I've always preferenced ibuprofen because I was concerned with long-term liver effects from acetaminophen as a casual drinker and someone who is a bit overweight (both things negatively impact the liver). I think one thing that's hard to understand as someone with no medical background is the long-term impacts of medications, it sounds like once it's processed there's no long-term negative impact for acetaminophen, where-as alcohol does have long-term negative impacts on the liver even after processing. Also, there's not enough information placed on the label or known how important not being dehydrated is to having good outcomes with ibuprofen. Obviously dehydration is bad, but it's also very commonplace.

Acetaminophen and Ibuprofen are taken for different things and can be taken together as well, it's not a versus...

Ibuprofen is mostly for inflammation and Acetaminophen for fever and pain. Now there's overlap in that both work on headaches and some other kinds of pain but the main use case for each is different.

Unfortunately, both of these medicines have substantially adverse effects on me. Ibuprofen destroys my stomach, often affecting me for days after a single dose. Acetaminophen leaves my stomach fine, but has subtle, but noticeably negative affects on my cognition and general energy levels. Both are often ineffective for bouts of significant pain, which is frequent for me.

To mitigate this, I supplement with NAC (N-Acetyl-L-Cysteine) anytime I'm forced to take acetaminophen. I will also sometimes take Betaine Anhydrous.

I do the same for ibuprofen, but sans betaine and instead take aloe, probiotics (bacillus subtilis/coagulans, Mastic Gum and experiment with other things.

For acute pain, neither does anything. And though I'll get attacked for this here, I find a stout dose of quality, lab tested Kratom (red strain) to be far more effective than both acetaminophen and ibuprofen combined. However, for regular pain, this is not a good plan, as the withdrawals can exceed the nature of the problem itself.

I sure do wish we'd get over the anti opiate [1] craze someday, or at least discover and make available an effective alternative.

1. Aside from constipation and obvious risks of dependency (or abuse), opiates have none of the deleterious effects of ibuprofen or acetaminophen, and the constipation is easily mitigated, and a bit of agmatine sulfate for saying adios when the pain subsides.

For those wondering why it's acetaminophen and paracetamol, the name difference is because they both took different random letters from an even longer name.