Pediatric Medication Dosage 2026: Acetaminophen, Ibuprofen, Amoxicillin (Quick Reference)
By the 3Tej Research Desk · Published May 23, 2026 · 3 min read
- Acetaminophen: 10 to 15 mg/kg every 4 to 6 hours, max 5 doses per 24 hours
- Ibuprofen: 5 to 10 mg/kg every 6 to 8 hours, NOT for infants under 6 months
- Amoxicillin: 45 to 90 mg/kg/day in 2 to 3 divided doses, indication-dependent
- ALWAYS use WEIGHT, not age, for pediatric dosing
- Use the syringe or cup that came with the medication; kitchen spoons are not accurate
Pediatric medication dosing in 2026 is weight-based, not age-based. A 30-pound 2-year-old and a 30-pound 4-year-old should get the same dose. The three medications parents ask about most are acetaminophen (Tylenol), ibuprofen (Motrin, Advil), and amoxicillin. Getting these wrong is one of the most common and most serious medication errors in the home. This guide gives the standard weight-based math, the practical mL conversions, and the safety footnotes that pharmacists wish every parent knew.
Why weight, not age?
Children of the same age can vary 2x in weight. A small 4-year-old at 14 kg vs a large 4-year-old at 28 kg need very different doses of weight-based drugs. Age-based dosing tables (still on some old packaging) systematically under-dose large kids and over-dose small ones.
Always use weight in kilograms. To convert pounds to kg, divide by 2.2 (or multiply by 0.45). Many medication labels still show pounds; doing the conversion before dosing avoids unit-confusion errors.
Acetaminophen (Tylenol / paracetamol)
Dose: 10 to 15 mg per kg every 4 to 6 hours. Maximum 5 doses (75 mg/kg total) per 24 hours.
Standard children's liquid: 160 mg per 5 mL teaspoon. Infant drops are also 160 mg per 5 mL since 2011 in the US (formerly 80 mg/0.8 mL concentrate, which caused dangerous overdoses and was withdrawn).
| Child weight | Dose at 12.5 mg/kg | Volume (160 mg/5 mL) |
|---|---|---|
| 5 kg (11 lb) | 62.5 mg | 2 mL |
| 10 kg (22 lb) | 125 mg | 4 mL |
| 15 kg (33 lb) | 187 mg | 6 mL |
| 20 kg (44 lb) | 250 mg | 7.5 mL |
| 25 kg (55 lb) | 312 mg | 10 mL |
| 30 kg (66 lb) | 375 mg | 12 mL |
| 35 kg (77 lb) | 437 mg | 14 mL |
Acetaminophen is the LEADING cause of acute liver failure in US children. Never exceed 75 mg/kg/day. Watch out for combination cold medications that already contain acetaminophen; do NOT add another dose on top.
Ibuprofen (Motrin, Advil)
Dose: 5 to 10 mg per kg every 6 to 8 hours. Maximum 4 doses (40 mg/kg) per 24 hours.
Important: NOT recommended for infants under 6 months old.
Standard children's liquid: 100 mg per 5 mL teaspoon. Infant drops: 50 mg per 1.25 mL.
| Child weight | Dose at 7.5 mg/kg | Volume (100 mg/5 mL) |
|---|---|---|
| 7 kg (15 lb) | Do not use - under 6 mo | N/A |
| 10 kg (22 lb) | 75 mg | 3.75 mL |
| 15 kg (33 lb) | 112 mg | 5 mL |
| 20 kg (44 lb) | 150 mg | 7.5 mL |
| 25 kg (55 lb) | 187 mg | 10 mL |
| 30 kg (66 lb) | 225 mg | 11 mL |
| 35 kg (77 lb) | 262 mg | 13 mL |
Take ibuprofen with food. Risk of kidney injury in dehydrated children; if your child has had vomiting or diarrhea, prefer acetaminophen until rehydrated.
Amoxicillin
Dose depends on indication. For most ear infections and strep throat: 45 to 90 mg per kg per day, divided into 2 (every 12 hours) or 3 (every 8 hours) doses. Maximum daily: 4,000 mg in any pediatric scenario.
Standard concentrations: 250 mg/5 mL or 400 mg/5 mL. ALWAYS verify which concentration was dispensed; dosing volumes differ by 60%.
| Child weight | Daily dose at 80 mg/kg | Per dose (2x daily, 400 mg/5 mL) |
|---|---|---|
| 10 kg (22 lb) | 800 mg | 5 mL twice daily |
| 15 kg (33 lb) | 1,200 mg | 7.5 mL twice daily |
| 20 kg (44 lb) | 1,600 mg | 10 mL twice daily |
| 25 kg (55 lb) | 2,000 mg | 12.5 mL twice daily |
| 30 kg (66 lb) | 2,400 mg | 15 mL twice daily |
| 35 kg (77 lb) | 2,800 mg | 17.5 mL twice daily |
Complete the full course (typically 5 to 10 days), even if symptoms resolve early. Stopping early increases the risk of recurrence and antibiotic resistance.
Practical tips that prevent overdose
- Always use the dispenser that came with the medication. Kitchen teaspoons range 3 to 7 mL; medication teaspoons are 5 mL exactly. Off by 40% in either direction is common with kitchen spoons.
- Verify the concentration on the bottle. Amoxicillin comes in 250 mg/5 mL and 400 mg/5 mL. Acetaminophen liquid is now uniformly 160 mg/5 mL but older bottles may differ. Read the label every time.
- Log doses with time. Sleep-deprived parents giving a second dose 'about 6 hours ago' often miscount. Write the time on a piece of paper next to the medication bottle.
- Never combine acetaminophen with combination cold meds. Most contain acetaminophen already. Read the active ingredients list on every box.
- Call Poison Control (1-800-222-1222 in the US) for any suspected overdose. They are open 24/7, free, and the right resource even when you are not sure if it is an overdose.
Frequently asked questions
What is the right dose of children's Tylenol by weight?
10 to 15 mg per kg every 4 to 6 hours, maximum 5 doses per 24 hours. For a 20 kg (44 lb) child using standard 160 mg/5 mL liquid, that is 7.5 mL per dose. Always verify with the dosing chart on your bottle as concentrations have changed historically.
Can I give ibuprofen and acetaminophen at the same time?
Many pediatricians recommend alternating them (e.g., acetaminophen at noon, ibuprofen at 3 pm, acetaminophen at 6 pm) for sustained fever control. They work by different mechanisms and do not interact dangerously. Do NOT give both at the same time unless your pediatrician has specifically advised it.
How is amoxicillin dosed for ear infection?
Standard ear infection (acute otitis media) dose: 80 to 90 mg per kg per day, divided into 2 doses every 12 hours, for 10 days (under age 2) or 5 to 7 days (over age 2). High-dose protocol used to overcome resistant pneumococcus. Always verify with your pediatrician.
Is it safe to give ibuprofen to a baby?
Not under 6 months old. Acetaminophen is the only fever reducer approved for infants under 6 months. For ages 6 months and up, ibuprofen at standard pediatric doses is safe, but must be taken with food and is not recommended in dehydrated children.
How do I convert pounds to kg for dosing?
Divide pounds by 2.2 (or multiply by 0.45). A 33-lb child weighs about 15 kg. Always do this conversion FIRST before looking up a weight-based dose to avoid unit confusion. Many medication labels still show pounds; the dosing tables are in kilograms.
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