Can a 2-year-old be given Ibuprofen (Advil)?

From the Guidelines

Ibuprofen can be given to a 2-year-old child, but only under specific conditions and with proper dosing, as it is considered safe and effective for children when used appropriately 1. When administering ibuprofen to a 2-year-old, it is essential to use children's ibuprofen formulations and follow the weight-based dosing on the package or as directed by a pediatrician.

• The typical dose is 5-10 mg per kilogram of body weight every 6-8 hours as needed.
• Never use adult formulations for young children.
• Before giving ibuprofen, ensure the child weighs at least 11 pounds (5 kg) and is well-hydrated.
• Ibuprofen helps reduce fever and relieve pain by blocking certain chemicals in the body that cause inflammation. However, it is crucial to note that ibuprofen has been shown to be ineffective in preventing recurrence of febrile seizures 1. Additionally, potential risks such as hepatotoxicity, respiratory failure, metabolic acidosis, renal failure, and coma have been reported in children after overdose or in the presence of risk factors, emphasizing the need for careful use and monitoring 1. It is also important not to use ibuprofen for more than 3 days for fever or 5 days for pain without consulting a doctor, and to check with a pediatrician first if the child has kidney disease, stomach problems, or is taking other medications.
• Always use the measuring device provided with the medication for accurate dosing.

From the FDA Drug Label

Pediatric Use Safety and effectiveness of ibuprofen tablets in pediatric patients have not been established

The FDA drug label does not provide information to support the use of ibuprofen in a 2-year-old. Caution is advised as the safety and effectiveness of ibuprofen in pediatric patients, including 2-year-olds, have not been established 2.

From the Research

Ibuprofen Administration in 2-Year-Olds

• The provided studies do not directly address the administration of ibuprofen to 2-year-olds, but they do offer insights into its use in infants and young children.
• A study from 3 discusses the safety and efficacy of ibuprofen in infants aged between 3 and 6 months, suggesting that short-term use is considered safe in infants older than 3 months with a body weight above 5-6 kg.
• Another study from 4 compares acetaminophen with ibuprofen for the treatment of fever or pain in children younger than 2 years, finding that ibuprofen resulted in reduced temperature and less pain within the first 24 hours of treatment, with equivalent safety.

Dosage and Safety Considerations

• The study from 3 recommends a dose of 5-10 mg/kg of ibuprofen for infants, administered 3-4 times a day, resulting in a maximum total daily dose of 30-40 mg/kg.
• The study from 4 notes that adverse events were uncommon, and acetaminophen and ibuprofen appeared to have similar serious adverse event profiles.
• It is essential to consider the weight and age of the child when administering ibuprofen, as well as to follow the recommended dosage guidelines to minimize the risk of adverse effects, as mentioned in 5 and 6.

Comparison with Acetaminophen

• The study from 4 suggests that ibuprofen may be more effective than acetaminophen in reducing temperature and pain in children younger than 2 years.
• Another study from 7 found that ibuprofen was more effective than acetaminophen as an antipyretic in children, while a study from 6 recommends treating young children who are unwell with fever with ibuprofen first.