Summary: Ibuprofen and acetaminophen should not be taken at the same time. However, many women find that alternating doses throughout the day to treat menstrual cramps and pain is helpful and may cut down on any side effects.
Dear Curtis: I have pretty bad premenstrual cramping and usually take Ibuprofen to help. But my last cycle I started mixing in Tylenol as well. It seems to help a bit but I don’t know if it’s OK for me to take them together?
As far as the makers of ibuprofen and acetaminophen are concerned these medications should NOT be taken together.
However, there is one caveat. Remember that ibuprofen and acetaminophen act differently in your body. I mention this because I know quite a few women who don’t take the medications at the same time (which is good), but who alternate the medications throughout their period.
For example, they may take ibuprofen when they get up in the morning. Take acetaminophen in the early afternoon and then an ibuprofen at bedtime. But you should never take the two medications together, at the same time.
In addition to the medications treating pain differently in your body it’s important to note that both of these medications can be pretty tough on your body with regular, long-term use. So, it’s actually a smart strategy to ‘interchange’ them.
Dangers of Ibuprofen and Acetaminophen
Let’s start with Ibuprofen. First of all, it’s notorious for being hard on your stomach. So, always take it with food. Secondly, it’s also hard on your kidneys. Ibuprofen can also stress your liver and you want to keep in mind that it can lessen platelet aggregation. Which means you may bleed more (however, this effect is much less than what you see with aspirin).
You didn’t mention other health related issues you might have, but just because a drug is over-the-counter doesn’t mean it can’t negatively effect you. For example, for people with any sort of ulceration in their stomach ibuprofen would be a big no-no.
The two side effects I mentioned above are part of the reason why the dose you take of Ibuprofen is limited to 3,200mg a day. Over-the-counter ibuprofen comes in 200mg tablets. So no more than 16 a day. This may sound like a lot but I know people who take 4 tablets at a time (800mg) because that is the prescription strength of ibuprofen and they are trying to match it.
In regards to acetaminophen there are also some things you need to be concerned about. The primary concern is liver problems. So, anyone with elevated liver enzymes or any sort of issue with their liver (cirrhosis, hepatitis, etc) needs to steer clear of acetaminophen.
The maximum daily dose of acetaminophen is 4,000mg daily.
Personal Observations of Other Women
I must admit that while acetaminophen, overall, appears to be safer. The feedback that I get from women makes it clear that ibuprofen is the drug of choice to treat menstrual pain. In fact, you may even want to include a second drug in your arsenal (again, not in addition to ibuprofen – but in it’s place).
It’s called naproxen and it’s the generic name for the over-the-counter drug Aleve. It acts in exactly the same way that ibuprofen does but I’ve had a few women swear that it’s more effective than ibuprofen.
While I don’t know the specific doses of ibuprofen or acetaminophen that you are taking, I’d encourage you to keep them as low as possible. As I said above, if they are taken long term and high doses they can be problematic. Incidentally, Krill Oil and Omega-3 Fish Oil supplementation have both shown the ability to help women with painful periods lower their ibuprofen doses by up to 50%. So that may be a more natural option you want to consider.