Acetaminophen (Tylenol), Ibuprofen (Advil/Motrin), and Benedryl Dosing

The tables below provide recommended dosage charts for acetaminophen (Tylenol) and ibuprofen (Motrin/Advil). Here are some important general guidelines for using these products:

  • We recommend acetaminophen/Tylenol as a first line treatment for fever. If your child’s response does not seem adequate, try ibuprofen as an alternative. Either medication can be used for pain; ibuprofen may have some benefits for pain related to inflammation.
  • You are treating your child, not a number on the thermometer. Your goal in treating a fever is to make your child comfortable, not to make the number lower.
  • Whenever possible, use your child’s most current weight when choosing an appropriate dose of medication.
  • Do not give both acetaminophen and ibuprofen to a child with fever. It is OK to “tag team” a dose of the second medicine on a one-time basis if you are having trouble making your child comfortable, but this should not be a recurrent procedure. Please discuss this with your physician.
  • Temperature should be measured with an appropriate device which you understand how to use correctly. Contact our office if you have questions.
  • Never give acetaminophen or ibuprofen to an infant under 2 months of age. In addition, do not give ibuprofen to an infant under the age of 6 months without specific direction from a physician.
  • Acetaminophen rectal suppositories can be purchased at your pharmacy without a prescription. They are helpful to have on hand in case your child has fever or pain and is vomiting and can’t keep down acetaminophen by mouth. Use K-Y Jelly or Vaseline to lubricate the suppository and insert in the child’s rectum every 4 hours as necessary.

Acetaminophen/Tylenol

Acetaminophen (Tylenol) Dosage Chart (every 4 hours, as needed)
WEIGHTAGEDROPPERTSP
6-11 lbs0-3 months1/2 (.4 ml)
12-17 lbs4-11 months1 (.8 ml)1/2
18-23 lbs12-23 months1-1/23/4
24-35 lbs2-3 years21
SUPPOSITORY80 mg120 mg325 mg

Ibuprofen/Advil/Motrin Dosages

Ibuprofen (Motrin/Advil) Dosage Chart (every 6-8 hours, as needed)
WEIGHTAGEDOSAGE
14-17 lbs6-11 months1/2 tsp
18-23 lbs12-23 months3/4 tsp
24-35 lbs2-6 years1 tsp
36-47 lbs4-5 years1-1/2 tsp
48-59 lbs6-8 years2 tsp (2-100mg tabs)
60-71 lbs9-10 years2-12 tsp (2-100mg tabs)
72-95 lbs11 years3 tsp (3-100mg tabs)

* NOTE: The above medicines should not be taken together!

Allergies in Children

Millions of Americans have pollen allergies, an unusual sensitivity to substances that are normally harmless. The most common allergy symptoms include sneezing, runny nose, nasal congestion, watery and itchy eyes and a scratchy throat. If you suspect your child has pollen allergies, here are some tips to minimize exposure:

  • Pollen is at its highest levels in late evening and early morning. Avoid going outside during peak levels. Also keep your windows closed as much as possible, especially during those hours.
  • Check the weather network for forecasts of local pollen counts and if you can, avoid going outside on a day when the pollen count is high (especially a dry, windy day.)
  • Keep the windows closed in your home and car, using air conditioners when possible. Air conditioning recirculates indoor air, instead of outside air which carries pollen.
  • Have someone kill weeds by cutting them or using weed killers.
  • Use HEPA filters in the home, including HEPA air filters and vacuum cleaners. HEPA stands for High Efficiency Particle Arrester, which is a type of filter designed to absorb most particles floating in the air.
  • Do not hang your laundry out to dry. Pollen collects on the clothing/sheets and increases pollen exposure inside your home.
  • If your child spends time playing outside, wash their hair before they go to sleep. Pollen settles on the scalp/hair and then falls on their pillows when they lay down.

If your child continues to experience symptoms, you may need to consider medication. In the past several years many of the common antihistamines used for allergies have gone over-the-counter (OTC). As a result, there is no longer any medical reason for patients to routinely request a prescription for an oral allergy medication. If you have tried one of the medications for 1-2 weeks without result, then you should give a different medication a trial. Sometimes patients will find that one medicine works well for a few years and then their body seems to build up a “tolerance” and that medicine no longer controls symptoms. In this case, patients often find relief with a different class of antihistamine. Many of these antihistamines also come in combination with decongestants. If your child is experiencing significant congestion you may want to try a combination product initially, but we recommend using a straight antihistamine for daily control during the allergy season. Ask your pharmacist for assistance if you are having difficulty choosing the right medicine for your child.

Flonase is now Over The Counter (OTC) and approved as a safe/effective allergy treatment for children 4 years of age and older. It can be used alone or in combination with an antihistamine for maximum allergy relief. During peak allergy seasons, many patients require both medications for control. In addition to nasal symptoms, many times Flonase is also helpful for itchy eyes. Be sure to read instructions on how to use Flonase correctly. Other approved intranasal sprays include Nasacort (approved for use in children 2 and older), and Rhinocort (approved for use 6 and up).

Benadryl (Diphenhydramine), one of the oldest and most effective antihistamines, comes as 12.5 mg/5 mL or 12.5 mg chewable tabs, and as 12.5 OR 25 mg tabs/capsules. It can be used for allergies, to dry up a runny nose, or for itching and hives. Benadryl usually makes children sleepy, but in about 5% of patients causes a “paradoxical” reaction and makes them hyperactive. (Don’t try it for the first time when you are boarding an airplane with a toddler, in case they happen to be one of those 5%.) Benadryl should be given every 6 hours as needed. Since the medicine may make your child sleepy, some people try to use a slightly lower dose during the day, with the full dose given at night.

Benadryl Dosages

WEIGHTDOSAGE
12 - 17 lbs1/2 tsp
18-23 lbs3/4 tsp
24-35 lbs1 tsp
36-47 lbs1-1/2 tsp
48+ lbs2 tsp
48-87 lbs1 (one) 25 mg tablets
87+ lbs2 (two) 25 mg tablets