Pediatric Ibuprofen (Motrin) Dosing
For pediatric patients, ibuprofen should be dosed at 10 mg/kg per dose, administered every 6-8 hours, with a maximum daily dose of 30-40 mg/kg per day. 1
Age and Weight Restrictions
- Ibuprofen is generally not recommended for infants under 6 months of age according to the American Academy of Pediatrics 1
- However, recent evidence supports that short-term use is considered safe in infants older than 3 months with body weight above 5-6 kg when special attention is given to hydration 2
- Children weighing more than 40 kg should receive adult dosing 1
Standard Dosing Protocol
- Dose: 5-10 mg/kg per dose (with 10 mg/kg being the standard recommendation) 1, 2
- Frequency: Every 6-8 hours (maximum 3-4 times daily) 1, 2
- Maximum daily dose: 30-40 mg/kg per day 2
- Route: Oral preferred—the rectal route has been shown to be less reliable due to erratic absorption, especially in young infants 2
Clinical Efficacy Timeline
- Maximum fever reduction occurs 3-4 hours after administration 3
- Ibuprofen provides longer duration of action compared to acetaminophen 3
- At doses of 5-10 mg/kg, ibuprofen is more effective as an antipyretic than acetaminophen (10-15 mg/kg) at 2,4, and 6 hours post-treatment 4
Combination Therapy Considerations
When alternating with acetaminophen:
- Give acetaminophen every 4-6 hours and ibuprofen every 6-8 hours, staggering timing so medications are given every 3-4 hours if both are needed 1
- Using both medicines provides an additional 2.5 hours without fever over 24 hours compared to ibuprofen alone 5
- Carefully record all dose times to avoid accidentally exceeding maximum recommended doses, as 11% of children exceeded the recommended maximum number of ibuprofen doses in clinical trials 5
Safety Profile
- No difference in adverse effects between ibuprofen and acetaminophen in comparative trials 4
- Ibuprofen is better tolerated by children than adults and safer in overdose than acetaminophen or aspirin 3
- Special attention must be given to hydration status in infants 3-6 months of age 2
- No drug-related adverse events were reported in recent pharmacokinetic studies of IV ibuprofen in infants 1-6 months of age 6
Critical Pitfall to Avoid
The most common error is using the rectal route in young infants—this results in erratic absorption and unpredictable therapeutic effect. Always use oral administration when possible 2.