Can You Give Motrin After Tylenol for Persistent Fever?
Yes, you can safely give ibuprofen (Motrin) now—it's been over an hour since the acetaminophen (Tylenol), and using both medications is more effective than either alone for reducing fever in children.
Immediate Action Plan
Give ibuprofen immediately at the weight-based dose of 10 mg/kg (not to exceed the maximum dose for age), as the Infectious Diseases Society of America recommends NSAIDs such as ibuprofen for moderate to severe symptoms or control of high fever 1.
Continue the amoxicillin as prescribed for the full course of strep throat treatment, as this addresses the underlying bacterial infection 1.
Why Both Medications Work Better Together
Combined therapy provides 4.4 additional hours without fever over 24 hours compared to acetaminophen alone, and 2.5 additional hours compared to ibuprofen alone 2.
Fever clearance is 23 minutes faster with both medications compared to acetaminophen alone 2.
Multiple randomized, double-blind, placebo-controlled studies demonstrate that ibuprofen provides superior antipyretic effects compared to acetaminophen, with longer duration of action (6-8 hours vs. 4 hours) 3.
Critical Dosing Safety Guidelines
Record all dose times carefully to avoid accidentally exceeding maximum recommended doses—8% of parents exceed the maximum paracetamol doses and 11% exceed ibuprofen doses when using both medications 2.
Maximum dosing limits: Acetaminophen 15 mg/kg every 4-6 hours (maximum 4 doses in 24 hours) and ibuprofen 10 mg/kg every 6-8 hours (maximum 3 doses in 24 hours) 2.
Aspirin must be avoided in children due to the risk of Reye syndrome 1.
Important Context About Fever Management
Fever itself is not harmful—it's a physiologic mechanism with beneficial effects in fighting infection, and there is no evidence that fever worsens illness course or causes long-term neurologic complications 4.
The primary goal is improving overall comfort, not normalizing body temperature 4.
Most fevers are relatively short-lived—only about 25% of children are "back to normal" by 48 hours and one-third by day 5 2.
When to Seek Emergency Care
Immediate evaluation is needed if the child develops signs of serious illness including oxygen saturation ≤92%, respiratory rate >50 breaths/min, difficulty breathing or grunting, signs of dehydration, or inability to maintain oral intake 5.
Watch for worsening symptoms despite appropriate antibiotic therapy for strep throat, as 5-15% of hospitalized children with infections may not respond to initial treatment 1.
Cost and Practical Considerations
Using both medications is actually cheaper for families over 5 days (£24 vs £26 for acetaminophen alone vs £30 for ibuprofen alone) due to lower healthcare service utilization, despite the extra medication cost 2.
Ibuprofen has comparable safety to acetaminophen when used appropriately, but acetaminophen overdose toxicity is reached much earlier, is more severe, and is more difficult to manage 3.