Children's Fever and Pain in Canada: Acetaminophen vs Ibuprofen
Short answer: acetaminophen (Tylenol) and ibuprofen (Advil) both lower fever and ease pain in children. Either can be a reasonable choice, but ibuprofen should not be given to babies under 6 months without a doctor's advice (Canadian Paediatric Society). Whichever you use, give the dose for your child's weight from the chart on the package, measure it with the syringe or cup that comes in the box, and don't alternate or combine the two unless a doctor or pharmacist tells you to. Never give ASA (aspirin) to a child.
Acetaminophen vs ibuprofen at a glance
| Acetaminophen | Ibuprofen | |
|---|---|---|
| Common brands | Tylenol (Infants' drops, Children's liquid) | Advil (Pediatric drops, Children's suspension, Junior chewables) |
| What it does | Lowers fever and relieves pain | Lowers fever and relieves pain. It is an NSAID (non-steroidal anti-inflammatory drug). |
| Youngest babies | Check with a doctor before giving it to a baby younger than the youngest age on the package chart | Not under 6 months without a doctor's advice (Canadian Paediatric Society) |
| Watch out for | Many cold medicines also contain acetaminophen. Doubling up can lead to an overdose, which can cause serious liver damage. | Give it only when your child is drinking fluids reasonably well. Don't combine it with other ibuprofen products. |
| Ask first if your child has | Liver disease or another long-term health condition. Don't use it if your child is allergic to acetaminophen. | Asthma, kidney or heart problems, or past stomach ulcers or bleeding. Don't use it if your child is allergic to ibuprofen or other NSAIDs. |
Both medicines lower a fever for a while, but neither treats what is causing it, and a fever doesn't always need medicine. The Canadian Paediatric Society advises against switching back and forth between acetaminophen and ibuprofen, because alternating them can lead to dosing errors.
How to give the right dose
- Dose by weight. Find your child's weight on the dosing chart on the package you have. Use age only if you don't know the weight. If your child is younger or lighter than the chart covers, ask a doctor or pharmacist first.
- Use the device in the box. Measure with the oral syringe or dosing cup that comes with the medicine. A kitchen spoon doesn't hold the right amount.
- Drops and liquids are not interchangeable. Infant drops are more concentrated than children's liquid. Children's products come in different strengths (infant drops are stronger than children's liquid), so always use the dosing chart and the syringe or cup that comes with that exact product, and ask a pharmacist if you're unsure.
- Follow the package for timing. Acetaminophen and ibuprofen have different dosing intervals and daily limits. Never go over the maximum number of doses on the label.
- Check every medicine you give. Read the medicinal ingredients on cold, flu and allergy products so your child doesn't get a second dose of acetaminophen or ibuprofen by accident.
- If you think your child has taken too much, call your provincial poison centre or get emergency help right away, even if your child seems fine.
Never give ASA (aspirin) to children
Children and teenagers with a fever should not be given ASA (acetylsalicylic acid, such as Aspirin). It is linked to Reye syndrome, a rare but serious illness.
Children's fever and pain medicines at Healthy Hub
- Infants' TYLENOL Fever & Pain Drops, Dye-Free Grape, 24 mL: acetaminophen infant drops, with an oral syringe in the pack.
- Children's Tylenol Liquid Suspension, Dye-Free Cherry: acetaminophen children's liquid, with a dosing device in the package.
- Advil Pediatric Drops for Infants, Dye-Free Grape, 24 mL: ibuprofen infant drops, with an oral syringe.
- Children's Advil Suspension, Dye-Free Bubble Gum, 100 mL: ibuprofen children's suspension, with a dosing device in the box.
See more in Kids & Baby and Pain Relief.
When to see a doctor
The Canadian Paediatric Society advises seeing a doctor if your child has:
- any fever and is under 3 months old (see a doctor right away), or any fever and is under 6 months old
- a fever lasting more than 72 hours (3 days)
- signs of dehydration: a dry, sticky mouth, no tears, or fewer wet diapers than usual (fewer than 4 in 24 hours for babies, fewer than 3 in 24 hours for older children, per the Canadian Paediatric Society dehydration handout)
- unusual sleepiness or irritability that doesn't go away
- fast or difficult breathing
- a fever with a rash
The package labels also say to see a doctor if fever lasts more than 3 days or pain lasts more than 5 days. If you're unsure, call your doctor or ask a pharmacist.
Sources
- Canadian Paediatric Society, Caring for Kids. Fever and temperature taking.
- Canadian Paediatric Society, Caring for Kids. Strep throat (advice not to alternate acetaminophen and ibuprofen).
- Canadian Paediatric Society, Caring for Kids. Croup (ibuprofen not under 6 months without a doctor's advice).
- Canadian Paediatric Society, Caring for Kids. Dehydration and diarrhea in children.
- Health Canada. Acetaminophen and children.
- Canadian product labels for Infants' and Children's Tylenol and Advil Pediatric Drops and Children's Advil, as shown on each product page.
This guide is general information, not medical advice. Ask your pharmacist or doctor about your own child.
Related guides: Cold & Flu Medicine in Canada: Decongestant, Expectorant or Cough Suppressant? · How to Check an NPN or DIN on Health Canada's Database