💊 Medical Blog — Medications
Common Paediatric Medications
in Singapore — A Doctor's Guide
👨⚕️ Dr Joel
⏱ 8 min read
📅 Updated 2025
🏪 Available at Watsons & Guardian
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⚠️ Medical disclaimer: This article is for educational purposes only. Doses listed are general guidelines — always verify against the specific product label, your child's current weight, and consult your doctor or pharmacist if in doubt. Do not self-medicate if your child is seriously unwell.
Every parent in Singapore has stood in the Watsons or Guardian aisle at 10pm, feverish toddler on hip, staring at a wall of brightly coloured syrups and wondering what to grab. As a paediatrician and a parent myself, I want to walk you through the medications I actually recommend — what they're for, which brands to look for, and how to dose them safely by your child's weight.
The golden rule: dose by weight, not age. Age-based dosing is a rough guide at best — a tall, heavy 4-year-old and a petite 4-year-old need very different doses of the same medication.
1. Paracetamol — For Fever & Pain
Paracetamol is the first-line medication for fever and mild-to-moderate pain in children of all ages, including newborns. It is safe, effective, and well-tolerated when used at the correct dose.
- Use for: Fever (≥38°C), mild to moderate pain (teething, ear ache, post-vaccination soreness)
- Safe from: Birth (newborns with fever still need to see a doctor regardless)
- Dose: 15 mg/kg/dose (range: 10–15 mg/kg)
- Frequency: Every 4–6 hours as needed, maximum 4 doses in 24 hours
- Max daily dose: 60 mg/kg/day or 4g/day (whichever is lower)
- Onset: 30–60 minutes; Duration: 4–6 hours
📊 Dosing Table — Panadol Children's Syrup (120 mg / 5 ml)
This is the standard children's formulation — the most widely available at Watsons and Guardian.
| Weight (kg) |
Approx. Age |
Dose (mg) |
Volume (120mg/5ml) |
Frequency |
| 4–6 kg | 0–3 months | 60–90 mg | 2.5–3.75 ml | Every 4–6h (max 4×/day) |
| 6–8 kg | 3–9 months | 90–120 mg | 3.75–5 ml | Every 4–6h (max 4×/day) |
| 8–10 kg | 9–18 months | 120–150 mg | 5–6.25 ml | Every 4–6h (max 4×/day) |
| 10–13 kg | 18m–3 years | 150–195 mg | 6.25–8 ml | Every 4–6h (max 4×/day) |
| 13–18 kg | 3–5 years | 195–270 mg | 8–11.25 ml | Every 4–6h (max 4×/day) |
| 18–25 kg | 5–8 years | 270–375 mg | 11.25–15 ml | Every 4–6h (max 4×/day) |
📊 Dosing Table — Panadol Children's Syrup (250 mg / 5 ml)
Higher-concentration formulation — suitable for older/heavier children (typically 6 years+). Always check the label.
| Weight (kg) |
Approx. Age |
Dose (mg) |
Volume (250mg/5ml) |
Frequency |
| 18–22 kg | 5–7 years | 270–330 mg | 5.5–6.5 ml | Every 4–6h (max 4×/day) |
| 22–27 kg | 7–9 years | 330–405 mg | 6.5–8 ml | Every 4–6h (max 4×/day) |
| 27–33 kg | 9–11 years | 405–495 mg | 8–10 ml | Every 4–6h (max 4×/day) |
| >33 kg | 11+ years | 500 mg (max dose) | 10 ml | Every 4–6h (max 4×/day) |
💡 Doctor's Tip
Always use the measuring syringe that comes with the bottle — never a kitchen spoon. A teaspoon is not a standardised measurement. For small infants, draw up the dose in the syringe and squirt gently into the side of the mouth in small amounts.
⚠️ Paracetamol Safety — Important
- Do not exceed 4 doses in 24 hours or give more frequently than every 4 hours
- Check for paracetamol in combination cold/flu products — double-dosing is a common and dangerous mistake
- Paracetamol overdose causes liver damage — if you suspect an overdose, go to A&E immediately
- Paracetamol does not treat the underlying infection — it only reduces fever and pain
2. Ibuprofen — For Fever & Inflammation
Ibuprofen is an NSAID (non-steroidal anti-inflammatory drug). It is more effective than paracetamol for fever reduction and has the added benefit of reducing inflammation (useful for ear infections, sore throats, and post-procedure pain). It is safe from 3 months of age.
- Use for: Fever, pain with inflammation (ear infection, sore throat, dental pain, post-vaccination)
- Safe from: 3 months of age and ≥5 kg body weight
- Dose: 7.5–10 mg/kg/dose
- Frequency: Every 6–8 hours as needed, maximum 3 doses in 24 hours
- Onset: 30–60 minutes; Duration: 6–8 hours (longer than paracetamol)
- Give with food or milk to reduce stomach upset
📊 Dosing Table — Nurofen for Children (100 mg / 5 ml)
| Weight (kg) |
Approx. Age |
Dose (mg) |
Volume (100mg/5ml) |
Frequency |
| 5–7.5 kg | 3–6 months | 50 mg | 2.5 ml | Every 6–8h (max 3×/day) |
| 7.5–10 kg | 6–12 months | 75 mg | 3.75 ml | Every 6–8h (max 3×/day) |
| 10–13 kg | 1–3 years | 100 mg | 5 ml | Every 6–8h (max 3×/day) |
| 13–18 kg | 3–5 years | 125–150 mg | 6.25–7.5 ml | Every 6–8h (max 3×/day) |
| 18–25 kg | 5–8 years | 175–200 mg | 8.75–10 ml | Every 6–8h (max 3×/day) |
| 25–35 kg | 8–12 years | 250–300 mg | 12.5–15 ml | Every 6–8h (max 3×/day) |
Paracetamol vs Ibuprofen — When to Use Which?
| Situation | Preferred Choice | Reason |
|---|
| Baby under 3 months | Paracetamol only | Ibuprofen not safe under 3 months |
| Mild fever, otherwise well | Either | Both equally effective at standard doses |
| High fever (≥39°C) | Ibuprofen preferred | More potent antipyretic effect |
| Ear infection / sore throat pain | Ibuprofen preferred | Anti-inflammatory benefit helps more |
| Post-vaccination soreness | Paracetamol | Ibuprofen may blunt vaccine immune response |
| Vomiting or stomach upset | Paracetamol | Ibuprofen can worsen GI symptoms |
| Child with asthma | Paracetamol | Ibuprofen can trigger asthma in some children |
| Dehydration or reduced urine | Paracetamol | Ibuprofen can affect kidney function when dehydrated |
💡 Can I alternate paracetamol and ibuprofen? Yes — this is a common and effective strategy for high fevers in children over 3 months. Give one, wait 3–4 hours, then give the other if still needed. This allows 24-hour fever coverage without exceeding the maximum dose of either drug. Discuss with your pharmacist or doctor first.
3. Antihistamines — For Allergy, Itch & Runny Nose
Antihistamines block histamine receptors and are used for allergic conditions — allergic rhinitis (hay fever/dust mite allergy), urticaria (hives), insect bite reactions, and allergic conjunctivitis. There are two generations: older ones cause drowsiness (sometimes useful at night), newer ones are non-drowsy.
- Concentration: 2 mg / 5 ml
- Use for: Allergic reactions, hives, itchy rashes, allergic runny nose. The drowsiness can help children sleep at night during allergic flares.
- Safe from: 1 year (use under 2 years with caution and medical guidance)
- Dose: 0.1 mg/kg/dose (max 4 mg)
- Frequency: Every 4–6 hours (max 4 doses/day)
- Note: Causes sedation in most children — avoid during the day if possible; may cause paradoxical excitability in some toddlers
📊 Piriton Syrup Dosing (2 mg / 5 ml)
| Age | Dose | Volume | Frequency |
|---|
| 1–2 years | 1 mg | 2.5 ml | Twice daily (with medical guidance) |
| 2–5 years | 1 mg | 2.5 ml | Every 4–6 hours as needed |
| 6–12 years | 2 mg | 5 ml | Every 4–6 hours as needed |
- Concentration: 5 mg / 5 ml
- Use for: Allergic rhinitis (dust mite allergy very common in Singapore!), chronic urticaria, allergic conjunctivitis. My preferred choice for daytime allergy management.
- Safe from: 2 years
- Frequency: Once daily (long-acting)
📊 Zyrtec / Cetirizine Dosing (5 mg / 5 ml)
| Age | Dose | Volume | Frequency |
|---|
| 2–6 years | 2.5 mg | 2.5 ml | Once daily (evening preferred) |
| 6–12 years | 5 mg | 5 ml | Once daily |
| 12+ years | 10 mg | 10 ml (or 1 tablet) | Once daily |
- Concentration: 5 mg / 5 ml
- Use for: Same as cetirizine. Alternative if cetirizine causes any drowsiness (rare).
- Safe from: 2 years
📊 Clarityne / Loratadine Dosing (5 mg / 5 ml)
| Age / Weight | Dose | Volume | Frequency |
|---|
| 2–12 years, <30 kg | 5 mg | 5 ml | Once daily |
| ≥12 years or >30 kg | 10 mg | 10 ml (or 1 tablet) | Once daily |
4. Nasal & Cold Remedies
Most colds in children are viral and self-limiting — they resolve in 7–10 days. There is no cure. The goal is comfort. Here is what actually helps:
- Use for: Blocked nose from any cause — cold, allergy, or dry air (very common with Singapore air-conditioning)
- Safe from: Birth — completely safe, no medication involved
- How to use: 2–3 drops or 1–2 sprays per nostril, 3–4 times daily. Use before feeding in infants. Can be used as frequently as needed.
- Why it works: Thins secretions, moisturises the nasal passage, and helps clear mucus physically
- ✅ My first recommendation for any child with a blocked nose — before any medication
⚠️ Cough and Cold Syrups in Young Children
- The WHO, AAP, and HSA advise against using cough and cold syrups in children under 6 years old
- Products like decongestants (pseudoephedrine), cough suppressants (dextromethorphan), and expectorants have not been proven effective in young children
- They carry risks of side effects including heart arrhythmias, seizures, and sedation
- For children under 6 with a cough: saline, hydration, honey (1 year+), and time are more effective and safer
- Studies show honey is as effective as dextromethorphan (standard cough syrup) for reducing cough frequency and improving sleep in children
- Dose: ½ teaspoon (2.5ml) for children 1–5 years; 1 teaspoon (5ml) for 6–11 years — given 30 minutes before bed
- ⚠️ Never give honey to children under 1 year — risk of infant botulism
5. Tummy Medications
- Use for: Diarrhoea and/or vomiting — the most important thing you can give a sick child with gastroenteritis
- Safe from: Birth
- How to use: Small, frequent sips — even 5–10 ml every 5 minutes is enough to start. Increase as tolerated. Continue breastfeeding.
- Why not plain water? Plain water doesn't replace the electrolytes lost in diarrhoea. ORS is specifically formulated to match what the gut can absorb during illness.
- Avoid: Sports drinks (too much sugar), fruit juice, soft drinks — these can worsen diarrhoea
- ✅ Every Singapore household with young children should have a box of ORS in the medicine cabinet
- Use for: Infant colic, wind, and bloating. Works by breaking up gas bubbles in the gut.
- Safe from: Birth — not absorbed into the bloodstream
- Dose: Usually 0.3–1 ml per dose given before or after feeds — follow the product label
- Honest note: Evidence for simethicone in infantile colic is mixed — some babies respond well, others don't. It's safe to try. If no response after 1 week, discuss other strategies with your PD.
- Use for: Reducing duration and severity of infectious diarrhoea (gastroenteritis), antibiotic-associated diarrhoea
- Evidence: Strongest evidence is for Lactobacillus rhamnosus GG (Culturelle) and Saccharomyces boulardii (Lacteol Fort) reducing duration of viral gastroenteritis by 1–1.5 days
- Safe from: Birth (specific strains — check packaging)
- Dose: Follow product instructions; give alongside, not as a substitute for, ORS
- Use for: Acute infectious diarrhoea — acts as an adsorbent, binding bacteria and toxins in the gut
- Safe from: Birth
- Dose: 1 sachet per day (under 1 year); 1–2 sachets per day (1–2 years); 2–3 sachets per day (over 2 years). Dissolve in 50 ml of water or formula.
- Note: Commonly prescribed by Singapore GPs for childhood diarrhoea. Available OTC at pharmacies.
6. Topical Creams & Lotions
- Use for: Chickenpox, heat rash, insect bites, mild sunburn — any itchy, irritated skin
- Safe from: Birth
- How to use: Apply a thin layer to affected area 3–4 times daily. Let dry before dressing. Shake well before use.
- Provides a soothing, cooling effect. Does not cure the rash but reduces the urge to scratch significantly.
- Use for: Mild eczema flares, contact dermatitis, insect bite reactions with significant swelling/redness
- Safe from: 2 years for OTC use (younger with doctor guidance)
- How to use: Apply thin layer to affected area twice daily for maximum 7 days
- ⚠️ Do NOT use on: Face (especially around eyes), groin/nappy area, broken skin, or infected skin
- ⚠️ Do NOT use long-term — prolonged use causes skin thinning. See a doctor if eczema is not controlled with short courses.
- Use for: Minor cuts, grazes, and superficial wounds
- Key principle: The most important step is thorough washing with soap and water — antiseptic cream is secondary
- For infected wounds (increasing redness, warmth, pus, spreading) — see a GP for antibiotic cream or oral antibiotics
7. Medications to NEVER Give Children
🚫 Do NOT Give These to Children
- Aspirin (Aspirin, Disprin) — risk of Reye's syndrome, a rare but potentially fatal brain and liver condition. Never give aspirin for fever or pain in anyone under 16.
- Adult ibuprofen or paracetamol tablets — safe at the correct dose but extremely easy to accidentally overdose. Use children's formulations only.
- Cough and cold syrups in under-6s — no proven benefit, real risk of harm (see above)
- Ibuprofen in infants under 3 months — immature kidney function, safety not established
- Codeine-containing medications (e.g., some prescription cough syrups) — banned in children under 12 in Singapore and many countries due to risk of respiratory depression
- Honey in infants under 1 year — risk of infant botulism
- Any medication prescribed for another child or adult — even the same drug at a different dose/formulation can be dangerous
Building Your Home Medicine Cabinet
Here is my recommended starter kit for Singapore parents with young children:
✅ Home Medicine Cabinet Essentials
- 💊 Paracetamol syrup (Panadol Children's 120mg/5ml) + oral syringe
- 💊 Ibuprofen syrup (Nurofen for Children) — for children 3 months+
- 💧 ORS sachets (Hydralyte or Pedialyte)
- 💧 Saline nasal drops/spray (Sterimar Baby or Physiomer)
- 🧴 Calamine lotion
- 🩹 Digital thermometer (axillary or tympanic)
- 🩹 Wound care: sterile gauze, plasters, Savlon or equivalent
- 🧫 Antihistamine syrup (Cetirizine or Loratadine) for allergy-prone children
💡 Doctor Dad's Final Tip
Know your child's current weight. Stick a Post-It note with their latest weight inside the medicine cabinet — it makes middle-of-the-night dosing so much less stressful. And always, always use the measuring syringe that comes with the bottle.
References & Further Reading:
1. Ministry of Health Singapore — MOH Clinical Practice Guidelines
2. Health Sciences Authority Singapore (HSA) — Consumer Medication Information
3. American Academy of Pediatrics (AAP) — Fever and Antipyretic Use in Children, 2024
4. WHO — ORS Formulation and Management of Childhood Diarrhoea
5. MIMS Singapore — Paediatric Drug Reference
6. Paul IM et al. "Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children." Archives of Pediatrics & Adolescent Medicine, 2007.
Always verify dosing with the specific product label and your child's healthcare provider. Information correct as of 2025.