How To Dose Acetaminophen

Author: Wendy Sue Swanson, MD, MBE

Earlier this year, the FDA recommended the discontinuation of infant acetaminophen drops. The goal was to minimize confusion by only making acetaminophen (aka Tylenol) in one universal liquid strength for both babies and older children. However, because the FDA provided a recommendation and not a mandate, there are currently two different liquid acetaminophen preparations on the shelves marketed for babies. And another liquid marketed for older children. Ultimately, it may be more confusing than ever. Thank goodness I just got a little help from my friends…

The pharmacists at The Everett Clinic (where I practice) created a beautiful handout designed to clarify dosing for infant and children’s over-the-counter (OTC) fever reducers/pain relievers. See the dosing chart below along with the renderings of typical dosing devices (syringe, dropper, or cap). Print it out and put it in your medicine cabinet. Review it with Grandma or the sitter or your partner. And remember, the most important way to avoid a dosing error is to keep the original dosing device with the actual OTC medication. Resist the urge to grab a kitchen spoon!

Check out a video I made last year about common OTC medication dosing problems. The numbers will surprise you (hint: nearly all pediatric OTC meds in the US had inconsistencies, superfluous, or confusing dosing instructions). Dosing medications for our children can be more complicated than we’d like. So let me know what else you want to know about dosing acetaminophen or ibuprofen.

Isolation of Paracetamol (Acetaminophen) - YouTube

Paracetamol Preparation (acetaminophen) by IonsClub SIUST ...

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26 Comments to “How To Dose Acetaminophen or Ibuprofen”

    • Courtney,
      You bring up a great point. I may author a separate post on this! There is NO DATA to support that alternating the use of tylenol and ibuprofen improves fever response or discomfort in children. Further—it can get very confusing due to different dosages from each medicine and different intervals. Although it is safe to use acetaminophen concurrent with ibuprofen, I don’t necessarily recommend it as it may not be necessary.

      My recommendation is to start with acetaminophen. If after 1-2 hours, your child isn’t improving or feeling better, it is okay to give a dose of ibuprofen. If that works far better, than you can continue to use the ibuprofen. But I would recommend waiting another 6 hours before giving any fever reducer/pain reliever to avoid confusion. You don’t need both fever reducers at once. As you see on the chart, acetaminophen is dosed every 4 hours (with no more than 5 doses in a 24 hour period), and ibuprofen can be dosed every 6 hours. SEE THE CONFUSION?

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Acetaminophen and Pain Relief - WebMD
... harmful if not taken correctly. Know the benefits and risks of acetaminophen
and how to use it safely. ... Make sure to use the correct dosage. Don't take more

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