Antipyretic Medications

ANTIPYRETIC MEDICATIONS
Detection of fever varies based on the site of body measurement.
FEVER THRESHOLDS
Rectal Oral Axillary Tympanic Temporal
>100.4°F >99.7°F >99.3°F >100.0°F 0−2mos >100.7°F
3−47mos >100.3°F
   ≥4yrs    >100.1°F
TREATMENT OPTIONS
Generic   Form Strengths Children’s Dose Adult Dose
aceta
minophen
Rx injection 10mg/mL 0–28days: 12.5mg/kg every 6hrs; max: 50mg/kg/24hrs. Minimum dosing interval: 6hrs.
29days–2yrs: 15mg/kg every 6hrs; max: 60mg/kg/24hrs. Minimum dosing interval: 6hrs.
≥2yrs: 15mg/kg every 6hrs (or 12.5mg/kg every 4hrs); max single dose: 15mg/kg (up to 750mg), max daily dose: 75mg/kg/24hrs (up to 3750mg). Minimum dosing interval: 4hrs.
<50kg: Same as children’s (≥2yrs) dose.
≥50kg: 1000mg every 6hrs (or 650mg every 4hrs); max single dose: 1000mg, max daily dose: 4000mg/24hrs. Minimum dosing interval: 4hrs.
OTC tabs 325mg, 500mg 10−15mg/kg every 4−6hrs
Max: <12yrs: 2.6g/day
Regular release: 325−650mg every 4−6hrs
Extended release: 1300mg every 8hrs
Max: 4g/day1,2
chew tabs 80mg
oral disinte
grating tabs
80mg, 160mg
ext‑rel tabs 650mg
caps 500mg
liquid/
 
elixir
160mg/5mL, 500mg/5mL
solution 160mg/5mL
suspen
sion
160mg/5mL
gel syrup 160mg/5mL
supposi
tory
80mg, 120mg, 325mg, 650mg
packet 950mg
aspirin OTC tabs 81mg, 325mg, 500mg ≤15yrs: Not recommended3 Oral: 325−650mg every 4−6hrs
Rectal: 300−600mg every 4−6hrs
Max: 4g/day
chew tabs 75mg, 81mg
oral disinte
grating tabs
81mg
del‑rel tabs 81mg, 162mg, 325mg, 500mg, 650mg
caplet 325mg, 500mg
supposi
tory
60mg, 120mg, 200mg, 300mg, 600mg
ibuprofen Rx injection 100mg/mL <6mos: Not established.
≥6mos–<12yrs: 10mg/kg up to max single dose of 400mg every 4–6hrs as needed. Max: 40mg/kg or 2.4g/day
12–17yrs: 400mg every 4–6hrs as needed. Max: 2.4g/day
Initially 400mg, then 400mg every 4−6hrs or 100−200mg every 4hrs
Max: 3.2g/day
OTC tabs 100mg, 200mg 6mos−12yrs:
<102.5°F (<39°C): 5mg/kg/dose;
>102.5°F (>39°C): 10mg/kg/dose every 6−8hrs
Max: 40mg/kg/day
200−400mg every 4−6hrs
Max: 1.2g/day
chew tabs 100mg
caps 200mg
suspen
sion
100mg/5mL, 40mg/mL, 50mg/
 
1.25mL
naproxen OTC tabs 220mg <12yrs: Consult physician. 220mg every 8–12hrs (may give 440mg as 1st dose initially). Max: 660mg/24hrs. Elderly: max 220mg every 12hrs.
caps
NOTES

1Max dose is 3250mg/day for Tylenol brand regular strength and 3g/day for Tylenol brand extra strength; dosing interval for Tylenol brand extra strength is every 6hrs.

2Max dose is 2g/day for patients with poor nutritional intake, those taking concurrent hepatotoxic medications, or those who drink three or more alcoholic beverages daily.

3Aspirin may be given to children ≤15yrs of age under physician supervision if influenza or chickenpox can be confidently ruled out (10−15mg/kg every 4−6hrs, max 5 doses/24hrs).

REFERENCES

Adapted from: Feret BM. Chapter 6. Fever. In: Krinsky DL, Berardi RR, Ferreri SP, et al, eds. Handbook of Nonprescription Drugs: An Interactive Approach to Self‑Care, 17th Edition. Washington, DC: American Pharmacists Association; 2012.

(Rev. 4/2018)

This article originally appeared on MPR