How close together can you take tylenol and ibuprofen

Drug information provided by: IBM Micromedex

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. Large amounts of acetaminophen may cause liver damage if taken for a long time.

Follow the instructions on the medicine label if you are using this medicine without a prescription.

You may take this medicine with milk or food to avoid stomach upset.

Do not drink 3 or more alcoholic drinks while you are using this medicine. Drinking alcoholic beverages while taking this medicine may increase your risk of liver damage and stomach bleeding.

This combination medicine contains acetaminophen (Tylenol®). Carefully check the labels of all other medicines you are using, because they may also contain acetaminophen. It is not safe to use more than 4 grams (4,000 milligrams) of acetaminophen in one day (24 hours).

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):
  • For minor aches and pains:
    • Adults and children 12 years of age and older—2 tablets every 8 hours as needed. Each tablet contains 250 milligrams (mg) acetaminophen and 125 mg ibuprofen. Do not take more than 6 tablets per day.
    • Children younger than 12 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Portions of this document last updated: Nov. 01, 2022

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When your child is sick, you'll probably reach for one of two medicine cabinet mainstays: acetaminophen or ibuprofen. Both effectively relieve pain and reduce fever, but they operate differently, so it can be difficult to know which one to choose. As it turns out, depending on the severity of your child's symptoms, some pediatricians will advise you not to choose at all. That's because alternating between ibuprofen (Advil or Motrin) and acetaminophen (Tylenol) may be the best way to treat serious symptoms. Here's what parents should know.

Can You Take Acetaminophen and Ibuprofen Together?

It's generally safe to take acetaminophen and ibuprofen together, as long as you follow proper dosing instructions. That's because the medications work differently in the body. They're also eliminated by different organs—the liver for acetaminophen and the kidneys for ibuprofen—so you don't need to worry about excess organ strain. The two medications don't cause additional side effects when taken together (though some kids might get an upset stomach).

What's more, multiple studies have shown increased effectiveness when taking acetaminophen and ibuprofen together. One reason is they have different mechanisms of action at the cellular level, explains Bande Mangaliso Virgil, M.D., a pediatric hospitalist at Piedmont Columbus Regional Hospital. "They are both fever reducers (antipyretics) and are helpful for pain (analgesia). However, the key difference is ibuprofen is also a more potent anti-inflammatory medication, helpful for swelling that occurs with fevers."

When Might You Alternate Between Acetaminophen and Ibuprofen?

Dr. Virgil says switching between acetaminophen and ibuprofen can help with fevers that aren't responsive to one of the medications alone—especially when the fever causes great discomfort, irritation, confusion, or lethargy.

"This can happen with high fevers associated with ear infections, significant viral infections like influenza, and bladder infections, to name a few," Dr. Virgil says. "Generally, it's easier to keep up with single medication dosing, but in the circumstances mentioned above, switching between the two may provide greater comfort and symptom and fever control."

Dr. Virgil recommends starting with one medication and waiting 30 minutes to see if the symptoms improve. If not, you can add in the second medication, following the safety tips outlined below.

How to Safely Switch Between Ibuprofen and Acetaminophen

Doubling up on pain medications must be done carefully. Katherine Kazmier, M.D., a pediatrician with Seattle Children's Hospital, says it's generally safe to give both medications at the same time every six hours (always following dosing instructions on the bottle). Your child can also alternate between them, taking one every three hours. "Although acetaminophen can [usually] be given every four hours, when alternating with ibuprofen we usually give it every six hours because it's simpler to alternate medications every three hours," says Dr. Kazmier.

To use both of these medications safely, always follow the correct dosage—and only combine them for a short period of time. "Both medications can have adverse effects when used at higher doses, so check the dose for your child's age and weight carefully, and check with your child's doctor if you're unsure," says Dr. Kazmier. She recommends keeping a written log of medications given, including the dosage and timing, to avoid accidentally mixing them up.

If your child is still miserable after a day of double dosing, it's time to check with their health care provider. "Your child is more likely to have adverse effects from the medications if they are dehydrated or if they have a serious infection, so if they are not drinking fluids well, having severe pain, or acting more sick than a typical childhood illness, please call your child's doctor for advice," says Dr. Kazmier.

Lastly, keep in mind that fever is usually not harmful. "In fact, it may be a helpful part of the immune response to infection, so I only recommend using acetaminophen or ibuprofen for comfort and to make them feel well enough to drink fluids and rest," says Dr. Kazmier. If your child acts playful or happy during a fever, they may not need any medicine at all.

The Bottom Line

It can be safe to take acetaminophen and ibuprofen together. Always follow proper dosing instructions, and take the minimum amount possible to reduce symptoms. Talk to your child's doctor for more information on safely using these medications.

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