Q: My 40kg child has otitis media and took Ibuprofen, but the fever isn't dropping. Can I cross-medicate with Tylenol syrup, and what is the dosage?

Medically reviewed by Sang Hyun Ahn, MD

Content edited by Myeongchan Kim, MD

This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.

Question:

Hello, I have a question about fever reducers. My child is currently taking antibiotics and other medications for otitis media (a middle ear infection). They were prescribed an ibuprofen-based medication and took it at 6:30, but the fever isn't going down. My child usually takes pills, but we don't have any Tylenol pills at home. Can I give them Tylenol syrup right now as an additional dose? Also, my child weighs 40 kg—how much syrup should I give?

Answer:

Hello. I understand you must be worried since your child's fever isn't going down while being treated for a middle ear infection.

Yes, it is perfectly fine to administer Tylenol (acetaminophen) after taking ibuprofen. Since ibuprofen and acetaminophen are different active ingredients, they can be safely used together. You can give Tylenol immediately if the fever has not subsided after the initial ibuprofen dose.

For a child weighing 40 kg, the recommended dose of Tylenol (acetaminophen) is between 400 mg and 600 mg per dose.

If you are using standard Tylenol syrup (concentration of 32 mg/ml):

• The required volume is between 12.5 ml and 19 ml.

• A highly recommended and safe dose would be 15 ml (which provides 480 mg of acetaminophen).

• You can give this dose every 4 to 6 hours, up to a maximum of 5 times a day.

• Please use a proper measuring cup or an oral syringe provided by the pharmacy to ensure accurate dosing.

Important things to check:

• Please verify the concentration on your Tylenol syrup bottle to ensure it is indeed 32 mg/ml before giving the medication.

• You can continue to alternate the Tylenol with the prescribed ibuprofen. Just remember that the ibuprofen doses should be kept at 6 to 8-hour intervals.

Make sure to finish the entire course of the prescribed antibiotics exactly as directed, even if the symptoms improve. If the fever persists for more than 48 hours despite cross-medicating, or if your child's ear pain worsens, please consult your pediatrician for a follow-up evaluation.

For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.

fevercoach.us

Apple App Store

Google Play

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