Kids health

Everything you need to know about over-the-counter painkillers for kids

When your child is in pain, you want to do everything you can to help, but it’s important to use caution with painkillers. Here’s what you need to know.

By Dina Kulik

Everything you need to know about over-the-counter painkillers for kids

Photo: iStockphoto

Which over-the-counter pain relievers are OK for kids? Which ones should be avoided? Acetaminophen and ibuprofen are safe for children. Ibuprofen is a non-steroidal anti-inflammatory, so it can reduce pain and fevers, as well as inflammation and swelling—for instance, from an injury. Acetaminophen is purely a painkiller and a fever reducer.

Any product that contains acetylsalicylic acid (Aspirin or ASA) is not safe for children because of the risk of Reye’s syndrome. Reye’s syndrome occurs in children with certain viral infections who are given ASA and can lead to liver disease and even death. If you are unsure whether a medication is safe, please ask your doctor or pharmacist.

Is it OK to give adult ibuprofen or acetaminophen to a child if you use a lower dose? The ideal dose of ibuprofen is 10 milligrams per kilogram every six to eight hours, and for acetaminophen, it’s 15 milligrams per kilogram every four to six hours—for both adults and children. If your child weighs enough that an adult dose falls in this range, you can give them this dose. This will be the case for many adolescents. Never crush up adult medication and guess how much would work for your child. There is a risk of toxicity, which can be deadly. Liquid medicines should be measured with a syringe, not a spoon, to avoid over- or under-dosing.

Is it safe to alternate acetaminophen and ibuprofen for pain? Absolutely. If you’re giving your child one or the other, and the pain persists, you can give them both. We commonly give acetaminophen and ibuprofen together or in alternating doses. As long as ibuprofen is only dosed every six hours, and acetaminophen is dosed no more than every four hours, it is safe to give them together or separately. That’s because acetaminophen is processed by the liver, while ibuprofen is broken down by the kidneys, so taking them together won’t overtax either organ. But it’s important to never exceed more than four doses of ibuprofen or six doses of acetaminophen in 24 hours—and when your kid is sick and you’re tired, it can sometimes be difficult to keep track. Write down each dose so you don’t forget what you’ve given them, especially if you’re not the only one looking after the child. This will help prevent an accidental overdose.

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