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Key takeaways
Alternating Tylenol and Motrin for pediatric fever is not recommended by healthcare professionals due to the risks of imprecise dosing and potential overdose.
In children with dehydration, renal disease, or cardiovascular issues, Tylenol is recommended over Motrin. For children with liver impairment, Motrin is preferred.
If your provider advises alternating between Tylenol and Motrin, adhering to proper weight-based dosing and dosing intervals is crucial.
Check your child’s fever with a thermometer and consider their discomfort level before administering medication for a fever. Consult a healthcare provider if your child is under six, has a fever that persists beyond three days, or has severe symptoms accompanying their fever.
Most parents and caregivers expect kids to get sick from time to time. Usual signs of illness include body aches, fatigue, and loss of appetite. A fever is one of the most significant indicators that a child is sick. According to the National Institutes of Health (NIH), pediatric fever is often caused by a viral infection.
Suppose your child is sick and has a fever. In that case, you may wonder which over-the-counter medicine is best—or if you can safely alternate common drugs like Motrin (a brand name for ibuprofen, which is an NSAID) and Tylenol (a brand name for acetaminophen, which is a non-opioid analgesic and antipyretic) to decrease the temperature. You may also want to know whether you can give your child acetaminophen and ibuprofen together to make it happen even faster. We spoke to two healthcare professionals to answer this critical question and discuss the correct doses.
Can you take Motrin and Tylenol together for a fever?
Despite the common practice of alternating Tylenol and Motrin for pediatric pain or fever, there is little evidence to suggest taking both provides more significant relief than taking one medication alone. In fact, many pediatricians actively discourage taking these OTC medications together.
“Treating pediatric fever may warrant the use of either Tylenol or ibuprofen; however, it’s no longer recommended to alternate Tylenol and ibuprofen, per the American Academy of Pediatrics (AAP),” says Christina M. Madison, Pharm.D., the founder of The Public Health Pharmacist. “Choose one medication, and only use that one to treat their fever.”
One reason AAP recommends against pediatric fever control with acetaminophen (Tylenol) and ibuprofen (Motrin or Advil) is because of the risk of imprecise dosing and a risk of accidental overdose.
“There’s a risk of calculating an incorrect dose by giving a child both Tylenol and ibuprofen at the same time,” says Blair Gingerich, Pharm.D., BCMTMS, a clinical care and retail pharmacist in northern Indiana.
Again, the combination of these meds is no longer recommended—but if you must switch medications throughout a child’s sickness (for example, if you run out of one option), pay careful attention to the dosage and intervals for each. Typically, Tylenol can be given every four to six hours and Motrin can be given every six to eight hours. The dosage will vary depending on whether you are using Infant Tylenol, Children’s Tylenol, or standard Tylenol. Always read the medication label and, if you’re unsure, ask your child’s physician or pharmacist.
What’s better for children’s fever: Tylenol or Motrin?
“As far as treating fever, when given at the correct weight-based dose, they are both effective,” Dr. Gingerich says. However, many healthcare professionals not only recommend against alternating Tylenol and Motrin, but they also recommend evaluating whether your child needs any medication to treat a fever.
“Fevers play a role in our body’s ability to fight off infection,” Dr. Gingerich says. “If a child has a fever and is still playing, they do not need a medication at that time. It is usually not necessary to treat a fever until it is greater than 101 degrees Fahrenheit.”
Treating mild symptoms like a low fever and headache won’t make the sickness go away faster, but it can make the sick day (or night) smoother. If your child has a fever and needs pain relief, Dr. Gingerich says Tylenol or Motrin can be an effective pain reliever and fever reducer.
“Tylenol would be preferred for [a] child who is dehydrated, has preexisting renal disease, or cardiovascular disease,” she says. “Motrin would be preferred for a child with liver impairment.”
How to break a child’s fever with Tylenol and Motrin
Though alternating Tylenol and Motrin is no longer recommended by the AAP, some parents might still choose to do so. In that case, it’s essential to stick to the proper weight-based dose and dosing intervals. At 6- or 8-hour dosage intervals for acetaminophen and ibuprofen, research suggests the quickest they can safely be alternated is every three hours.
Again, many pediatricians and pharmacists advise treating a fever only if it causes discomfort.
Fever ranges and timeline
It’s essential to read your child’s temperature with a thermometer to verify a fever before treating with medication. A temperature of 100.4 F or higher is generally considered a fever. Rectal, ear, and oral thermometers offer the most accurate readings. Armpit or forehead temperature readings are not always precise.
If your child has a fever and is uncomfortable, Tylenol or Motrin can relieve pain and reduce the fever—but one or the other will suffice. “Tylenol should be dosed every four to six hours. Ibuprofen should be dosed every six to eight hours,” Dr. Madison says. “Redose as needed if the child still has a fever.”
If you choose to alternate Tylenol and Motrin, Dr. Gingerich recommends carefully verifying the correct dose and dosage time. “The recommended milliliters for Tylenol may differ from Motrin for the child’s weight-based dose,” she adds.
If a child’s fever reaches 104 degrees Fahrenheit or other symptoms worsen after the fever has been controlled with medication, Dr. Gingerich says it’s time to take your child to your healthcare provider. If any of the following happens, you should stop administering OTC drugs and consult a healthcare provider:
- A fever that does not resolve within three days
- A fever that does not show signs of improving after medication
- Severe symptoms such as trouble breathing, lethargy, or difficulty moving
- Symptoms of dehydration such as very dark urine, dry mouth, or absence of tears or markedly decreased urine output
Appropriate dose
When medicating a child’s fever or other symptoms, it’s essential to remember that dosage is determined by weight, not age. Always refer to the information on the bottle, especially if you are switching from one form to another. Liquid, chewable, and even suppository forms of Motrin and Tylenol are available with differing strengths.
When in doubt, consult the dosing recommendations for acetaminophen and ibuprofen from the American Academy of Pediatrics (AAP).
Age appropriateness
Tylenol OTC dosing is FDA-approved at age 2 while Motrin OTC dosing begins at 6 months old. Once a child is old enough to take the medication, calculate their dose based on their current weight.
Still, every child is different. Dr. Madison recommends consulting a healthcare provider before administering new over-the-counter medications to children under 6.
If your baby is under 12 weeks old, call your healthcare provider rather than attempting to treat the fever at home. According to the AAP, a temperature over 100.4 F in the first 12 weeks of life needs to be immediately evaluated and treated in the emergency department.
The bottom line
Taking Tylenol and Motrin together is not recommended by healthcare professionals.
If you decide to alternate Tylenol and Motrin, you should take precautions: Ensure the correct weight-based dose of ibuprofen or acetaminophen is given. Ensure that the frequency of the dose is not more often than instructed on the bottle.
Other necessary precautions include always taking the person’s temperature before administering any OTC fever medications. Don’t treat a fever below 101 F. Check the active ingredients in any other medications the person is taking to ensure they have not already taken it as some cold medicines contain ibuprofen or acetaminophen.
When in doubt, give one type of medication and discuss specific concerns and symptoms with your family’s healthcare provider.