One of the most common medications I get asked about by patients are about acetaminophen (Tylenol) and ibuprofen (Advil). How do I dose it for my child? Are these safe medications? Can I give both to my child? Here is some information on acetaminophen and ibuprofen to help guide you when your little one is sick.

What are acetaminophen and ibuprofen anyways?

• Acetaminophen = Tylenol TM

• Ibuprofen = Advil TM or Motrin TM

When should I give acetaminophen and ibuprofen to my child?

• You can give acetaminophen and/or ibuprofen to your child when they are in pain
• You can give acetaminophen and/or ibuprofen to your child to bring down a fever. A fever is considered a temperature of over 38 degrees Celsius or over 100.4 degrees Fahrenheit.
• Fever itself is not dangerous to your child, but as you know when your child has a fever they can be fussy because they are uncomfortable. Giving acetaminophen and/or ibuprofen will bring down the fever, which will treat the discomfort and help them be less fussy.
• You can administer acetaminophen and ibuprofen after vaccinations if your child is having fever or pain. Administering them before vaccination or before symptoms develop may blunt vaccine effects and lower the body’s immune response. Generally it is not recommended to give acetaminophen or ibuprofen before your child gets vaccinated, and instead wait until afterwards.

What does acetaminophen and ibuprofen do?

• Acetaminophen and ibuprofen (aka Tylenol and Advil) both reduce fevers.
• Acetaminophen and ibuprofen (aka Tylenol and Advil) both treat pain. They are non-addictive and safe for the brain, therefore are safe to use in children for pain.
• The mechanism of action of Acetaminophen is different than Ibuprofen, therefore they are often used together to improve pain and fever management. In other words, they work in synergy, to improve the treatment of pain and fevers.
• You can give Tylenol TM and Motrin TM at the same time because they work on different pathways, but do NOT give Motrin TM and Advil TM together.

How much acetaminophen or ibuprofen can I give my child?

• The dosing on the back of the bottle is safe but it is an estimate.

• Do not give Ibuprofen to your child if they are under 6 months of age unless discussed with your health care provider.

• Doctors and Nurses may dose these medications based on the weight of your child in kilograms, therefore they may give a different dose than the recommended dose on the back of the bottle.

• If you have questions you can always bring your bottle of Acetaminophen and/or Ibuprofen to your pharmacist for more guidance

Are there side effects or risks with acetaminophen and ibuprofen?

• Ibuprofen can cause stomach upset if taken on an empty stomach or for prolonged periods of time. Try to take Ibuprofen with food to avoid this. Ibuprofen can also cause injury to the kidneys if your little one is also significantly dehydrated.

• Some parents worry that if they give Acetaminophen or Ibuprofen to their child that it will “hide” a diagnosis of a serious illness like appendicitis or meningitis. This typically does not happen. The role of these medications is to help better control the pain or fever associated with illnesses or injuries, they will not mask a more serious condition.

When should I worry about pain or fevers for my little one? When should I bring my child to the doctor?

If your child has a prolonged fever (5 or more days) or if pain persists after administering acetaminophen and/or ibuprofen bring your child in for assessment.

If you are ever worried about your little one, do not hesitate to seek medical attention.

This post was co-authored by Dr. Meghan Gilley, a pediatric emergency physician at BC Children’s Hospital (BCCH) and Stephanie Liu, MD, MSc, BHSc.