Acetaminophen (used in Tylenol) and ibuprofen (used in Advil and Motrin) are medications used to treat fever and pain. Here are answers to some common questions about fever, and how acetaminophen and ibuprofen can be used to manage your child’s symptoms. Please note that manufacturers are introducing a new concentration of infant acetaminophen/Tylenol requiring new dosing, and the old infant acetaminophen/Tylenol drops will be discontinued. During this transition please be sure of the concentration of the product you are using so the correct dose for your infant or toddler can be determined.
When should I worry about fever?
Fever is our body’s normal response to infections and is a very common symptom of childhood illness. Fever can help our bodies fight infection, and a fever, even a high one, is generally not harmful as long as the underlying reason for the fever is not dangerous, such as a virus. There some instances, however, when we should worry about a child’s fever. Infants less than three months of age with a rectal temperature greater than 100.4 may have a serious illness; parents should call immediately if such a fever is noted so your child can be promptly evaluated. For older infants and children there is no specific temperature that is the sign of a serious problem; instead, our level of concern is guided by a child’s behavior. Any infant, child or adolescent who is apathetic, inconsolable or looks “toxic” despite adequate doses of fever-reducing medication should be seen and evaluated. If your child can smile and respond to you, and take fluids well, you can treat the fever with fever-reducing medication and observe, but if the fever persists or your child’s behavior or symptoms change, he or she should be seen. If you have any questions about your child’s condition, please do not hesitate to call!
What medicine should I give my child for fever?
Acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) can be used to treat fever. There is no data to suggest that one is better than another, although some parents feel that their child responds better to one or the other. Acetaminophen (Tylenol) is safe for young children and is generally our “first line” product to treat fever. Children must be over six months of age to be given ibuprofen (Advil or Motrin).
Acetaminophen comes in a rectal suppository form (Feverall) that is useful when a child is vomiting or cannot tolerate oral medication. In these instances we can advise you about the dose.
Is it safe to alternate acetaminophen and ibuprofen?
Since acetaminophen and ibuprofen are different types of medications, it is generally safe to use either one at appropriate dosages and approved intervals. If your child is still “hot” and uncomfortable after an appropriate dose of fever reducing medication, consider a lukewarm bath and pushing fluids for comfort. Neither medication should be used more than four times a day.
Can I give acetaminophen or ibuprofen with other over-the-counter medications?
Yes, as long as the medication you are using does not also contain acetaminophen or ibuprofen in it. Remember to read all medicine labels carefully.
Are there any tips for administering acetaminophen and ibuprofen?
If you are using infant drops, use only the dropper that came with the package. If you are using children’s suspension, use the dosage cup that came with the package or a specific medication syringe that can be provided by a pharmacist. Please note that kitchen teaspoons do not accurately measure medication. One pharmacy teaspoon is equal to 5 milliliters (mLs).
Give every 4-6 hours, as needed, and not more than five times in 24 hours unless directed by a health care professional.
|Weight||Age||Infant Oral Suspension: Concentration
5 mL = 160mg
1 tsp (5 mL) =
1 tablet = 160mg
|6-11 pounds||0-3 months
only to be given if directed
|12-17 pounds||4-11 months||2.5 mL||2.5 mL|
|18-23 pounds||12-23 months||3.75 mL||3.75 mL|
|24-35 pounds||2-3 years||5 mL||5 mL||1 tablets|
|36-47 pounds||4-5 years||7.5 mL||1.5 tablets|
|48-59 pounds||6-8 years||10 mL||2 tablets|
|60-71 pounds||9-10 years||12.50 mL||2.5 tablets|
|72-95 pounds||11 years||15 mL||3 tablets|
Give every 6-8 hours, as needed, and not more than four times in 24 hours unless directed by a health care professional.
1.25 mL = 50 mg
|Children’s Liquid or Suspension
5.0 mL = 100 mg
1 tablet =
1 tablet =
|under 11 pounds||less than 6 months|
|12-17 pounds||6-11 months||1.25 mL|
|18-23 pounds||12-23 months||1.875 mL|
|24-35 pounds||2-3 years||5 mL||2 tablets|
|36-47 pounds||4-5 years||7.5 mL||3 tablets|
|48-59 pounds||6-8 years||10 mL||4 tablets||2 tablets|
|60-71 pounds||9-10 years||12.5 mL||5 tablets||2.5 tablets|
|72-95 pounds||11 years||6 tablets||3 tablets|
Diphenhydramine, the active ingredient in Benadryl, is a type of medicine that provides temporary relief of allergy symptoms, including those associated with insect bites and stings. Benadryl comes in a liquid form, chewable form, quick dissolve strips, or as a tablet or capsule. Brand name Benadryl will say “Benadryl Allergy” on the label. Dosage guidelines for diphenhydramine are found in the table below. When comparing the different forms of Benadryl, please remember it is the total milligrams per dose that is the important value.
Give every 4-6 hours, as needed, and not more than four times in 24 hours unless directed by a health care professional.
12.5 mg = 5 mL
|Benadryl Quick Dissolve Strips
|22-32 pounds||3.75 mL|
|33-43 pounds||5 mL||1 chewable|
|44-54 pounds||7.5 mL||1 1/2 chewable|
|55-109 pounds||10 mL||2 chewable||1 capsule||1 strip|
|110 pounds and up||4 chewable||2 capsules||2 strips|