Antipyretic Medications- MPR

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	>99.5°F		>99.0°F	>100.4°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 strength immediate-release: 650mg every 4–6hrs Extra strength immediate-release: 1000mg every 6hrs Ext-rel: ≥12yrs: 2 tabs every 8hrs Max: 4g/day^1,2
		chew tabs	80mg
		ODT	80mg, 160mg
		ext‑rel tabs	650mg
		caps	500mg
		liquid/ elixir	160mg/5mL, 500mg/15mL
		solution	160mg/5mL
		suspen– sion	160mg/5mL
		gel syrup	160mg/5mL
		supposi– tory	80mg, 120mg, 325mg, 650mg
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	81mg
		ODT	81mg
		del‑rel tabs	81mg, 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.
naproxen	OTC	caps	220mg	<12yrs: Consult physician.
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, 20th Edition. Washington, DC: American Pharmacists Association; 2020. (Rev. 11/2023)

Want to read more?