They’re both non-prescription pain killers, and they’re recommended for everything from headaches to breast cancer to Alzheimer’s. But which should you take – ibuprofen or aspirin?

Both are effective for pain control (they have analgesic properties), fever control (with their antipyretic properties) and fighting inflammation. Both are classed as non-steroidal anti-inflammatory drugs, or NSAIDs, a category that also includes naproxen (Aleve, for example), indomethacin (Indocin), nabumetone (Relafen) and others.

Aspirin (branded as Bayer, Excedrin, Bufferin, etc.) can irritate the stomach and intestines, causing ulcers and stomach bleeding. It can also cause allergic reactions in some people, and, at higher doses, tinnitus or ringing in the ears.

Ibuprofen (such as Advil, Motrin, and Nuprin) can cause a rash, ringing in the ears, headaches, drowsiness, nausea and heartburn, but only in some people.

That’s the downside to these over-the-counter drugs. But in many respects, they’re also wonder-drugs.

Aspirin can play a critical role in saving heart attack victims. Studies show that if heart attack patients take aspirin when symptoms first appear, and then daily for one month, they significantly lower their risk of dying or of having another heart attack or stroke.

As for ibuprofen, research suggests that it can cut a woman’s risk of developing breast cancer in half. Data from Ohio State University suggests that using ibuprofen on a regular basis for more than 10 years may decrease a woman’s chance of developing breast cancer by nearly 50%. (Aspirin reduces breast cancer risk by about 22%, the OSU study says. A 2008 aspirin-a-day study, involving AARP members, found a 16% risk reduction.)

And, according to a new report in the journal Neurology, long-term ibuprofen use reduces the chance of developing Alzheimer’s disease by more than 40%.
Anti-pain, anti-cancer, anti-dementia… For most people, trial-and-error will tell which works best, Ibuprofen or aspirin, but both appear to offer remarkable life-improving benefits with rare complications and minimal downside.

A word of caution from the FDA, however: Heavy drinkers may have an increased risk of liver damage and stomach bleeding from these medicines, so talk to your doctor before going overboard with self-medication.