Acetaminophen and Ibuprofen

These are the most common medications that are used in children, and they’re probably used more than they need to be. This page will let you know how to use them properly, including when they’re needed and when they’re not.

Pain. Their best use is for pain. They provide highly effective and relatively well-tolerated pain relief.

Fever. They are both extremely effective as fever-reducers. However, it is best NOT to treat fevers whenever possible, as fevers are part of the body’s natural defense system. (See my page about fever here before giving either of these medications for fever, as well as the precautions below.)

Inflammation. Only ibuprofen reduces inflammation such as joint pain associated with swelling.

Cold symptoms. Neither medication will do anything for cold symptoms such as cough, congestion, runny nose, or noisy breathing. Do not use these, nor any other over-the-counter cough and cold medicine, for this purpose in children. They do not work and can only cause harm.

Which is better? It depends on the situation.

Acetaminophen (Tylenol®) is gentler on the tummy, and as such is helpful for pain relief in a child with severe dehydration or tummy upset. However, more and more studies are finding that acetaminophen increases a child’s risk of asthma, so like any medication, only administer it if you really need it. Any child with recurring respiratory issues, or with a family history of asthma, should avoid acetaminophen when possible. It is also far too easy (and dangerous) to overdose on this medication, so make sure that it is kept out of reach of children and that you pay very close attention to the correct dosage.

Ibuprofen (Motrin®, Advil®) has anti-inflammatory properties and lasts a bit longer than acetaminophen, so I have generally found it to be more effective when it comes to most pain reduction. However, it is a little bit rougher on the stomach, should not be given to infants younger than 6 months of age and should generally be avoided during severe dehydration or immediately before or after major surgery (unless directed by a physician). Always take it with food. Despite these potential side effects, ibuprofen is very safe and quite well tolerated in most children. Because it is so effective and longer lasting, it is usually my first choice for pain relief.

What are the doses? Be careful when administering these medications: dosing errors are common and can be serious. I recommend double-checking your doses, and writing down the time and dose of each medication you administer to keep track. It will often come in handy later when you can’t remember, and will reduce dosing errors. This is especially important if giving both acetaminophen and ibuprofen. While they do not interact and can be given together when one of them alone is not achieving adequate relief, it is generally not recommended as it frequently leads to harmful dosing errors.