How bad is it really to take ibuprofin with an ulcer?

Not the Best Choice: Depending on the problem, Ibuprofen is generally not a good medicaiton if you have an ulcer since it can cause stomach upset as well. Tylenol (acetaminophen) would be less likely to irritate the ulcer but if you need the anti-inflammatory property of ibuproefen, the affect on the ulcer can be minimized by taking it with food.