Biogesic or Advil? Paracetamol or ibuprofen? Filipino parents face this choice every time their child has a fever. This complete guide tells you exactly which to use, when, and at what dose — with a critical warning about dengue.
Critical: Never Give Ibuprofen for Dengue
If dengue is suspected, use paracetamol ONLY. Ibuprofen increases bleeding risk in dengue and can be life-threatening. During rainy season (June–November), when in doubt, use paracetamol.
| Paracetamol | Ibuprofen | |
|---|---|---|
| Generic name | Paracetamol / Acetaminophen | Ibuprofen |
| Philippine brand names | Biogesic, Tempra, Calpol, Panadol | Advil, Nurofen, Calprofen, Motrin |
| Minimum age | Any age (including newborns) | 6 months and older only |
| Dose | 10–15 mg/kg every 4–6 hours | 5–10 mg/kg every 6–8 hours |
| Maximum doses per day | 5 doses in 24 hours | 4 doses in 24 hours |
| Fever reduction | Effective | Slightly more effective, longer lasting |
| Pain relief | Mild to moderate pain | Mild to moderate pain + anti-inflammatory |
| Safe for dengue? | YES — first choice for dengue fever | NO — increases bleeding risk in dengue |
| Safe with stomach problems? | Yes — gentler on stomach | Use with food — can irritate stomach |
| Safe with kidney problems? | Generally yes | Avoid if kidney problems present |
| Safe with liver problems? | Avoid — processed by liver | Generally safer than paracetamol for liver |
| Overdose risk | Serious liver damage if overdosed | Kidney and stomach damage if overdosed |
Always dose by weight, not age. Doses are based on standard Philippine syrup concentrations (paracetamol 250mg/5mL, ibuprofen 100mg/5mL).
| Child's Weight | Paracetamol Dose | Ibuprofen Dose |
|---|---|---|
| 5 kg (newborn) | 50–75 mg (1 mL of 250mg/5mL syrup) | Not recommended under 6 months |
| 8 kg (4–6 months) | 80–120 mg (1.6–2.4 mL) | 40–80 mg (1–2 mL of 100mg/5mL syrup) |
| 10 kg (9–12 months) | 100–150 mg (2–3 mL) | 50–100 mg (2.5–5 mL) |
| 12 kg (1–2 years) | 120–180 mg (2.4–3.6 mL) | 60–120 mg (3–6 mL) |
| 15 kg (2–3 years) | 150–225 mg (3–4.5 mL) | 75–150 mg (3.75–7.5 mL) |
| 20 kg (4–5 years) | 200–300 mg (4–6 mL) | 100–200 mg (5–10 mL) |
| 25 kg (6–8 years) | 250–375 mg (5–7.5 mL) | 125–250 mg (6.25–12.5 mL) |
| 30 kg (9–10 years) | 300–450 mg (6–9 mL) | 150–300 mg (7.5–15 mL) |
* These are general guidelines. Always confirm dosing with your child's pediatrician. Weigh your child regularly — dosing based on outdated weight can lead to under- or over-dosing.
Q: Can I alternate paracetamol and ibuprofen?
A: The Philippine Pediatric Society (PPS) does not recommend routine alternating. Alternating increases the risk of dosing errors and accidental overdose. Use one medicine at the correct dose and interval. If fever is not controlled with one medicine, see a doctor.
Q: Which is better for dengue fever?
A: Always use paracetamol for dengue fever. Ibuprofen is an NSAID that inhibits platelet function and increases bleeding risk — which is extremely dangerous in dengue where platelet counts are already dropping. Never give ibuprofen if dengue is suspected.
Q: My child's fever is not going down with paracetamol. Should I switch to ibuprofen?
A: If paracetamol at the correct dose is not reducing fever after 1 hour, you can give ibuprofen (if the child is over 6 months and dengue is not suspected). However, if fever persists despite both medicines, see a doctor — the fever may need medical evaluation.
Q: What is the correct dose of Biogesic for my child?
A: Biogesic (paracetamol) dose is 10–15 mg per kg of body weight. For a 10 kg child: 100–150 mg every 4–6 hours. Biogesic syrup is 250 mg per 5 mL, so a 10 kg child needs 2–3 mL per dose. Always dose by weight, not age.
Q: Can I give adult paracetamol tablets to my child?
A: Only if you can accurately calculate and cut the dose. Adult paracetamol tablets are 500 mg each. For a 10 kg child needing 100–150 mg, you would need 1/4 to 1/3 of a tablet. It is much safer to use children's syrup where dosing is easier to measure accurately.
Q: Is it safe to give paracetamol every day for a week?
A: No. Paracetamol should not be given for more than 3 consecutive days without medical evaluation. If your child needs fever medicine for more than 3 days, see a doctor to identify the cause of the persistent fever.
Q: My child vomited after taking paracetamol. Should I give another dose?
A: If the child vomited within 15 minutes of taking the medicine, you can give another dose. If they vomited after 30 minutes, the medicine was likely absorbed — do not give another dose. Paracetamol suppositories (rectal) are an option for children who cannot keep oral medicine down.
Q: What should I do if I accidentally gave too much paracetamol?
A: Call the Philippine Poison Control Center at (02) 8524-1078 or go to the nearest ER immediately. Paracetamol overdose causes serious liver damage that may not be apparent for 24–72 hours. Do not wait for symptoms.
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