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Acetaminophen

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Acetaminophen is a non-aspirin medicine to relieve pain or fever. Follow the guidelines the doctor gives you on how much acetaminophen to give your child and how often you should give it. The guidelines on the bottle or the chart below may also help you decide how much medicine to give your child. Be sure to measure the dose correctly with the dropper, dosage cup or oral syringe.

This dosing chart does NOT include acetaminophen infant drops. In 2011, the Food & Drug Administration (FDA) recommended that drug companies only produce one strength of liquid acetaminophen to avoid dosing errors that can cause serious liver damage for children. It may take several months, even years, before the infant drops are removed from all store shelves. If you have already purchased acetaminophen infant drops (80 mg/0.8 ml), follow the dosing instructions on the bottle very carefully.

DO NOT GIVE THE DOSES LISTED ON THIS CHART IF YOU ARE USING ACETAMINOPHEN INFANT DROPS. Follow the directions on the bottle to make sure you do not overdose your child. Always measure infant drops with the dropper provided in the bottle.

 Chewable Tablets 80 mg tabs Suspension Liquid Elixir 160 mg/5ml Junior Strength 160 mg Caplets/ Chewables Regular Strength 325 mg Caplets/ Tablets Extra Strength 500 mg Caplets/ Gelcaps
2-3 mos
6-11 lbs.
 1/4 tsp

 (1.25 ml)

 

 

  
4-11 mos
12-17 lbs.
 1/2 tsp (2.5 ml)   
12-23 mos
18-23 lbs.
  3/4 tsp (3.75 ml)   
2-3 yrs
24-35 lbs.
2 tabs1 tsp (5 ml)   
4-5 yrs
36-47 lbs.
3 tabs1 1/2 tsp (7.5 ml)   
6-8 yrs
60-71 lbs
4 tabs 2 tsp (10 ml)2 caps/tabs   
9-10 yrs
60-71 lbs.
 5 tabs 2 1/2 tsp (12.5 ml) 2 1/2 caps/tabs  
11 yrs
72-95 lbs.
6 tabs  3 tsp (15 ml)3 caps/tabs  
Adults & Children
12 years and older
96 lbs and over
    4 caps/tabs2 caps/tabs 1 or 2 caps/gel caps (Take no more than 6 caps/gel caps per day)

 

Do not give acetaminophen to infants under 2 months of age unless the doctor tells you to give it. Always call the doctor before giving an infant under 2 months of age any over- the-counter medications.

Read all labels carefully. Be sure all the information on the bottle or package matches the information on the chart before you give the dose on the chart. Not all products are the same strength.  

How should I give this medicine?

  • There are several forms and strengths of acetaminophen that are given by mouth. It can be given with or without food. Give with food if it causes an upset stomach on an empty stomach. •
  • If you are using the liquid, shake well before measuring the dose.
  • If your child has a feeding tube the liquid suspension can be used. Flush the feeding tube with water before and after you give the medicine.
  • Acetaminophen is given “as needed.” Once your child is no longer in pain or no longer has a fever stop giving the medicine unless the doctor told you to give it on a set schedule.
  • Do not give this medicine more often than every 4-6 hours. If your child is sleeping you do not need to wake him.
  • Check the label to make sure you do not give your child more than the maximum dose in a 24 hour period.

    Infants and toddlers:
     
    • Measure the correct dose of the liquid in a medication syringe. If you are using INFANT DROPS do NOT use the dose chart in this handout. Follow the directions on the bottle and measure the correct dose with the dropper in the bottle.
    • Hold your child with his head tipped back a little.
    • Place the medication syringe to the side of the tongue and give the medicine a few drops at a time to reduce the risk of choking. 
    • A nipple or medicine pacifier can also be used. Do not add the medicine to your baby’s bottle.
     
    Preschoolers: Use chewable tablets (80 mg) or liquid form of medicine.
    • You can give the liquid by an oral medicine syringe, medicine spoon or medicine cup that comes with the liquid. Always measure to get the correct dose the doctor told you to give.
    • Some preschoolers do not like to take medicine. It may help to offer an ice pop to numb the tongue right before you give the medicine.
    • Do not force feed medicine to your child. This can cause choking. Sometimes it helps to just wait a few minutes until your child is calm.
    • Pretending to give medicine to your child’s favorite doll or stuffed animal may improve cooperation.
    • Never tell your child that medicine tastes like candy.
     
    Children 6-12 years of age: Junior strength chewable caplets (160 mg) or the liquid are the best choices.
    • Chewable tablets (80 mg) can also be used, but your child will need to take twice as many tablets to get the same dose.
     
    12 years of age and older: If your child is able to swallow pills, Regular Strength or Extra Strength caplets or tablets are the best choice.
    • Junior strength chewable caplets (160 mg) can be used for older children who cannot swallow pills.
    • Do not give more than a total of 3 grams of acetaminophen per day for this age group.
    • 3 grams is equal to 3,000 mg.
    • Two Regular Strength caps provide 650 mg of acetaminophen.
    • Extra Strength caps are each 500 mg. Two Extra Strength caps equal 1 gram or 1,000 mg. If you are giving your child two Extra Strength, wait six hours before you give another dose.
    • Give your child the lowest dose of acetaminophen that relieves his pain or fever.
    • If your child has a feeding tube you will use the liquid as instructed by the doctor.
     
    Suppositories: If your child is vomiting you may need to use suppositories instead of giving the medicine by mouth. Suppositories are for rectal use only. Suppositories come in 80, 120, 525 and 650 mg strengths. Read the package to determine the correct strength for your child. 
    • Wash your hands. Make sure the nail of the finger you will use to insert the suppository has been trimmed. Use your pinky finger for infants and small children or your index finger for older children.
    • Remove the wrapper.
    • Wet the suppository with warm water. Wet your finger with warm water.
    • Have your child lie on his left side with right leg slightly bent. ◦ Insert the suppository 1 inch into your child’s rectum.
    • Hold the buttocks together for one minute if your child is too young to understand that it should not be pushed out. This helps the medicine to be absorbed.
    • Wash your hands.  

Important Safety Measures

  • Keep all medicines out of reach of children and pets.
  • Measuring liquid medicine correctly is very important. Liver damage can occur if your child receives too much acetaminophen. If a measuring device did not come with your medicine, ask your pharmacist to give you one.
  • Do not give your child other medicines that contain acetaminophen without the approval of your doctor. Many over-the-counter cough and cold products and prescription combination pain medications (for example, Tylenol with Codeine, Lortab Elixir) contain acetaminophen. Giving medicines that contain acetaminophen could cause an overdose. Read all labels carefully and ask your child’s doctor or pharmacist if you are not sure.
  • Some acetaminophen products can contain phenylalanine. If you child has PKU talk to your doctor before you give this medicine.
  • Anemia may occur when children with G6PD deficiency take acetaminophen. Talk to your doctor.
  • If you suspect an overdose, call the poison control center immediately.

When should I call the doctor?

  • If your child’s symptoms seem to be getting worse instead of getting better
  • If your child gets a rash
  • Call immediately if your child is having any of these signs of a serious allergic reaction:
    • Wheezing
    • Chest tightness
    • Gray-blue skin color
    • Itching
    • Swelling of the face, lips, tongue, or throat
    • Unusual behavior  

Disclaimer:This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.

Reviewed: 08/2011

(757) 668-7000