# Teething Pain

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: NICE Clinical Knowledge Summaries Teething 2020 · MSF Essential Drugs 2024 - paracetamol (oral) · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · StatPearls: Ibuprofen (NCBI Bookshelf NBK542299)
- Verified date: 2026-08

## Verified against

- MSF Essential Drugs 2024 - paracetamol (oral)
- Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560)
- MSF Essential Drugs 2024 (ibuprofen oral monograph)

## Treatment metadata

- Paracetamol — 120 mg — oral.liquid
- Ibuprofen — 100 mg — oral.liquid

## Complete treatment card

```text
TEETHING PAIN
Sources: NICE Clinical Knowledge Summaries Teething 2020 · MSF Essential Drugs 2024 - paracetamol
         (oral) · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · StatPearls: Ibuprofen
         (NCBI Bookshelf NBK542299)
Review status: REVIEWED against MSF Essential Drugs 2024 - paracetamol (oral), Ibuprofen 100 mg/5 ml
               SmPC section 4.2 (eMC product 4560), MSF Essential Drugs 2024
               (ibuprofen oral monograph)  (2026-08)

1. PARACETAMOL                                            [1st line]
   Adult    Not applicable - not applicable
   Peds     10-15 mg/kg/dose  [child max 500 mg]
            (Every 4-6 hours as needed; max 4 doses in 24 hours (infants >2
            months))
            3kg -> 30-45 mg/dose                    4kg -> 40-60 mg/dose
            5kg -> 50-75 mg/dose                    6kg -> 60-90 mg/dose
            7kg -> 70-105 mg/dose                   8kg -> 80-120 mg/dose
            9kg -> 90-135 mg/dose                   10kg -> 100-150 mg/dose
            11kg -> 110-165 mg/dose                 12kg -> 120-180 mg/dose
            13kg -> 130-195 mg/dose                 14kg -> 140-210 mg/dose
            15kg -> 150-225 mg/dose                 16kg -> 160-240 mg/dose
            17kg -> 170-255 mg/dose                 18kg -> 180-270 mg/dose
            19kg -> 190-285 mg/dose                 20kg -> 200-300 mg/dose
            21kg -> 210-315 mg/dose                 22kg -> 220-330 mg/dose
            23kg -> 230-345 mg/dose                 24kg -> 240-360 mg/dose
            25kg -> 250-375 mg/dose                 26kg -> 260-390 mg/dose
            27kg -> 270-405 mg/dose                 28kg -> 280-420 mg/dose
            29kg -> 290-435 mg/dose                 30kg -> 300-450 mg/dose
            31kg -> 310-465 mg/dose                 32kg -> 320-480 mg/dose
            33kg -> 330-495 mg/dose                 34kg -> 340-500 mg/dose (upper capped)
            35kg -> 350-500 mg/dose (upper capped)  36kg -> 360-500 mg/dose (upper capped)
            37kg -> 370-500 mg/dose (upper capped)  38kg -> 380-500 mg/dose (upper capped)
            39kg -> 390-500 mg/dose (upper capped)  40kg -> 400-500 mg/dose (upper capped)
            41kg -> 410-500 mg/dose (upper capped)  42kg -> 420-500 mg/dose (upper capped)
            43kg -> 430-500 mg/dose (upper capped)  44kg -> 440-500 mg/dose (upper capped)
            45kg -> 450-500 mg/dose (upper capped)  46kg -> 460-500 mg/dose (upper capped)
            47kg -> 470-500 mg/dose (upper capped)  48kg -> 480-500 mg/dose (upper capped)
            49kg -> 490-500 mg/dose (upper capped)  50kg -> 500 mg/dose (capped)
   Source   MSF Essential Drugs 2024 - paracetamol (oral)
   Why      Pediatric acute presentation.
   Caution  Try non-pharmacological measures first: a chilled teething ring and gentle gum massage.
            Do not attribute high fever (>38C), diarrhea, or systemic illness to teething.
            Avoid topical choline salicylate gels in children due to Reye syndrome risk.
            500 mg is the per-dose ceiling used here for a child. 1000 mg is the adult dose and does
            not belong in a weight calculation - the daily 60 mg/kg limit is the one that binds
            first in any case.
   Egypt    CETAMOL 120MG/5ML PEDIATRIC SYRUP 120 ML MEMPHIS                                8.50 EGP
            PARAGESIC BABY 120MG/5ML 120ML SUSP. AMRIYA                                    36.00 EGP
            PARAMOL 120MG/5ML SYRUP 125ML    MISR                36.00 EGP
            FEBRIMOL ORAL DROPS 20 ML        PHARCO               4.00 EGP
                -> ? strength differs, ? different route - not oral liquid
            THERA-LO 3.2G/100ML ORAL SUSP. 100 ML PHAROPHARMA                               5.00 EGP
                -> ? strength differs, ? different route - not oral liquid

2. IBUPROFEN                                              [2nd line]
   Adult    Not applicable - not applicable
   Peds     5-10 mg/kg/dose  [child max 400 mg]
            (Every 6-8 hours after food; infants >3 months (>5 kg). Child over
            3 months: 5 to 10 mg/kg 3 to 4 times daily, maximum 30 mg/kg
            daily. The suspension's own label caps pain-and-fever use lower
            still, at 20 mg/kg/day. Never exceed 400 mg in a single dose.)
            3kg -> 15-30 mg/dose                    4kg -> 20-40 mg/dose
            5kg -> 25-50 mg/dose                    6kg -> 30-60 mg/dose
            7kg -> 35-70 mg/dose                    8kg -> 40-80 mg/dose
            9kg -> 45-90 mg/dose                    10kg -> 50-100 mg/dose
            11kg -> 55-110 mg/dose                  12kg -> 60-120 mg/dose
            13kg -> 65-130 mg/dose                  14kg -> 70-140 mg/dose
            15kg -> 75-150 mg/dose                  16kg -> 80-160 mg/dose
            17kg -> 85-170 mg/dose                  18kg -> 90-180 mg/dose
            19kg -> 95-190 mg/dose                  20kg -> 100-200 mg/dose
            21kg -> 105-210 mg/dose                 22kg -> 110-220 mg/dose
            23kg -> 115-230 mg/dose                 24kg -> 120-240 mg/dose
            25kg -> 125-250 mg/dose                 26kg -> 130-260 mg/dose
            27kg -> 135-270 mg/dose                 28kg -> 140-280 mg/dose
            29kg -> 145-290 mg/dose                 30kg -> 150-300 mg/dose
            31kg -> 155-310 mg/dose                 32kg -> 160-320 mg/dose
            33kg -> 165-330 mg/dose                 34kg -> 170-340 mg/dose
            35kg -> 175-350 mg/dose                 36kg -> 180-360 mg/dose
            37kg -> 185-370 mg/dose                 38kg -> 190-380 mg/dose
            39kg -> 195-390 mg/dose                 40kg -> 200-400 mg/dose
            41kg -> 205-400 mg/dose (upper capped)  42kg -> 210-400 mg/dose (upper capped)
            43kg -> 215-400 mg/dose (upper capped)  44kg -> 220-400 mg/dose (upper capped)
            45kg -> 225-400 mg/dose (upper capped)  46kg -> 230-400 mg/dose (upper capped)
            47kg -> 235-400 mg/dose (upper capped)  48kg -> 240-400 mg/dose (upper capped)
            49kg -> 245-400 mg/dose (upper capped)  50kg -> 250-400 mg/dose (upper capped)
   Source   Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) for the adult dose: "The
            recommended dose is 200 mg-400 mg (10-20 ml), up to three times a day as required... do
            not take more than 1200 mg (60 ml) in any 24 hour period". That label's paediatric
            section gives weight bands and a 20 mg/kg/day pain-and-fever ceiling but states no mg/kg
            per dose, so the paediatric 5 to 10 mg/kg per dose is from MSF Essential Drugs 2024
            (ibuprofen oral monograph): "Child over 3 months: 5 to 10 mg/kg 3 to 4 times daily (max.
            30 mg/kg daily)".
   Why      Pediatric acute presentation.
   Caution  Take with or after milk feed to reduce stomach irritation.
            Avoid if child is dehydrated or vomiting.
            Use lowest effective dose for shortest duration.
            The 400 mg per-dose ceiling comes from the reference literature, not from the suspension
            label - that label's largest paediatric single dose is 200 mg. Below about 40 kg the
            weight calculation binds first and the ceiling never comes into it.
   Egypt    NOVA-PROFEN  100MG/5ML ORAL SUSP. 100ML SANOFI                                  2.25 EGP
            IBUPROFEN 100MG/5ML SUSP. 120 ML SEDICO               5.00 EGP
            MARCOFEN 100MG/5ML SUSP. 120ML   GLAXO SMITHKLINE     5.85 EGP
            MAFO 100MG/5ML SYRUP 100 ML      EIPICO              25.00 EGP
            IBUCALMIN 100MG/5ML SYRUP 120 ML MASH PREMIERE       28.00 EGP
            JUSPOLED 100MG/5ML SYRUP 120 ML  EGPI > JASPER...    31.00 EGP
            MEGAFEN-N 100MG/5ML SUSP. 120 ML RAMEDA              35.00 EGP
            BRUFEN 100MG/5ML SYRUP 150ML     KAHIRA > ABBO...    44.00 EGP
            BRUFEMOL-N SUSP. 60 ML           ARAB DRUG COM...     4.50 EGP
                -> ? strength differs, ? different route - not oral liquid
            IBUFEN 2% SUSP. 60ML             ALEXANDRIA           4.50 EGP
                -> ? strength differs, ? different route - not oral liquid

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

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Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement.

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