Acetaminophen and Ibuprofen Dosing for a 13-Month-Old with Hand, Foot, and Mouth Disease
For a 13-month-old child with hand, foot, and mouth disease, give acetaminophen 10-15 mg/kg per dose every 4-6 hours (maximum 5 doses per day) and ibuprofen 10 mg/kg per dose every 6-8 hours, and both can be used safely for several days as needed for symptom control.
Acetaminophen (Tylenol) Dosing
- Single dose: 10-15 mg/kg every 4-6 hours 1, 2
- Maximum frequency: Up to 5 doses per 24 hours 3
- Maximum daily dose: 60-75 mg/kg/day 2, 4
Practical Dosing Strategy for Acetaminophen
- A loading dose of 15 mg/kg provides more consistent antipyretic effect than 10 mg/kg 4
- Maintenance doses of 12.5-15 mg/kg every 6 hours are effective for sustained fever and pain control 4
- Doses below 10 mg/kg have minimal antipyretic effect, while 20 mg/kg single doses are more effective than 10 mg/kg 4
Ibuprofen Dosing
- Single dose: 10 mg/kg every 6-8 hours
- Maximum daily dose: 40 mg/kg/day (based on standard pediatric dosing)
- Ibuprofen is appropriate for children 6 months and older
Duration of Treatment
- Both medications can be used for as many days as symptoms persist - there is no arbitrary limit for acute viral illnesses like hand, foot, and mouth disease 2
- Treatment should continue as long as the child has fever or pain causing discomfort
- Hand, foot, and mouth disease typically resolves within 7-10 days, so analgesic/antipyretic use would rarely extend beyond this timeframe
Important Safety Considerations
- Chronic overdosing (>140 mg/kg/day of acetaminophen for several days) carries risk of serious hepatotoxicity 2
- Single therapeutic doses are remarkably safe when kept within the 10-15 mg/kg range 1, 2
- Parents frequently underdose (27% give <10 mg/kg) or overdose (12% give ≥20 mg/kg) acetaminophen, so clear weight-based instructions are essential 3
Alternating Medications
- Acetaminophen and ibuprofen can be alternated every 3-4 hours if needed for severe discomfort, though this should be explained carefully to parents to avoid dosing errors
- When alternating, maintain the maximum daily limits for each medication separately