Dosing Frequency for Tylenol and Motrin in Children
Acetaminophen (Tylenol) should be dosed every 4 hours, while ibuprofen (Motrin) should be dosed every 6 to 8 hours in children. 1
Acetaminophen (Tylenol) Dosing
- Administer every 4 hours as needed for fever or pain management 2
- Standard dosing is 10-15 mg/kg per dose 3, 4
- Maximum daily dose should not exceed 4-5 doses in 24 hours to avoid hepatotoxicity 2
The American Academy of Pediatrics guideline specifically references acetaminophen being given "every 4 hours" in multiple studies examining fever management in children 2. This shorter dosing interval reflects acetaminophen's pharmacokinetics and duration of action.
Ibuprofen (Motrin) Dosing
- Administer every 6 to 8 hours as needed for fever or pain management 1
- Standard dosing is 4-10 mg/kg per dose 3, 4
- The longer dosing interval (compared to acetaminophen) is a key advantage, providing more convenient administration 1
Ibuprofen's longer duration of action allows for less frequent dosing compared to acetaminophen, which improves compliance and convenience for caregivers 1.
Comparative Efficacy
- Ibuprofen demonstrates superior antipyretic efficacy compared to acetaminophen at 2,4, and 6 hours post-treatment 3, 4
- Both medications show comparable analgesic efficacy for pain relief 3, 4
- Ibuprofen (10 mg/kg) reduces temperature more effectively than acetaminophen (10-15 mg/kg) with effect sizes of 0.34 at 2 hours, 0.81 at 4 hours, and 0.66 at 6 hours 3
Safety Considerations
- Both medications have comparable safety profiles when used at recommended doses 2, 3, 4
- Acetaminophen carries risk of hepatotoxicity, particularly with overdose or in presence of risk factors 2
- Ibuprofen can cause respiratory failure, metabolic acidosis, renal failure, and coma after overdose 2
- In overdose situations, paracetamol toxicity is reached earlier, is more severe, and is more difficult to manage than ibuprofen overdose 1
Important Clinical Caveats
- Scheduled dosing (every 4 hours for acetaminophen) does not prevent febrile seizures better than as-needed dosing 2
- Caregivers should be educated to ask children about pain every 4 hours, as children may not spontaneously report pain 2
- Pain medication should be given on a regular schedule for the first few days after procedures like tonsillectomy, potentially waking the child at night 2
- Alternating or combining ibuprofen and acetaminophen may provide superior antipyresis at 4-6 hours compared to ibuprofen alone 5