The short answer
- Yes, together is fine for most adults: for example 2 Panadol (1,000 mg) and 1–2 Nurofen (200–400 mg) at the same time, with food.
- Daily limits stay separate: paracetamol up to 4,000 mg (8 × 500 mg tablets), ibuprofen up to 1,200 mg (6 × 200 mg tablets) in 24 hours without a doctor’s advice.
- Not for everyone: skip the Nurofen if you have stomach ulcers, kidney or heart problems, are pregnant, take blood thinners, or have asthma that reacts to anti-inflammatories.
Why can you take Nurofen and Panadol together?
Panadol contains paracetamol (acetaminophen), which acts mainly in the brain and spinal cord to reduce pain signals and fever. Nurofen contains ibuprofen, a non-steroidal anti-inflammatory drug (NSAID), which blocks the production of prostaglandins at the site of injury or inflammation. Because they use different pathways and are cleared differently (paracetamol by the liver, ibuprofen mostly through the liver and kidneys without competing), they don’t change each other’s levels or add to each other’s side effects.
The combination also works better than either medicine alone for many kinds of pain. Studies in dental and post-operative pain, summarised in a Cochrane review, found that ibuprofen plus paracetamol gave more and longer-lasting pain relief than the same dose of either drug alone. This is why doctors and dentists often recommend both after procedures. For the broader picture, see our pain relief guide.
How to take them together: doses for adults
|
Panadol (paracetamol) |
Nurofen (ibuprofen) |
| Usual dose |
500–1,000 mg (1–2 × 500 mg tablets) |
200–400 mg (1–2 × 200 mg tablets) |
| Minimum gap between doses |
4 hours |
4 hours (6–8 hours is often enough) |
| Maximum in 24 hours |
4,000 mg = 8 tablets of 500 mg |
1,200 mg = 6 tablets of 200 mg (OTC) |
| With food? |
Not needed |
Yes, with or after food or milk |
| Self-treatment limit |
3 days for fever; see a doctor if pain persists |
10 days for pain, 3 days for fever |
You can take both at the same moment, or alternate them so that something is working at all times. Alternating doesn’t give stronger relief than taking them together, but some people find it smooths out the “gaps” before the next dose is due. The schedule and a sample day are in how far apart to take Nurofen and Panadol.
Start with one. UK guidance suggests trying each painkiller on its own first. If one alone at a full dose isn’t enough, add the other. Use the lowest dose that controls the pain and stop as it eases.
Which Nurofen and Panadol products can be combined?
Many products carry the Nurofen or Panadol name but contain different ingredients. Always read the active ingredients on the pack.
| Product |
Contains |
Add Panadol? |
Add Nurofen? |
| Nurofen, Nurofen Express, Nurofen Zavance |
Ibuprofen 200 or 400 mg |
Yes |
— |
| Panadol, Panadol Rapid, Panadol Osteo |
Paracetamol 500 mg (Osteo 665 mg modified release) |
— |
Yes |
| Nurofen Plus (UK, pharmacy) |
Ibuprofen + codeine |
Yes |
No (already contains ibuprofen) |
| Maxigesic, Nuromol and other combination tablets |
Ibuprofen + paracetamol |
No |
No |
| Panadeine, Panadeine Forte, co-codamol |
Paracetamol + codeine |
No |
Usually yes |
| Cold and flu products (many) |
Often paracetamol, sometimes ibuprofen |
Check |
Check |
Codeine products need extra care; see Endone or codeine with Nurofen.
Who should not take Nurofen with Panadol?
The combination is only as safe as its riskier half, which is the ibuprofen. Choose Panadol alone, and ask a pharmacist or doctor, if you:
- have had a stomach ulcer or bleeding, or get frequent indigestion;
- have kidney disease, heart failure, uncontrolled high blood pressure, or have had a heart attack or stroke;
- take blood thinners, SSRIs, steroids, lithium, methotrexate, or blood pressure tablets with a diuretic (see ibuprofen and blood pressure medicines);
- are pregnant, especially from 20 weeks;
- have asthma that worsens with aspirin or NSAIDs;
- are dehydrated from vomiting or diarrhoea;
- are over 65, where lower doses and shorter courses are wiser.
Paracetamol has its own cautions: liver disease, regular heavy drinking, weighing under 50 kg, and taking other products that contain paracetamol.
What about children?
Children can have paracetamol and ibuprofen too, with doses based on weight. Most guidelines suggest starting with one and switching if it doesn’t help, rather than giving both routinely. See can a child have Panadol and Nurofen together?
When to see a doctor
See a doctor if you still need both medicines after 3 days for fever or about 10 days for pain, if pain is severe or getting worse, or if you notice black stools, vomiting blood, stomach pain or swelling of the ankles. If you think you’ve taken more than the maximum paracetamol, get advice immediately, even if you feel well: call a poisons information centre (Australia 13 11 26, US 1-800-222-1222) or NHS 111 in the UK.
Frequently asked questions
Can I take 2 Panadol and 2 Nurofen at the same time?
For most healthy adults, yes: two 500 mg Panadol (1,000 mg paracetamol) and two 200 mg Nurofen (400 mg ibuprofen) is a standard combined dose. Take the Nurofen with food, and don’t repeat either dose within 4 hours.
If I’ve had 8 Nurofen in 24 hours, can I take paracetamol?
Eight 200 mg Nurofen is 1,600 mg of ibuprofen, which is above the 1,200 mg over-the-counter limit, so take no more ibuprofen for now. Paracetamol at its normal dose can still be used. If you went over the limit, keep an eye out for stomach pain and ask a pharmacist for advice.
Can I take Panadol with Nurofen Plus?
Usually yes, because Nurofen Plus contains ibuprofen and codeine but no paracetamol. Don’t add any other codeine or ibuprofen products, and note that codeine can cause drowsiness and constipation.
Can I take Panadol Osteo with Nurofen?
Yes, as long as you stay within the Panadol Osteo maximum of 6 caplets a day and the ibuprofen limits. For long-term joint pain, talk to your doctor about whether regular ibuprofen is a good idea; an anti-inflammatory gel may be safer.
Is it a problem to take Panadol and Nurofen together once a week?
Occasional use at normal doses is not a problem for most adults. If you are reaching for both every week for the same pain, such as headaches, see a doctor: frequent painkiller use can itself cause headaches.
Can I take Nurofen Express with paracetamol?
Yes. Nurofen Express is ibuprofen in a faster-absorbed form (ibuprofen lysine or liquid capsules), and it combines with paracetamol in the same way as standard Nurofen.
Sources and further reading
CanforaMedicine Guide
