Ibuprofen vs. Aspirin

See how Ibuprofen and Aspirin compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Ibuprofen and aspirin are both NSAIDs that relieve pain, fever, and inflammation, but they work through slightly different effects on blood clotting.

  • Aspirin is the only one of the two FDA-approved for long-term prevention of heart attack and stroke, while ibuprofen carries a boxed warning against use after bypass surgery.

  • Both drugs can irritate the stomach and raise bleeding risk, so people with ulcers, kidney problems, or bleeding disorders should check with a doctor before regular use.

Ibuprofen vs. Aspirin Drug Summary

Ibuprofen

Ibuprofen is a propionic acid NSAID that relieves pain, fever, and inflammation by blocking prostaglandin production. It is FDA approved for conditions like arthritis, mild to moderate pain, and menstrual cramps. It comes as a tablet, capsule, or liquid, available over the counter up to 400 mg or by prescription up to 800 mg.

Aspirin

Aspirin is a salicylate NSAID that has been used for over a century to relieve pain, fever, and inflammation. Beyond everyday aches, low daily doses are FDA approved to help prevent a second heart attack or stroke in people with existing cardiovascular disease. It is taken orally as a standard, chewable, or enteric-coated tablet.

Ibuprofen vs. Aspirin Side Effects

Ibuprofen

Most common
Nausea (3-9%)
Dyspepsia (3-9%)
Epigastric pain (1-3%)
Heartburn (1-3%)

Aspirin

Most common
Stomach upset (common)
Heartburn (common)
Easy bruising/bleeding (common)
GI bleeding (uncommon but serious)

Ibuprofen vs. Aspirin Dosage

Ibuprofen

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 400 mg every 4-6 hours At the start
Maximum dose 300-800 mg 3-4x daily If needed
Dose changes 1 increase As tolerated

Aspirin

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 325-650 mg every 4 hrs At the start
Maximum dose 75-325 mg once daily If needed
Dose changes 2 increases As tolerated

Ibuprofen vs. Aspirin Indications

Ibuprofen

Ibuprofen is approved to treat pain and swelling from arthritis, general mild to moderate pain, menstrual cramps, and fever. It works by lowering prostaglandins, the chemicals that drive inflammation and pain signals. It is specifically not approved for use around coronary artery bypass graft surgery.

  • Rheumatoid arthritis

  • Osteoarthritis

  • Mild to moderate pain

  • Primary dysmenorrhea

Aspirin

Aspirin treats everyday aches, fever, and inflammatory joint conditions like rheumatoid arthritis. At low daily doses, it is also FDA approved to reduce the risk of a second heart attack or stroke in people with known cardiovascular disease. Some doctors also prescribe it off-label for primary heart disease prevention in select adults.

  • Pain and fever relief

  • Secondary CV event prevention

  • Rheumatologic conditions (e.g., RA)

  • Primary CV prevention (off-label)

Ibuprofen vs. Aspirin Pros and Cons

Ibuprofen

Ibuprofen tends to work well for inflammatory pain, such as arthritis flares and menstrual cramps, and it comes in both OTC and higher prescription strengths. Like all NSAIDs, it carries boxed warnings for cardiovascular and gastrointestinal risks and should be avoided around bypass surgery.

Pros

  • Often more effective for inflammatory pain and swelling

  • Available in higher prescription-strength doses up to 800 mg

  • No Reye's syndrome risk, so it can be used in children

  • Reversible effect on platelets, shorter bleeding impact

Cons

  • Boxed warning for heart attack and stroke risk

  • Contraindicated for pain relief after CABG heart surgery

  • Not proven to protect against heart attack or stroke

  • Needs more frequent dosing, every 4 to 6 hours

Aspirin

Aspirin stands apart for its FDA-approved role in preventing a second heart attack or stroke, taken daily at very low doses. Its irreversible effect on platelets means bleeding risk lasts longer than with ibuprofen, and it is not safe for children or teens with viral illnesses due to Reye's syndrome risk.

Pros

  • FDA-approved for secondary heart attack and stroke prevention

  • Low daily dose option, as little as 81 mg, for long-term use

  • Decades of safety data as one of the oldest medicines available

  • No dose-related cardiovascular boxed warning like ibuprofen

Cons

  • Higher bleeding risk from irreversible platelet inhibition

  • Not safe for children or teens with viral illness

  • Can cause serious GI bleeding, even without warning symptoms

  • Generally less effective for inflammatory conditions like arthritis

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