Can I mix ibuprofen and acetaminophen for a child’s fever? Guidance for parents

Short answer

Why people ask this

Parents dosing a child with fever often want faster relief and to keep temperatures down overnight. They also worry about comfort when one medicine doesn’t seem to last long enough. Mixing can help in select cases, but the child’s age, weight, hydration, and illness severity matter. The main goal is comfort and hydration, not driving the number to normal.

When it might be safe

• Your child is 6 months or older, well-hydrated, and you use correct weight-based doses from the product label or clinician advice
• You alternate or combine on a written schedule (with times and amounts) to avoid dose overlap or confusion
• You use the same concentration for each product (e.g., standard 160 mg/5 mL acetaminophen) and a dosing syringe that matches the label
• You’re not using any multi-symptom cold products that already contain acetaminophen or ibuprofen

When it is not safe

• Your child is under 6 months old (avoid ibuprofen at this age) or under 3 months with any fever (needs clinician evaluation first)
• Your child is dehydrated, vomiting repeatedly, or has kidney issues (ibuprofen can worsen kidney strain)
• Your child has liver disease, has taken too much acetaminophen already, or you can’t verify total daily acetaminophen from all products
• You’re unsure of the child’s current weight, the product concentration, or you lack a proper dosing device, increasing risk of error

Possible risks

• Liver injury from acetaminophen if total daily amount is exceeded or hidden acetaminophen is duplicated
• Kidney strain and stomach irritation or bleeding with ibuprofen, especially if the child is dehydrated
• Dosing mix-ups from different product concentrations or household spoons leading to under- or overdosing
• Masking a more serious illness and delaying care if fever is high, persistent, or in very young infants

Safer alternatives

• Use a single medicine (either acetaminophen or ibuprofen) at correct weight-based doses and reassess comfort
• Focus on comfort measures: fluids, light clothing, room-temperature environment, and rest
• If the child is vomiting, consider rectal acetaminophen (suppository) per label instructions instead of mixing liquids
• Call your clinician if fever lasts more than 3 days, the child is under 3 months with any fever, or your child seems very ill despite medication

Bottom line

For children 6 months and older, mixing or alternating ibuprofen and acetaminophen can be reasonable for comfort if you follow weight-based labels, keep a written schedule, and avoid duplicate ingredients. Skip ibuprofen in infants under 6 months and seek care for any fever under 3 months. When in doubt, treat comfort first, use accurate dosing tools, and contact your child’s clinician with questions.

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