It's the wee hours of the morning, and your young child has a fever and is crying out for relief. You drag yourself out of bed and face the medicine cabinet.
You're not comfortable using aspirin because it may increase the risk of Reye's syndrome, a potentially fatal disease that affects all of the body's organs. The Pediatrics Association also cautions against using aspirin in children under the age of 14 if there is a high suspicion of chicken pox or influenza.

That leaves you with either ibuprofen or acetaminophen. Which one do you choose?

Ibuprofen works by inhibiting prostaglandins, or the chemicals in the body that cause pain and fever. No one is sure exactly how acetaminophen works, but it may be by a similar mechanism.

The two are about equal when it comes to relieving pain and lowering a fever, according to most authorities. However, ibuprofen has the added advantage of being an anti-inflammatory so it can help with swelling, something acetaminophen doesn't do.

There are other ways to rank the two, including formulation and dosing. Acetaminophen for children usually comes in different flavored liquids, which are easier to swallow, Gorman says. Because ibuprofen is not as liquid-soluble, it tends to be thicker and, consequently, less palatable for some children.

The dosing interval for ibuprofen is six to eight hours. For acetaminophen, it's about four hours. This gives ibuprofen an advantage, Gorman says, because you don't have to give it as often.

Ibuprofen can cause gastric distress and vomiting while acetaminophen, in extremely high doses or over prolonged periods, can cause liver damage.

The proportion of people getting liver damage from acetaminophen is tiny, but the dangers should not be ignored. Liver damage is extremely rare but, because of the millions of doses of acetaminophen ingested every day, liver failure does occur.

In a policy statement issued in October 2001, the Canadian Pediatrics Association said that although the incidence of acetaminophen toxicity was low, regional poison centers had treated more than 1000 cases (adults and children) of acetaminophen overdose in 1997.

Ultimately, the choice is yours to make.

Here are some tips for using both acetaminophen and ibuprofen as safely and effectively as possible:


  • Never give extended release, double-strength, adult acetaminophen products to young children. "This exceeds the upper limit of safe dosages for children," Ward says.
  • Make sure that each child is taking the preparation intended for that child since there may be children of different ages requiring different preparations.
  • Keep the measuring device with the preparation it was intended for.
  • Keep in mind that in children above the age of 3 months, fevers are very common. Experts prefer that parents not treat children younger than that without calling their physician, as there is a possibility that the fever is a sign of sepsis, a bacterial infection of the bloodstream that can lead to meningitis. The child should be evaluated for this potentially serious condition, Ward says.
  • Be aware that there are many different products containing acetaminophen, and that all products containing this ingredient should be included in the total daily dose for your child.

Request a Refill

6 + 2 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.