Fever help!

Q: I’ve heard it’s OK to give infants Advil and Tylenol at the same time when treating fever. Is this true?

A: I get many questions as to how to best administer these medications in combination. The honest answer is that there is no one, single way. 

Both Advil (ibuprofen) and Tylenol (acetaminophen) work to reduce fever. And, indeed, in children older than 6 months, it may be more effective to manage a fever with both Advil and Tylenol. 

It isn’t recommended, however, to use Advil for children younger than 6 months old. (Tylenol is OK to use for these young infants.) 

And for infants less than 3 months old, it’s recommended that you first contact your primary care provider regarding any fever, rather than trying to manage it at home with medicine. 

Though the combination therapy of the two drugs can be more effective than using either individually, this practice can cause confusion regarding which drug you gave last and how much you gave of it. There can be an increased risk of accidental inaccurate dosing, especially if the doses are different for the two medications. 

Some parents find it easier to give them at the same time, and others find it better to alternate.

Tylenol can be given every 4 to 6 hours and Advil can be given every 6 to 8 hours, so often I recommend that parents give both drugs at the same time every six hours (for ease of math). Another option is to alternate by giving one medication every 3 hours as needed.  

If you go this route, I recommend keeping a written log or schedule to help reduce the middle-of-the-night confusion. 

It’s also important to remember that dosing of both Advil and Tylenol is based on your child’s weight (not age); if you have any questions regarding the appropriate dose, you should contact your clinic or pharmacy. 

It’s also recommended that parents not rely on dosing information in the form of “teaspoon,” but rather in specific milliliter amounts (such as 5 milliliters) as there can be confusion among caregivers regarding the correct amount of a teaspoon. 

Also, parents should look to see how a child is acting and feeling, rather than just focusing on a thermometer number. 

Medicines may not fully reduce the fever back to normal, but will, one hopes, bring it down enough for improved comfort. 

I’ve seen kids running around, playful and laughing with temperatures of 101, who may have looked pretty darn draggy with a temp of 103. 

Fever is generally a sign that the immune system is doing what we want it to do — fight off infection. 

We just want to make your child as comfortable through that period, so he or she can rest, drink fluids and stay hydrated and recover as quickly as the illness will allow.


Dr. Kimara Gustafson is a Minneapolis mother who works as a pediatrician at Masonic Children’s Hospital and the Adoption Medicine Clinic, both at the University of Minnesota. Send your questions to kgustafson@mnparent.com.