Not denying that acetaminophen/paracetamol has a horrible therapeutic index, but there are reasons why it is still so widely used. Despite potential hepatoxicity, it is considered the safest pain relief drug (this emerging research notwithstanding)

Ibuprofen is not better in every way. For instance ibuprofen, as well as other NSAIDs, is much less gentle on gastrointestinal tract and puts much more strain on kidneys.

Some people (e.g. with inflammatory bowel diseases or renal diseases) do not tolerate NSAIDs well, which is why acetaminophen is on the same step of analgesic ladder - it is still considered better in some cases. Both are also used complementary to each other in pediatrics.

Your comment is fair; obviously I wrote a pretty flippant comment, but the message is largely useful for most people.

The fact is that (largely due to the incredible marketing of Johnson & Johnson's Tylenol brand in the US) way too many people think acetaminophen is "safe and effective" when it's actually both pretty unsafe and pretty ineffective. Most people just "pop a Tylenol" by default without realizing it's not much better than placebo.

Sure there are cases where people have unique risks and should avoid NSAIDs. But for the vast majority of the public, if they or their kid are dealing with a headache, fever, menstrual cramp, or other transient pain or fever, they should reach for ibuprofen (with a snack) over acetaminophen. It's not remotely a close call.

I'm frankly pleased that people are becoming more aware of this and I don't mind taking a couple correction comments for presenting the info in a superficial way.