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

≥2−12yrs: 15mg/kg every 6hrs; 12.5mg/kg every 4hrs

Max: 75mg/kg/day

<50kg: Same as children's dose.

≥50kg: 1000mg every 6hrs; 650mg every 4hrs

Max: 4g/day

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

Not recommended

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: Not recommended

220mg every 8−12hrs

 

Max: 660mg/day

 

≥65yrs: 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. 1/2014)

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