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
Aspirin
Ibuprofen vs. Aspirin Dosage
Ibuprofen
Aspirin
| 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 |
| 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
| 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
| 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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