Fever and chills are your body’s built-in defense against infection, and most cases can be managed at home with a combination of over-the-counter medication, fluids, and basic comfort measures. An oral temperature of 100°F (37.8°C) or higher counts as a fever. The chills that come with it feel miserable, but they’re actually your muscles generating heat on purpose. Here’s how to get through it.
Why Fever and Chills Happen Together
When your immune system detects an infection, it sends chemical signals to the brain’s temperature control center in the hypothalamus. That center essentially raises your body’s thermostat to a new, higher set point. Your brain now treats your normal 98.6°F body temperature as “too cold,” and it responds the same way it would if you stepped outside in winter: it makes you shiver.
Shivering is involuntary muscle contractions designed to produce heat. Your body also constricts blood vessels near the skin to conserve warmth, which is why you may feel cold and pale even while your core temperature is climbing. Once your temperature reaches the new set point, the chills typically stop and you feel hot instead. When the fever breaks (either naturally or with medication), the set point drops back down, and you start sweating to shed the extra heat.
Over-the-Counter Fever Reducers
Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) are the two main options. Both lower fever effectively, and choosing between them mostly comes down to personal tolerance. Ibuprofen also reduces inflammation, which can help if you’re dealing with body aches alongside the fever. The daily ceiling for acetaminophen is 4,000 milligrams, and for ibuprofen it’s 1,200 milligrams for adults and children over 12.
If one medication alone isn’t controlling the fever well enough, you can alternate between the two. The key is spacing them out: take one, then wait four to six hours before taking the other. You can continue rotating every three to four hours throughout the day. Write down each dose and the time you took it so you don’t accidentally double up or exceed the daily limit for either drug. If you find yourself alternating for more than three days straight, that’s a signal to check in with a healthcare provider. For children under 12, the same alternating approach can work, but dosing is based on body weight, so confirm amounts with a pediatrician first.
Staying Hydrated
Fever increases fluid loss through sweating, faster breathing, and the metabolic demands of running a higher temperature. Dehydration can sneak up on you quickly, especially if you’re also dealing with vomiting or diarrhea. Water is fine for most adults, but if you’re not eating much, drinks with electrolytes (sports drinks, broth, or oral rehydration solutions) help replace sodium and potassium you’re losing.
Don’t wait until you feel thirsty. Sip small amounts frequently rather than trying to gulp a full glass at once, particularly if nausea is an issue. Good signs that you’re keeping up with fluids include urinating regularly, having light-colored urine, and a moist mouth. For young children, breast milk, formula, or a pediatric electrolyte solution are the best options. Signs of improvement include increased activity, better appetite, and more frequent wet diapers.
Comfort Measures That Actually Help
Remove excess layers of clothing and blankets. This feels counterintuitive when you’re shivering, but piling on heavy covers traps heat and can push your temperature higher. A single light blanket during the chills phase is reasonable; once the shivering stops and you feel warm, strip back to light clothing.
Keep the room cool and well-ventilated. A fan circulating air or a slightly open window can make a meaningful difference. Tepid sponging (using lukewarm, not cold, water on the forehead, neck, and arms) can bring temperature down relatively quickly through direct skin contact. Replace the cloths every 30 minutes or so to keep them effective. Avoid ice baths or very cold water. These can trigger intense shivering, which is your body’s attempt to raise its temperature back up, working against what you’re trying to accomplish. The resulting vasoconstriction actually traps heat in your core rather than letting it dissipate.
Rest matters more than it might seem. Your immune system consumes enormous energy fighting an infection, and physical activity generates additional heat your body then has to manage. Lying down in a cool, comfortable room gives your body the best conditions to do its job.
Fever and Chills in Children
Children spike fevers more easily and more often than adults, and parental instinct is to bring the number down as fast as possible. The temperature itself, though, isn’t usually the danger. How the child looks and acts matters more than the number on the thermometer. A child with 102°F who is still drinking fluids and somewhat alert is generally in better shape than a child with 100.5°F who is limp and unresponsive.
The one firm rule involves very young infants. Any baby younger than 3 months with a rectal temperature of 100.4°F (38°C) or higher needs immediate medical evaluation. Their immune systems are immature, and serious infections can progress quickly with few obvious symptoms. For older babies and toddlers, focus on keeping them hydrated, dressed lightly, and comfortable. Pediatric doses of acetaminophen or ibuprofen (ibuprofen only for babies 6 months and older) can help, but always dose by weight rather than age.
When Fever and Chills Need Medical Attention
Most fevers from common infections resolve within three to five days. Certain symptoms alongside a fever signal something more serious:
- Stiff neck combined with headache and light sensitivity, which can indicate meningitis
- Confusion, difficulty staying awake, or unusual irritability, particularly in older adults or young children
- A rash that doesn’t fade when you press on it, sometimes called a non-blanching rash, which can suggest a blood infection
- Difficulty breathing or chest pain, which may point to pneumonia or another lung infection
- Severe abdominal pain, especially with fever, which could indicate appendicitis or another surgical condition
- No improvement after three days or a fever that goes away and then returns
- Temperature above 103°F (39.4°C) that doesn’t respond to medication
People with weakened immune systems (from chemotherapy, organ transplant medications, or conditions like HIV) should treat any fever as potentially urgent, since their bodies may not mount the usual visible signs of a serious infection.
What Not to Do
A few common responses to fever and chills can actually make things worse. Bundling up in heavy blankets during chills traps heat. Rubbing alcohol baths, an old home remedy, can cause dangerous drops in temperature and alcohol absorption through the skin. Aspirin should never be given to children or teenagers with a fever, as it’s linked to Reye’s syndrome, a rare but serious condition affecting the liver and brain. Skipping fluids because you “don’t feel like drinking” is one of the fastest routes to dehydration when you’re febrile. Even a few sips every 15 minutes adds up over the course of a day.