How the dose is calculated
Ibuprofen is dosed in mg/kg/day divided every 8 hours. Standard dosing covers analgesia and fever; the higher-dose regimen is used for anti-inflammatory indications such as juvenile idiopathic arthritis.
Typical dosing by indication
| Indication | Dose | Frequency | Max |
|---|---|---|---|
| Standard | 20 mg/kg/day | every 8h (3×/day) | 1200 mg/day |
| Higher-dose | 30 mg/kg/day | every 8h (3×/day) | 2400 mg/day |
Clinical use
- Ibuprofen is a first-line NSAID for pain and fever in children over 6 months, offering an alternative or adjunct to paracetamol, with the two sometimes alternated in refractory fever per local protocol.
- Avoid in dehydration, active or history of GI bleeding/ulceration, significant renal impairment, and in children under 6 months (or under 3 months per some product labels) unless specifically directed.
- Higher anti-inflammatory doses are used for conditions like juvenile idiopathic arthritis under specialist supervision, with attention to long-term GI and renal safety.
- Historic concern about NSAIDs worsening varicella (chickenpox) skin/soft-tissue infections means many clinicians prefer paracetamol first-line during active chickenpox, though the evidence is debated.
Frequently asked questions
Can ibuprofen be given with paracetamol?
Yes — they work by different mechanisms and are sometimes alternated or combined for better fever/pain control under medical guidance, but always track total doses of each separately to avoid exceeding either drug's daily maximum.
Is ibuprofen safe for babies?
It's generally avoided under 6 months of age (or 3 months per some product labelling) unless specifically directed by a clinician, and should not be used in a dehydrated child.
Why is ibuprofen avoided in dehydration?
NSAIDs like ibuprofen can reduce blood flow to the kidneys, which is riskier when a child is already dehydrated and has lower circulating blood volume — this can precipitate acute kidney injury.
Can ibuprofen be given during chickenpox?
Many clinicians prefer paracetamol first-line during active chickenpox because of a historical (though debated) concern that NSAIDs may be associated with more severe skin and soft-tissue infections in this setting.
References
- British National Formulary for Children (BNFc) — Ibuprofen.
- American Academy of Pediatrics. Clinical Report — Fever and Antipyretic Use in Children. Pediatrics.
- World Health Organization. Model Formulary — Ibuprofen.