The short answer
- Yes, it can be done safely: both medicines may be given together or alternately if each is given at the right dose for the child’s weight and within its own limits.
- Usually one is enough. Start with one; switch to (or add) the other only if your child is still distressed before the next dose is due.
- Limits: paracetamol up to 4 times in 24 hours (at least 4 hours apart); ibuprofen up to 3 times in 24 hours (at least 6 hours apart), from 3 months of age.
What paediatric guidelines say
The Royal Children’s Hospital Melbourne says giving both medicines at the same time or one after the other is considered safe if the package instructions are followed, but notes that for most everyday pain one medicine works as well as the other and is usually enough. The UK’s NICE guideline on fever in under-5s recommends not giving both at the same time routinely, and considering alternating only if the child’s distress persists or comes back before the next dose is due.
The reason for caution is practical: using two medicines makes dosing mistakes more likely, especially at night or when several people are caring for the child, and fever itself is not harmful. It is part of the body’s response to infection. Treat discomfort, not the number on the thermometer.
Doses for children
Children’s doses depend on weight (and the product’s age bands). Always use the measuring device that comes with the product and check the strength on the label, because liquids come in different concentrations.
|
Paracetamol (Panadol, Calpol, Dymadon) |
Ibuprofen (Nurofen for Children, Calprofen) |
| From what age |
From birth; ask a doctor for babies under 1 month (UK products: from 2 months) |
From 3 months and at least 5 kg |
| Usual dose |
Weight-based (commonly 15 mg/kg) |
Weight-based (commonly 5–10 mg/kg) |
| How often |
Every 4–6 hours |
Every 6–8 hours |
| Max in 24 hours |
4 doses |
3 doses |
| With food? |
Not needed |
With food or milk if possible |
| See a doctor if needed for more than |
48 hours |
48 hours |
Check the strength. Infant drops, 120 mg/5 mL and 240–250 mg/5 mL paracetamol liquids, and 100 mg/5 mL or 200 mg/5 mL ibuprofen liquids are all on sale. Mixing them up is a common cause of overdose. Never give adult tablets to a child unless the product is labelled for their age. Don’t give aspirin to anyone under 16.
How to alternate if you need to
If your child is still uncomfortable two or three hours after one medicine, you can give the other. A written log prevents mistakes:
| Time |
Medicine and dose |
Next allowed |
| 08:00 |
Paracetamol (dose for weight) |
Paracetamol from 12:00 |
| 11:00 |
Ibuprofen (dose for weight), with a snack |
Ibuprofen from 17:00 |
| 14:00 |
Paracetamol |
Paracetamol from 18:00 |
Stop the second medicine once your child is comfortable. For adults, see how far apart to take Nurofen and Panadol.
When to avoid ibuprofen in children
- Vomiting, diarrhoea or not drinking (dehydration plus ibuprofen can harm the kidneys).
- Chickenpox (linked to serious skin infections).
- Asthma that has worsened with ibuprofen before.
- Kidney problems, or a bleeding disorder.
- Babies under 3 months or under 5 kg.
When to see a doctor
Get medical advice for a baby under 3 months with a temperature of 38 °C or more, a child who is drowsy, floppy, hard to wake, has a rash that doesn’t fade when pressed, trouble breathing, signs of dehydration (few wet nappies), a fit, or pain or fever lasting more than 48 hours. If you think too much medicine was given, call the Poisons Information Centre (Australia 13 11 26), NHS 111 (UK) or Poison Control (US 1-800-222-1222) straight away.
Frequently asked questions
Can I give Calpol two hours after Nurofen?
Yes, if your child is still distressed and hasn’t had paracetamol in the last 4 hours, you can give Calpol (paracetamol) two hours after Nurofen. Keep each medicine within its own daily limit and write down the times.
Can babies have Nurofen and Calpol together?
Ibuprofen is only for babies over 3 months and 5 kg. Under that age, ask a doctor before giving any medicine for fever, and see a doctor promptly for fever under 3 months.
Can I mix Calpol and Nurofen liquid in one spoon?
No. Measure and give each separately with its own syringe, so you know exactly how much of each was taken.
Can you give Piriton with Calpol?
Chlorphenamine (Piriton) and paracetamol (Calpol) don’t interact and are sometimes used together for itchy rashes with discomfort, at the right doses for age. Piriton can cause drowsiness; check the age limit on the pack.
Sources and further reading
CanforaMedicine Guide
