Ibuprofen vs. Acetaminophen for Pain and Fever in Infants

Some doctors prefer ibuprofen for treating fever and pain in babies; others use acetaminophen. A new review of studies has found that ibuprofen may be marginally more effective.

Researchers combined data from 19 studies including more than 240,000 children under 2 years old that compared acetaminophen (Tylenol and generics) with ibuprofen (Advil, Motrin and other brands) for safety and effectiveness. The analysis is in JAMA Network Open.

Ibuprofen was slightly more effective in reducing fever between four and 24 hours after being administered, and there was moderate quality evidence that ibuprofen was also more effective after that. Neither drug was more effective than the other in reducing fever within four hours of administration.

Ibuprofen was associated with better pain reduction from four to 24 hours after it was given, and there was weak evidence that it was more effective than acetaminophen after that.

Some experts have suggested that acetaminophen could be associated with an increased risk for asthma, and ibuprofen with an increased risk for kidney problems, but this review found few serious side effects from either drug, and there were some studies that found no side effects at all.

“Actually both these medicines are very safe in young children,” said the senior author, Dr. Stuart R. Dalziel, a professor of pediatrics at the University of Auckland in New Zealand. “I give my kids ibuprofen, which is potentially associated with less asthma, and may be more effective in pain relief.”

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