Paracetamol or Ibuprofen for Gout: Which Helps More?
A Clear, NHS-Aligned Answer
Gout pain comes mostly from inflammation, so ibuprofen (an anti-inflammatory) generally helps more than paracetamol (a pain reliever alone) for an acute flare — but ibuprofen and other NSAIDs aren't suitable for everyone. Here's the difference, and what to do if NSAIDs aren't right for you.
For a gout flare, ibuprofen generally helps more than paracetamol. Ibuprofen is an NSAID (non-steroidal anti-inflammatory drug) — it reduces both pain and inflammation, which matters because gout pain is driven largely by joint inflammation. Paracetamol relieves pain but does not have the same anti-inflammatory action, so it usually isn't as effective on its own for a significant flare. However, ibuprofen and other NSAIDs aren't suitable for everyone — for example, if you have certain stomach, kidney, heart or asthma conditions, or take certain other medicines. If NSAIDs aren't right for you, don't just rely on paracetamol alone — speak to your GP or pharmacist, since colchicine or a short course of steroids are usually better alternatives. Neither paracetamol nor ibuprofen lowers uric acid or clears the crystals that cause gout.
Why Ibuprofen Usually Works Better for a Flare
Paracetamol (acetaminophen) works mainly as a pain reliever and fever reducer. It's effective for many everyday aches, but at standard doses it has little to no meaningful anti-inflammatory action — it doesn't do much to reduce the swelling, redness or heat in a joint.
Ibuprofen belongs to a group of medicines called NSAIDs (non-steroidal anti-inflammatory drugs). NSAIDs work by reducing the inflammatory chemicals your body produces, which is why they ease both pain and swelling. Because a gout attack is driven by the body's inflammatory response to uric acid crystals in the joint, an NSAID like ibuprofen typically brings more relief than a painkiller that only targets pain. NHS guidance on gout notes that attacks are usually treated with an NSAID such as ibuprofen.
That doesn't make paracetamol useless for gout. It can still take the edge off pain, and it's sometimes used alongside other treatment, or in place of an NSAID when NSAIDs aren't suitable for you (see below). It just isn't usually enough on its own to control a significant flare, because it isn't tackling the inflammation driving the pain.
You may be advised to avoid ibuprofen, or to check with a doctor or pharmacist first, if you have (or have had) a stomach ulcer; asthma or certain allergies; chickenpox; heart, liver or kidney problems; a blood clotting problem or previous stroke; or an allergic reaction to ibuprofen, aspirin or another NSAID. It's generally advised to avoid ibuprofen during pregnancy unless a doctor says otherwise, since paracetamol is usually preferred, and to check with a pharmacist or doctor before taking it while breastfeeding. Ibuprofen can also interact with other medicines, including anticoagulants (blood thinners), other steroid medicines, some antidepressants and blood pressure medicines, as well as other NSAIDs. Always read the patient information leaflet, follow the dose on the packet or as prescribed, and ask your GP or pharmacist if you're unsure whether ibuprofen is safe for you.
Paracetamol vs Ibuprofen — Quick Comparison
| For a Gout Flare | Paracetamol | Ibuprofen (NSAID) |
|---|---|---|
| Pain relief | Yes, mild-to-moderate | Yes — generally more effective for gout |
| Reduces inflammation/swelling | No meaningful effect | Yes, this is its main action |
| Lowers uric acid or dissolves crystals | No | No |
| Suitable with stomach, kidney, heart or asthma issues | Often better tolerated, but check with a pharmacist or GP | Not always suitable, ask a pharmacist or GP first |
| Role in NHS gout guidance | Sometimes used alongside, or when NSAIDs aren't suitable | Commonly used as a first self-care option for attacks |
| Key safety notes | Don't exceed the packet dose; check other medicines don't also contain paracetamol | Don't exceed the packet or prescribed dose; don't combine with other NSAIDs |
If NSAIDs Aren't Right for You
If ibuprofen or another NSAID isn't suitable for you, or doesn't fully control your symptoms, your GP may consider other options such as colchicine or a short course of oral steroids (corticosteroids). These work differently to NSAIDs and can be appropriate when NSAIDs aren't. They're prescription-only treatments that need to be started and dosed by a doctor, not self-selected. Our full gout treatment guide covers how each option works and how they compare.
Treating This Attack vs Managing Gout Long-Term
Paracetamol, ibuprofen, colchicine and steroids all do the same basic job during a flare: they calm down the current attack. None of them lower the uric acid that caused it in the first place, so on their own they don't stop future attacks happening. If you're having repeated flares, that's usually a sign the underlying condition needs separate, ongoing management — typically uric acid-lowering medicine prescribed by a doctor and taken regularly, even between attacks. See our full gout treatment guide for both the short-term and long-term picture.
What Else Helps During a Flare?
- Rest and protect the joint — avoid unnecessary weight-bearing or pressure.
- Consider a wrapped ice pack for short periods — see our ice or heat for gout guide.
- Keep normally hydrated with water.
- Start treatment as early as possible once you know what you're dealing with.
- Follow the complete step-by-step approach in our what to do during a gout attack guide.
This is your first time having symptoms like this and you don't already have a gout diagnosis; you have a fever, chills or feel generally unwell; the joint is rapidly getting worse, hot and very swollen; you can't move or bear any weight on it; or something feels clearly different from your usual gout pattern. These can be signs of a joint infection or another condition needing prompt attention. In the UK, contact your GP for a same-day appointment, call NHS 111 outside GP hours, or go to A&E if you feel very unwell.
Paracetamol and Ibuprofen for Gout FAQs
Can I take paracetamol and ibuprofen together for gout?
They work in different ways, and some people are advised to combine them for pain relief. Because ibuprofen isn't suitable for everyone, and interactions with other medicines are possible, check with a pharmacist or GP before combining them, especially if you have other health conditions or take regular medication.
Is ibuprofen better than paracetamol for gout?
For most people, yes — ibuprofen's anti-inflammatory action generally makes it more effective for a gout flare than paracetamol alone, because gout pain is largely driven by inflammation. This depends on your own health, though, since ibuprofen isn't suitable for everyone.
Why doesn't paracetamol work well for gout?
Paracetamol relieves pain but has little effect on inflammation, and gout attacks are primarily inflammatory. It can still help take the edge off discomfort, but it usually isn't enough on its own for a significant flare.
Who shouldn't take ibuprofen for gout?
People with a history of stomach ulcers, certain allergies or asthma, chickenpox, heart, liver or kidney problems, blood clotting issues or a previous stroke are among those commonly advised to avoid ibuprofen or check first. It's generally avoided in pregnancy, and care is needed while breastfeeding or if you take certain other medicines, such as blood thinners or blood pressure tablets. Ask your GP or pharmacist if you're unsure whether it's safe for you.
Can I take two NSAIDs together for gout?
No. Taking more than one NSAID at the same time — for example ibuprofen with naproxen or aspirin — increases the risk of side effects like stomach bleeding, without adding extra benefit. Use only one NSAID at a time, at the dose on the packet or as prescribed.
Does paracetamol or ibuprofen lower uric acid?
No. Neither medicine lowers uric acid levels or dissolves the crystals that cause gout — they only manage the pain and, in ibuprofen's case, the inflammation of a current flare. Lowering uric acid long-term needs separate, dedicated treatment.
What can I take for gout if I can't take ibuprofen?
If NSAIDs aren't suitable for you, your GP may consider colchicine or a short course of steroids instead, alongside supportive measures like rest, ice and hydration. See our full gout treatment guide for how these options compare.
How much ibuprofen or paracetamol can I take for gout?
This depends on your individual health, other medicines and whether a doctor has prescribed something specific, so it isn't something we can advise on generally. Always follow the dose on the packet or your prescription, and ask a pharmacist if you're unsure.
Related Reading
What to Do During a Gout Attack
A full step-by-step guide to medication, ice, hydration and when to get help.
Read guide →Home Remedies for Gout
What actually helps, what doesn't, and when you need more than home care.
Read guide →Ice or Heat for Gout
Which is better for a painful, swollen attack, and how to use it safely.
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