Pain Management


  • Brand name: Tylenol
  • Given for pain or fever
  • May be inadequate for severe pain control
  • Given every four to six hours
  • May be given by mouth or rectally
  • Usually dosed at about 10 mg/kg
  • Metabolized by the liver


  • Brand names:  Motrin, Advil, Nuprin
  • Given for pain and fever
  • More potent pain and fever reliever
  • Every six to eight hours, effects last longer
  • Usually dosed at about 7 mg/kg
  • When taken regularly, can thin the blood or increase the time it takes bleeding to stop
  • Cleared by the kidneys

Acetaminophen and Hydrocodone

  • Brand names:  Lortab, Hycet
  • Given for severe pain
  • Every four to six hours
  • Hydrocodone is a synthetic form of codeine and a narcotic
  • It is usually dosed based on the hydrocodone at about 0.1 to 0.15mg/kg
  • It is important to note that each form contains different concentrations of acetaminophen
  • It can be very sedating and even causing breathing to be slow or be very shallow
  • Overdosing can lead to serious breathing problems or even respiratory arrest

Acetaminophen and Codeine

  • Brand name: Tylenol #3 Elixir
  • This medication is not used regularly by Frisco ENT for Children
  • The metabolism of this drug can be unpredictable in some patients leading to more sedation and respiratory depression

Maximal Pain Management

  • Best achieved by alternating Acetaminophen with ibuprofen every three to four hours.
  • May substitute the acetaminophen with acetaminophen/hydrocodone combination with ibuprofen also every three to four hours for persistent severe pain.
  • It is important to note the concentration of acetaminophen in the combination forms
  • When using the combination medication, sometimes the amount of acetaminophen in the concentration is too low.  If that is the case, additional acetaminophen can be supplemented for better pain control.  Only do this under the direction of your physician or their nurse.

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