Tylenol vs. Motrin: Which Is Better for Your Kids?

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Children's Tylenol and Children's Motrin both used to claim they were the first choice of pediatricians. They no longer make those advertising claims, but you may wonder whether one is better than the other for your child if he has a fever.

One thing to keep in mind is that it is not always necessary to give your child a fever reducer. In most cases, fever is treated as a comfort measure.

Treating a fever, especially if it is caused by an infection, will not help your child get better any faster, but it may help make her feel better. If your child has a fever, especially if it is low grade, but does not feel bad, then you don't really need to give her a fever reducer.

Age Restrictions

Motrin (ibuprofen) should never be given to a child younger than 2 years old without a doctor's approval. Tylenol (acetaminophen) should not be used for infants under the age of 12 weeks unless you are directed to do so by your doctor.

Tylenol vs. Motrin Safety and Effectiveness Studies

Tylenol (acetaminophen) and Motrin (ibuprofen) have been studied for both reducing fever and pain in children. A meta-analysis of 85 studies that directly compared the two drugs for the relief of fever and pain found that ibuprofen was as effective (or more so) as acetaminophen and both drugs were equally safe.

A narrative literature review found that in low-risk childhood fever where the child had no underlying health issues ibuprofen seemed to be more effective in reducing the child's distress.

But both ibuprofen and acetaminophen had the same safety profiles for these children.

But one review of the pediatric literature cautioned that the adverse events reported for ibuprofen were more likely to occur when it was used for fever or flu-like symptoms. As such, it concluded that ibuprofen might not be the first choice for fever, but it should remain the first choice for treating inflammatory pain in children.

Tylenol vs. Motrin Benefits

Acetaminophen does have the benefit that it comes in a suppository form (Feverall), so you may be able to use it if your child is vomiting or is refusing to take any medications by mouth. Acetaminophen can be used in younger children, while ibuprofen is usually limited to children over 6 months of age. Motrin does have the benefit that it is supposed to last longer, though—six to eight hours versus the four to six hours of Tylenol.

Alternating Tylenol With Motrin

Another common question is whether it is safe to alternate acetaminophen and ibuprofen. If you are using the correct dosage of each medicine at the correct times, then it is probably safe for most children, although there is no research to prove that it helps or that it is safe. The problem is that it is easy to get confused and give an extra dose of one or the other medicines. And in some children, especially if they are dehydrated or have other medical problems, giving both medications can cause serious side effects, especially affecting the kidneys.

If you are alternating fever reducers, then write down a schedule with the times that you are giving the medicines, so that the correct medicine is always given at the correct time.

The American Academy of Pediatrics neither supports nor discourages alternating acetaminophen and ibuprofen every three to four hours, although they do think that it helps promote fever phobia and state that parents should be careful about proper dosing intervals so as to not overdose on either fever reducer.

Deciding What to Use for Your Child

If your child has a fever but no distress, no medication is needed. If your child has any underlying health conditions, discuss appropriate use of these medications with your pediatrician to get a recommendation. For a normally-healthy child, as long as you are following the age restrictions and dosage recommendations, you could choose either medication.

 If one worked better in the past without side effects, it might be the best one for your child.

Sources:

Kanabar D. A Practical Approach to the Treatment of Low-Risk Childhood Fever. Drugs in R&D. 2014;14(2):45-55. doi:10.1007/s40268-014-0052-x.

Martino MD, Chiarugi A, Boner A, Montini G, Angelis GLD. Working Towards an Appropriate Use of Ibuprofen in Children: An Evidence-Based Appraisal. Drugs . 2017;77(12):1295-1311. ​doi:10.1007/s40265-017-0751-z.

Pierce CA, Voss B. Efficacy and Safety of Ibuprofen and Acetaminophen in Children and Adults: A Meta-Analysis and Qualitative Review. Annals of Pharmacotherapy. 2010;44(3):489-506. doi:10.1345/aph.1m332.

Wong T, Stang AS, Ganshorn H, et al. Combined and Alternating Paracetamol and Ibuprofen Therapy for Febrile Children. Cochrane Database of Systematic Reviews. 2013. doi:10.1002/14651858.cd009572.pub2.