Children’s ibuprofen is a generic over-the-counter medicine that can temporarily relieve fever or minor aches and pains due to the common cold, flu, headache, toothache, or sore throat. Brand-name children’s ibuprofen products include Children’s Motrin or Children’s Advil. It is also available from well-known generic brands such as Equate, Up & Up, RiteAid, Walgreens, CVS Health, Major, Topcare, Perrigo, and others. While most are packaged as “Children’s Ibuprofen,” some are marketed as “Junior Strength Ibuprofen.”
Both brand-name and generic children’s ibuprofen are sold either as an oral solution or chewable tablets. The doses are suitable for children between the ages of 2 and 11. Manufacturers of children’s ibuprofen sold in the United States caution that caregivers consult with a doctor before giving children’s ibuprofen to kids younger than 2.
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Children’s (or Junior Strength) ibuprofen is sold as flavored chewable tablets or as a flavored oral suspension. In both brand-name and generic products, the base dose is 100 milligrams (mg) of ibuprofen per tablet or for every 5 milliliters (ml) of liquid.
Chewable tablets: 100 milligrams (mg) ibuprofen per tablet
Oral suspension: 100 mg per 5 ml liquid
Technically, children’s ibuprofen is approved for use in children 6 months or older. In the United States, though, manufacturers market children’s ibuprofen for use in children between the ages of 2 and 11. Infants’ ibuprofen is available in both brand-name and generic versions as a more concentrated oral suspension and includes a medicine syringe for measuring doses.
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| Children’s ibuprofen dosage by weight and age* | ||||
|---|---|---|---|---|
| Weight | Age | Tablet recommended dosage | Liquid recommended dosage | Maximum dosage |
| < 24 lb | < 2 yrs | Ask a doctor | Ask a doctor | Ask a doctor |
| 24-35 lb | 2-3 yrs | 1 chewable (100 mg) every 6-8 hours | 5 mL (100 mg) every 6-8 hours | 4 chewables or 20 mL (400 mg) in 24 hours |
| 36-47 lb | 4-5 yrs | 1½ chewables (150 mg) every 6-8 hours | 7.5 mL (150 mg) every 6-8 hours | 6 chewables or 30 mL (600 mg) in 24 hours |
| 48-59 lb | 6-8 yrs | 2 chewables (200 mg) every 6-8 hours | 10 mL (200 mg) every 6-8 hours | 8 chewables or 40 mL (800 mg) in 24 hours |
| 60-71 lb | 9-10 yrs | 2½ chewables (250 mg) every 6-8 hours | 12.5 mL (250 mg) every 6-8 hours | 10 chewables or 50 mL (1000 mg) in 24 hours |
| 72-95 lb | 11 yrs | 3 chewables (300 mg) every 6-8 hours | 15 mL (300 mg) every 6-8 hours | 12 chewables or 60 mL (1200 mg) in 24 hours |
*Weight-based dosing is safer than age-based dosing.
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Children’s ibuprofen is indicated for the temporary relief of minor aches and pain due to the common cold, flu, headache, toothache, and sore throat in children between the ages of 2 and 11. It is also indicated to relieve fever in children within the same age group.
Children’s ibuprofen does not have an upper age limit. It can be administered to children as young as 6 months of age, adolescents, or adults. However, children’s ibuprofen products do not come with instructions for infants, adolescents, or adults. Before giving children’s ibuprofen to any person outside the recommended age range, get medical advice from a doctor or other healthcare provider. They may be able to steer you to more suitable medications such as infants’ or adult ibuprofen.
You should consult with the child’s doctor about an appropriate dose if the child has liver or kidney problems.
Renally impaired patients:
Creatinine clearance of 30-60 mL/min: Avoid use
Creatinine clearance less than 30 mL/min: Do not use
Dialysis patients: Do not use
Hepatically impaired patients: Do not use
Children’s ibuprofen should not be used unless under the advice of a healthcare professional if the child has any of the following conditions:
Allergies to NSAIDs
Asthma
Fluid retention
Dehydration due to vomiting, diarrhea, or low fluid intake
Stomach or gastrointestinal bleeding indicated by stomach pain, vomiting blood, or bloody stools
High blood pressure
Kidney problems
Liver problems
Bleeding problems
Heart problems
Stroke
If a child is taking blood-thinning drugs or other NSAIDs such as aspirin or naproxen, talk to the child’s doctor before giving the child ibuprofen.
Children’s ibuprofen is administered as a chewable tablet or oral suspension. You may want to consider the following safety and effectiveness tips when administering children’s ibuprofen:
Read the directions and warnings before giving children’s ibuprofen to a child.
Find the appropriate dose on the dosage chart, directions, or medication guide included with or printed on the medication’s packaging.
Use weight to determine the correct dose. If the child’s weight is unknown, weigh the child in order to calculate the proper dose. As a last resort, the dose can be based on age, but it is not as accurate or safe as weight-based dosing.
Ask a pharmacist if you’re unsure how much children’s ibuprofen to give a child.
When giving children ibuprofen, avoid giving other medications containing ibuprofen or other NSAIDs such as aspirin or naproxen unless under the direction of a healthcare provider. Doing so raises the risk of gastrointestinal bleeding or other problems.
Check the expiration date on the bottle or package. Expired medicines should be disposed of safely and replaced.
When administering the oral suspension, always shake the bottle vigorously before drawing out a dose. The ibuprofen may settle to the bottom.
Use the child’s weight rather than age to determine the correct dose. If the child’s weight is unknown, weigh the child first. In a pinch, use the child’s age to guide dosing decisions.
Always use the measuring cup or a measuring syringe to measure the dose. Do not use any other kind of devices such as measuring spoons or regular spoons. If you lose the cup, a pharmacy can provide a dosing cup or medicine syringe free of charge.
The chewable tablets may cause burning in the mouth or esophagus, so keep the child upright for about 15-30 minutes after taking the medicine.
Give this medicine with milk or food if it causes stomach problems.
If possible, have another adult check the dosing chart and the measured dose before giving the medicine.
For each dose, record the time in a diary or schedule to ensure that the next dose is not given too early.
Use the scoring mark on the tablet if you need to divide a tablet into half a dose.
The chewable tablet should be chewed completely before swallowing.
Have the child drink a small glass of water after swallowing the medicine.
Repeat the dose every six to eight hours if symptoms persist.
Do not give more than four doses in a single 24-hour period.
With the cap still on, shake the bottle well before measuring out a dose.
Remove the child-resistant cap from the bottle.
The oral suspension comes with a metered cup that is included with the medication. Marks on the cup indicate each of the six recommended doses: 2.5 mL, 5 mL, 7.5 mL, 10 mL, 12.5 mL, and 15 mL.
Pour the liquid to the appropriate dose mark on the measuring cup.
Have the child drink all the contents of the measuring cup.
Tightly replace the child-resistant cap.
Repeat the dose every six to eight hours if symptoms persist.
Do not give more than four doses in a single 24-hour period.
The body absorbs ibuprofen quickly, especially when it’s taken as a liquid or chewable tablet. This means that children’s ibuprofen will start to work about 15 to 30 minutes after the medicine is taken. Peak effectiveness hits in about one to two hours.
For rapid results and maximum effectiveness, ibuprofen can be taken on an empty stomach, but this may increase the risk of stomach pain or bleeding. When ibuprofen is taken with food, peak effectiveness is delayed by 30 to 60 minutes and peak levels are 30% to 60% lower than when taken on an empty stomach. However, many caregivers choose to give children ibuprofen with milk or food to spare the child stomach discomfort.
The manufacturers of children’s ibuprofen advertise on their packaging that children’s ibuprofen lasts eight hours. However, this will vary from person-to-person.
The half-life of ibuprofen in children averages two hours. This means that the effects will start to wear off in four hours or so.
No matter what, caregivers should take care to follow the dosing schedule. Do not give a second dose until at least six hours have passed since the last dose and do not exceed the maximum dosage specified by the manufacturer.
Children’s ibuprofen is a symptom medication, so don’t fret about a missed dose. Just give the missed dose as soon as you remember. Make sure, however, when a missed dose is given that the next dose not be given for at least six hours. Above all, never give a double dose to make up for a missed dose.
Ibuprofen is considered one of the safest over-the-counter pain relievers. If given as directed, children’s ibuprofen can be discontinued without problems or withdrawal symptoms. However, if a child is being given children’s ibuprofen or another pain reliever chronically—that is, for 15 days or more per month—talk to the child’s doctor or another healthcare provider. They may suggest more appropriate therapies and give sound medical advice on how to discontinue children’s ibuprofen.
Children’s ibuprofen is not the only medicine that can help a child with minor aches, pain, or fever. Ibuprofen itself belongs to a class of drugs called NSAIDs (nonsteroidal anti-inflammatory drugs) which work by blocking the production of substances that cause swelling. Other types of OTC NSAIDs include aspirin and naproxen. Unfortunately, ibuprofen is considered one of the safest NSAIDs, so if it’s causing problems, chances are aspirin or naproxen will also cause problems. Aspirin can also cause additional complications during viral illnesses, so it is often avoided.
The most effective substitute for children’s ibuprofen is children’s acetaminophen. Available as a brand-name product (Tylenol Children’s) or less-costly generic versions, children’s acetaminophen comes as an oral solution or chewable tablets in dosages suitable for children between the ages of 2 and 11.
RELATED: Is Tylenol an NSAID?
A child’s weight determines the maximum ibuprofen dosage that should be given to that child. Doses should not exceed the recommended dose and should not be given less than six hours apart. See dosage chart above for dosage by weight and age.
While no particular food interferes with the body’s absorption of ibuprofen, the body absorbs and uses ibuprofen faster when it’s taken on an empty stomach. The downside is that taking ibuprofen on an empty stomach is more likely to cause stomach distress. Although it will add time to the clock, do not hesitate to give children’s ibuprofen with food or milk if the drug is causing discomfort.
Relatively few drugs or dietary supplements alter ibuprofen’s effectiveness as a fever or pain reliever. The notable exception is caffeine. When taken with a pain reliever such as ibuprofen, caffeine increases the drug’s pain-relieving properties.
Ibuprofen, though, can decrease the effectiveness of some important prescription medications such as blood pressure medications (ACE inhibitors, beta-blockers, angiotensin receptor blockers, and diuretics). Use of children’s ibuprofen is discouraged in children with high blood pressure unless a doctor directs otherwise.
Some drugs increase the risk of ibuprofen side effects. The most obvious culprits are other OTC NSAIDs such as aspirin or naproxen, but prescription NSAIDs such as diclofenac are also to be avoided. Be careful to read the ingredients of combination cold, flu, or allergy medications. Many of these products include an NSAID, usually ibuprofen. Besides NSAIDs, also watch out for corticosteroids such as prescription prednisone and prednisolone. Hydrocortisone or fluticasone can also be found in common OTC drugs such as anti-itch creams or allergy medications. These, too, can enhance ibuprofen side effects.
Among the most serious possible side effects, drugs like ibuprofen interfere with the body’s ability to form blood clots. Bleeding and bruising can range from being a minor to a life-threatening consequence of taking NSAIDs, especially if they are overused. For this reason, children’s ibuprofen should be avoided if the child is taking anticoagulant (blood thinner) medications or has bleeding problems.
Chad Shaffer, MD, earned his medical doctorate from Penn State University and completed a combined Internal Medicine and Pediatrics residency at the University of Pittsburgh Medical Center and Children’s Hospital of Pittsburgh. He is board certified by the American Board of Internal Medicine and the American Board of Pediatrics. He has provided full-service primary care to all ages for over 15 years, building a practice from start up to over 3,000 patients. His passion is educating patients on their health and treatment, so they can make well-informed decisions.
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