Accurate dosages of acetaminophen and ibuprofen for children and adolescents are very important. As of fall 2011 there will be just one concentration of acetaminophen for infants and children and all cold medicines with acetaminophen must be labeled clearly so that there is not an inadvertent overdose.
The first rule of thumb is not to panic when your child has fever. It is a normal response to an infection and an expected part of childhood. Fevers tend to rise in the late afternoon and in the very early morning. If fever lasts for 3 days you should make an office visit with a physician or come in sooner if there are any concerning symptoms such as respiratory distress, persistent lethargy, less than 2 months, dehydration etc. Our triage nurse can help you sort this out. Check this chart for your child’s weight and you can easily find the correct dose.
Click here for important safety information about
acetaminophen use.
Here are some other helpful hints:
-
Measuring the dosage: Syringes and droppers are more accurate than teaspoons. If you must use a teaspoon it should be a measuring teaspoon used in cooking.
-
One level teaspoon = 5 ml ( or cc)
-
Avoid multi ingredient products for kids less than 6 years (ie cold medicines). These have been withdrawn from the market as they don’t work and there is a risk of medicine overdose.
-
Don’t use any fever reducer if your infant is less than 2 months without consulting your physician. Fever in infants at this age requires a prompt visit with your doctor. The only exception to this is if your infant has some mild symptoms after vaccinations although most infants are fine and do not require any medication
-
No aspirin for anyone less than 19 years of age due to the risk of Reyes syndrome.
-
No ibuprofen in infants less than 6 months
-
Dosing for acetaminophen is every 4 – 6 hours with no more than 5 doses a day. Ibuprofen is every 6 hours with no more than 4 does a day. We do not recommend rotating acetaminophen and ibubrofen due to the risk of overdose with multiple medications while a child (especially if that child is not eating or drinking normally).
-
The flavors of these medicines are usually acceptable to kids. If you have trouble you can crush up a chewable form of the medicine and sprinkle it on pudding. There are also suppository forms of acetaminophen that can work although their absorption is not as reliable as those that get ingested.
-
Remember not to use the word “candy” for any medicine given to a child. Store all medicines away from children. Keep a log of the time and dosage of medicine so that all caregivers are aware of doses given.
-
Lukewarm baths are a nice way to help bring down temperature if it is still elevated after the proper dose of fever reducer. The temperature will reduce by one degree an hour but may not go down to normal (98.6 F). Any child with a fever greater than 106 that is taken with a digital thermometer should call our office. This is unusual and usually not dangerous but we should be consulted.
-
The best thermometers never quite get the temperature right so don’t get frustrated. There is a lot of user variability with forehead and ear thermometers so we recommend just a simple digital thermometer used rectally for infants less than three years and used orally or axillary for those older.
-
Generic forms of these medicines are just fine and are often significantly cheaper.
-
Never use alcohol rubs to cool a child as this is dangerous and can harm a child.
-
Temperature will naturally increase in the late afternoon and early morning. This occurs when your child gets a fever elevation with illness.
|
| Correct Dosages of Acetaminophen (i.e. Tylenol® or Tempra®) |
Child's
Weight (lbs) |
6-11 |
12-17 |
18-23 |
24-35 |
36-47 |
48-59 |
60-71 |
72-95 |
96+ |
lbs |
|
Total Amount (mg) |
40 |
80 |
120 |
160 |
240 |
325 |
400 |
480 |
650 |
mg |
Infant Drops
80 mg/0.8 ml |
0.4 |
0.8 |
1.2 |
1.6 |
2.4 |
-- |
-- |
-- |
-- |
ml |
Syrup:
160 mg/5 ml |
1.25 |
2.5 |
3.75 |
5 |
7.5 |
10 |
12.5 |
15 |
20 |
ml |
Syrup:
160 mg/1 teaspoon |
-- |
½ |
¾ |
1 |
1½ |
2 |
2½ |
3 |
4 |
tsp |
Chewable
80 mg tablets |
-- |
-- |
1½ |
2 |
3 |
4 |
5 |
6 |
8 |
tabs |
Chewable
160 mg tablets |
-- |
-- |
-- |
1 |
1½ |
2 |
2½ |
3 |
4 |
tabs |
Adult
325 mg tablets |
-- |
-- |
-- |
-- |
-- |
1 |
1 |
1½ |
2 |
tabs |
Adult
500 mg tablets |
-- |
-- |
-- |
-- |
-- |
-- |
-- |
1 |
1 |
tabs |
|
|
Administer the acetaminophen according to the above table and/or doctor's instructions
every four hours as needed. Since acetaminophen pediatric products are available without a prescription, the package label should be read before the drug is administered. Be careful of any over the counter products, particularly those sometimes given for colds, which may also contain acetaminophen. This can lead to an overdose.
|
| Correct Dosages of Ibuprofen (i.e. Motrin® or Advil®) |
Child's Age
|
6-11
Months |
12-23
Months |
2-3
Years |
4-5
Years |
6-8
Years |
9-10
Years |
11-12
Years |
12-14
Years |
Child's
Weight (lbs) |
13-17 |
18-23 |
24-35 |
36-47 |
48-59 |
60-71 |
72-95 |
95+ |
Drops
(50mg/1.25ml) |
1.25 ml |
1.875 ml |
2.5 ml |
-- |
-- |
-- |
-- |
-- |
Elixir
(100mg/5ml) |
½ tsp |
¾ tsp |
1 tsp |
1½ tsp |
2 tsp |
2½ tsp |
3 tsp |
-- |
Chewable Tablets
(50mg) |
-- |
-- |
2 tabs |
3 tabs |
4 tabs |
5 tabs |
6 tabs |
-- |
Junior Strength
(100mg) |
-- |
-- |
-- |
-- |
2 tabs |
2½ tabs |
3 tabs |
4 tabs |
|
|
Administer the ibuprofen according to the above table and/or doctor's instructions
every six hours as needed. Acetaminophen has a longer track record in pediatrics so we recommend this be used initially. Do not use ibuprofen after head trauma or with a history of ulcer disease or in cases of dehydration.
|
