What is better for ear pain, ibuprofen or paracetamol?

October 13, 2025 •

4 min read

According to a study published on PubMed, low-quality evidence suggests both ibuprofen and paracetamol are more effective than placebo for short-term ear pain in children with acute otitis media. When deciding what is better for ear pain, ibuprofen or paracetamol, the choice often depends on the underlying cause, individual health, and specific symptoms, as these medications have different primary mechanisms of action.

Quick Summary

Both ibuprofen and paracetamol can effectively relieve ear pain, though they function differently. Ibuprofen addresses pain and inflammation, while paracetamol primarily relieves pain and fever. The optimal choice depends on the presence of inflammation, individual medical history, and age, making consultation with a healthcare provider essential for severe or persistent symptoms.

Key Points

Choose based on symptoms: Use ibuprofen for ear pain accompanied by swelling, as it is an anti-inflammatory, while paracetamol is better for pain and fever with little or no inflammation.
Consider age: Paracetamol can be given to younger infants (12 weeks+) than ibuprofen (6 months+), but always check dosage guidelines and consult a doctor, especially for babies.
Check for inflammation: Ibuprofen's anti-inflammatory properties make it potentially more effective for conditions like middle ear infections, which involve swelling.
Mind stomach sensitivity: Paracetamol is generally safer for individuals with sensitive stomachs or pre-existing conditions like stomach ulcers where NSAIDs are contraindicated.
No one-size-fits-all: There is no conclusive evidence that one medication is definitively better than the other for all cases of ear pain, especially for short-term relief in children.
Combine with home remedies: Effective relief often involves both medication and other measures, such as applying a warm compress and elevating the head to reduce pressure.
Know when to seek professional help: Severe, persistent, or worsening ear pain, especially with fever, dizziness, or discharge, warrants an immediate medical evaluation.

Ear pain, medically known as otalgia, is a common ailment with a variety of potential causes, from infections to changes in pressure. When a person experiences an earache, the immediate priority is finding relief, and over-the-counter pain relievers are a common first line of defense. However, the question of what is better for ear pain, ibuprofen or paracetamol, requires a deeper look into how each medication works and what specific symptoms they treat.

Understanding the Difference: Ibuprofen vs. Paracetamol

Ibuprofen and paracetamol are both effective over-the-counter medications for managing pain and fever, but they belong to different drug classes and have distinct mechanisms of action. This difference is key to understanding which might be more suitable for a given earache.

Ibuprofen: The Anti-inflammatory Choice

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID). As its classification suggests, it works by reducing both pain and inflammation. Ear pain is often accompanied by swelling in the ear canal or middle ear, especially in the case of an infection. Ibuprofen's ability to tackle this inflammation directly can make it a particularly effective option for relieving the pressure and discomfort associated with such swelling.

Paracetamol: The Pain and Fever Specialist

Paracetamol, also known as acetaminophen, is an analgesic (pain reliever) and antipyretic (fever reducer). Unlike ibuprofen, it has only a small effect on inflammation. This makes it a good option when the primary symptom is pain or fever without significant swelling. Because paracetamol is not an NSAID, it is often a better choice for individuals with sensitive stomachs, certain kidney problems, or other conditions where NSAIDs are not recommended.

Which Is Best for Your Symptoms?

Choosing between ibuprofen and paracetamol depends on a number of factors, including the suspected cause of the ear pain, the individual's medical history, and age. Here's a breakdown to help guide your decision:

For Earaches with Swelling: If the ear pain is linked to conditions like a middle ear infection (otitis media) or swimmer's ear (otitis externa), which cause inflammation, ibuprofen's dual action on pain and swelling may offer more comprehensive relief.
For Pain and Fever Without Swelling: If the pain is referred from another area, such as a sore throat or dental issue, and there is no significant swelling in the ear itself, paracetamol may be sufficient to manage the pain and any associated fever.
For Infants and Children: Paracetamol can typically be given to younger babies (12 weeks and older), whereas ibuprofen is generally recommended for infants over 6 months of age. Always follow a doctor's advice and weight-based dosage guidelines for children. For children over 6 months, both are considered effective, and a Cochrane review found insufficient evidence to prove one is superior to the other for short-term pain relief. In some cases, alternating between the two under a doctor's guidance might be considered for severe pain, but this should be done with caution to avoid dosing errors.
For Individuals with Medical Conditions: People with stomach ulcers, kidney problems, or asthma should generally avoid NSAIDs like ibuprofen unless specifically directed by a healthcare provider. In these cases, paracetamol is often the safer option for pain management.

Comparison Table: Ibuprofen vs. Paracetamol


Feature	Ibuprofen	Paracetamol (Acetaminophen)
Drug Class	Non-steroidal Anti-inflammatory Drug (NSAID)	Analgesic, Antipyretic
Mechanism	Reduces pain, fever, and inflammation	Reduces pain and fever, minimal anti-inflammatory effect
Primary Use for Ear Pain	Best for earaches with inflammation and swelling, like ear infections	Suitable for general pain relief, especially when inflammation is not the main issue
Age Suitability (OTC)	6 months and older (always check packaging and consult a healthcare provider for dosage)	12 weeks and older (check packaging and consult a healthcare provider for dosage)
Main Side Effects	Stomach upset, potential kidney issues with long-term use	Liver damage with overdose
Special Considerations	May not be suitable for those with stomach ulcers or kidney problems	Safer for sensitive stomachs and NSAID-sensitive individuals

Alternative Relief Measures and When to See a Doctor

Medication is not the only way to manage ear pain. Other home remedies can provide significant comfort, either alone or in combination with pain relievers:

Apply a warm compress or heating pad to the outer ear for 10-15 minutes.
Sleep with your head elevated to encourage fluid drainage and reduce pressure.
Chew gum or yawn to help equalize pressure, especially if the pain is caused by altitude changes.
Stay hydrated to help thin mucus and promote drainage.

While over-the-counter treatments can be effective for many earaches, it is crucial to know when to seek professional medical advice. You should see a doctor if you experience any of the following:

Ear pain that is severe or lasts for more than a few days.
Fever, especially a high fever.
Fluid, pus, or blood draining from the ear.
Dizziness or hearing loss.
The affected person is a young infant or toddler.

Conclusion: Making an Informed Choice

For most individuals, both ibuprofen and paracetamol are effective and safe options for temporary ear pain relief when used correctly. The key is to consider the primary symptoms: choose ibuprofen if inflammation and swelling are contributing to the pain, or paracetamol if pain and fever are the main concerns or if you have a sensitive stomach. In all cases, especially concerning children, the guidance of a healthcare professional is invaluable. Promptly addressing the underlying cause of the ear pain is the most important step toward lasting relief.

For more detailed information on a wide range of medical topics, consult reputable sources like the American Academy of Family Physicians.

Sources

This article is based on information from reliable medical sources and studies, as cited throughout the text.

Frequently Asked Questions

Yes, for children over 6 months, both medications can be used. Some healthcare providers may suggest alternating between the two for severe pain, but this should be done with a clear record of dosage to avoid errors. Paracetamol is suitable for younger infants (12 weeks+). Always consult a healthcare professional for guidance on administering medication to children.

Ibuprofen is a good choice if the ear pain is accompanied by noticeable swelling or inflammation, as is common with ear infections. Its anti-inflammatory action can help reduce pressure and discomfort more effectively in these cases.

Paracetamol is a better option if the pain is referred from another source (like a sore throat or dental issue) or if you have a sensitive stomach. It primarily treats pain and fever without the anti-inflammatory effects of ibuprofen.

Ibuprofen can cause stomach upset and should be used with caution in people with stomach ulcers or kidney issues. Paracetamol overdose can lead to serious liver damage. It's crucial to follow dosage instructions and not exceed the maximum daily limits as recommended by a healthcare professional or product packaging.

Yes, for some conditions like swimmer's ear, specific medicated ear drops may be prescribed in addition to oral pain relievers. Never use ear drops if a perforated eardrum is suspected. Always consult a doctor or pharmacist for advice on combined treatments.

You should not take both at the same time unless directed by a healthcare professional. To manage persistent pain, some medical advice suggests alternating them, but this increases the risk of dosing errors. Always keep track of when each dose was given and follow the guidance of a healthcare provider.

See a doctor if ear pain is severe, lasts more than 48 hours, is accompanied by a high fever, dizziness, or discharge from the ear. These can be signs of a serious infection or another underlying issue.

If ear pain is due to congestion from allergies or a cold, treating the underlying condition with decongestants or antihistamines may help. Both ibuprofen and paracetamol can also help with the pain, but they won't address the root cause of the congestion.