Recommended Dosing for Ibuprofen and Acetaminophen in Toddlers
For toddlers, the recommended dose of ibuprofen is 5-10 mg/kg every 6-8 hours (maximum 40 mg/kg/day), while acetaminophen should be dosed at 10-15 mg/kg every 4-6 hours (maximum 75 mg/kg/day).
Ibuprofen Dosing
Dosage Guidelines:
- Dose range: 5-10 mg/kg per dose
- Frequency: Every 6-8 hours as needed
- Maximum daily dose: 30-40 mg/kg/day
- Maximum doses per day: 3-4 doses
Weight-Based Dosing Chart:
- 10-15 lbs (4.5-7 kg): 40-50 mg per dose
- 16-23 lbs (7.5-10.5 kg): 50-100 mg per dose
- 24-35 lbs (11-16 kg): 100-150 mg per dose
- 36-47 lbs (16.5-21.5 kg): 150-200 mg per dose
Important Considerations:
- Ibuprofen is not recommended for infants under 3 months of age 1
- Ensure child weighs more than 5-6 kg before administering ibuprofen 1
- Monitor hydration status when giving ibuprofen to toddlers 1
- Oral route is more reliable than rectal administration in young children 1
Acetaminophen (Tylenol) Dosing
Dosage Guidelines:
- Dose range: 10-15 mg/kg per dose
- Frequency: Every 4-6 hours as needed
- Maximum daily dose: 75 mg/kg/day (not to exceed 4 doses in 24 hours)
- Maximum doses per day: 4 doses
Weight-Based Dosing Chart:
- 10-15 lbs (4.5-7 kg): 40-80 mg per dose
- 16-23 lbs (7.5-10.5 kg): 80-120 mg per dose
- 24-35 lbs (11-16 kg): 120-160 mg per dose
- 36-47 lbs (16.5-21.5 kg): 160-240 mg per dose
Administration Tips
Accurate Dosing:
- Always dose based on weight, not age or fever height 2
- Use the measuring device provided with the medication
- Record all dose times to avoid accidental overdosing 3
Alternating Medications:
- When using both medications, carefully record all dose times to avoid exceeding maximum recommended doses 3
- If using both medications, give ibuprofen first as it provides longer fever relief 3
- Alternating medications can provide up to 2.5 additional hours without fever over 24 hours compared to ibuprofen alone 3
Efficacy Considerations
- Ibuprofen has been shown to be equally or more effective than acetaminophen as both an analgesic and antipyretic 4
- Ibuprofen has a longer duration of action than acetaminophen 4
- Maximum temperature reduction occurs 3-4 hours after ibuprofen administration 4
- For fever reduction, the relationship between dose and response for ibuprofen is linear in the 5-10 mg/kg range 4
Safety Considerations
- Avoid exceeding recommended doses - studies show 8% of parents exceed maximum acetaminophen doses and 11% exceed maximum ibuprofen doses 3
- Ibuprofen appears to be better tolerated by children than adults 4
- Ibuprofen is generally safer in overdose than acetaminophen 4
- Short-term use of ibuprofen is considered safe in children older than 3 months weighing more than 5-6 kg 1
Remember that fever is typically a short-lived symptom, but may have more serious implications than other common childhood symptoms. Approximately 25% of children will return to normal within 48 hours, and one-third by day 5 3.