Treating a fever in a child still uses the same two medicines for decades: ibuprofen (Motrin, 布洛芬) and paracetamol/acetaminophen (Tylenol, Panadol, ). But dosing is actually really tricky, as there are different concentrations for infants and toddlers, and it’s all too easy to give too much or too little. This was such a problem in America that those separate mixtures were banned a couple years ago, and now there is only one size. But in China we still have the issue of the two concentrations. Plus, there’s the added problem that the recommended dosing on the boxes is a bit on the conservative side, compared to recommended doses from the manufacturer or most Western pediatricians.

In general, the rules are fairly easy: think 10. As in 10 milligrams per kilogram per dose (which again is fairly easy, at 4-6 hour intervals for both). That’s the general dose for both medicines, although the range varies (4-10 mg/kg for ibuprofen, 7-15 mg/kg for acetaminophen). The problem then lies with each mixture, which offers different milligrams per milliliter. Instead of explaining each level, here’s a much better guide: I’ve uploaded a big image below with exact dosing of both medicines at most weights, provided by the great pharmacy team here at BJU. You can click on the image to get a larger, printable image and keep a copy in your medicine cabinet. Please note that our pharmacists recommend acetaminophen at 15 mg/kg and ibuprofen at 10 mg/kg.

As for which one I prefer, I’ve mentioned a few times that reviews show that ibuprofen lowers fever better than acetaminophen, and for longer duration. Here’s the conclusion from the research review:

CONCLUSIONS:
In children, single doses of ibuprofen (4-10 mg/kg) and acetaminophen (7-15 mg/kg) have similar efficacy for relieving moderate to severe pain, and similar safety as analgesics or antipyretics. Ibuprofen (5-10 mg/kg) was a more effective antipyretic than acetaminophen (10-15 mg/kg) at 2, 4, and 6 hours posttreatment.

Also, don’t forget to use official measuring spoons and droppers as studies showed a wide range of dosing errors when parents rely on teaspoons and tablespoons.