# Painkillers in Nigeria: Paracetamol vs Ibuprofen vs Diclofenac

- Source: https://ogbogwu.com/conditions/pain-and-fever/
- Last updated: July 2026
- Educational information, not medical advice.

Pain and fever are the most common reasons Nigerians buy medicine, and the pharmacy shelf offers three everyday workhorses: paracetamol, ibuprofen, and diclofenac. Used correctly they're safe and effective; used carelessly they're a leading cause of kidney damage, stomach ulcers, and accidental overdose.

Paracetamol is the default first choice for most pain and all fevers — gentle on the stomach, safe in pregnancy at normal doses, and safe for children in weight-appropriate doses. Its danger is stacking: many 'flu' and combination remedies already contain paracetamol, and doubling up is how overdoses happen.

Ibuprofen and diclofenac (NSAIDs) add an anti-inflammatory effect that suits period pain, toothache, arthritis, and injuries — but they irritate the stomach, strain the kidneys, and can raise blood pressure, so they're the wrong routine choice for ulcer patients, kidney patients, many hypertensives, and late pregnancy. Tramadol is a controlled opioid for significant pain under prescription — not an energy booster; misuse is dangerous and illegal.

## Signs & symptoms

- Everyday: headache, body aches, period pain, toothache, joint/muscle pain, fever with malaria or infections
- Fever red flags: any fever in an infant under 3 months; fever with stiff neck, rash, confusion, or convulsion; fever beyond 3 days
- Pain red flags: crushing chest pain, sudden worst-ever headache, pain with weakness/numbness, severe abdominal pain — these need diagnosis, not painkillers

## Medicines used in Nigeria

- paracetamol (https://ogbogwu.com/drugs/paracetamol/): First-choice for most pain and fever; safest routine option — mind the total daily dose across all products
- ibuprofen (https://ogbogwu.com/drugs/ibuprofen/): NSAID for inflammatory pain (period pain, toothache, sprains) — with food; not for ulcer/kidney patients
- diclofenac (https://ogbogwu.com/drugs/diclofenac/): Stronger NSAID for joint and musculoskeletal pain — same cautions as ibuprofen, plus cardiovascular care
- tramadol (https://ogbogwu.com/drugs/tramadol/): Prescription-only opioid for moderate-to-severe pain under clinical supervision; controlled in Nigeria due to misuse

## How it's treated

Match the drug to the person, not just the pain: paracetamol first for most people; an NSAID (ibuprofen/diclofenac) for inflammatory pain in people with healthy stomach, kidneys, and blood pressure — taken with food, at the lowest dose for the shortest time.

Fever is a signal, not a disease. In Nigeria, treat the fever for comfort but find its cause — test for malaria rather than repeatedly 'flushing' fevers with painkillers while an infection advances.

## See a doctor if

- Fever in a baby under 3 months, or any fever with convulsion, stiff neck, or confusion — emergency
- Fever beyond 3 days despite treatment (test for malaria/typhoid rather than escalating painkillers)
- Pain needing daily painkillers beyond two weeks — the cause needs diagnosis
- Black stools or vomiting blood while on NSAIDs — stop and seek care
- Before using NSAIDs with hypertension, kidney disease, ulcers, or in pregnancy

## Prevention

- Read labels for hidden paracetamol in flu/combination remedies before adding tablets
- Take NSAIDs with food and never on a 'daily maintenance' basis without medical review
- Never share tramadol or take it without prescription
- Verify NAFDAC numbers — painkillers are among Nigeria's most faked medicines

## FAQs

### Which is better: paracetamol or ibuprofen?

For most everyday pain and all fevers, start with paracetamol — it's the gentlest option and safe for nearly everyone at correct doses. Ibuprofen wins when inflammation drives the pain (period pain, toothache, sprains) in people with healthy stomach, kidneys, and blood pressure. They can be alternated short-term for stubborn pain in adults, but that's a temporary tactic, not a lifestyle.

### How much paracetamol is too much?

Adults should not exceed 4 grams (eight 500 mg tablets) in 24 hours from ALL sources combined — and many flu remedies, 'combination analgesics', and branded sachets already contain paracetamol. Overdose damages the liver, often silently at first. Children's doses go by weight; use the measuring device provided, not household spoons.

### Why is tramadol restricted in Nigeria?

Tramadol is an opioid: effective for real moderate-to-severe pain under prescription, but addictive and dangerous in the high, unprescribed doses behind Nigeria's misuse problem — seizures, dependence, and deaths. NAFDAC restricts strengths and sale channels accordingly. Buying tramadol without a prescription is both risky and illegal.