FEVER: DON'T ALTERNATE ACETAMINOPHEN AND IBUPROFEN

Fever may be the most common symptom why parents seek help from a health care provider. Even though fever is merely a symptom of an illness, its mere presence is enough to incite panic and fear for many parents. See our full explanation on fever and dosage charts.

Regimen for managing fever can include exposing a child to a lukewarm bath and/or administering anti-fever medications. Antifever medications may include acetaminophen (Tylenol or FeverAll suppositories), ibuprofen (Motrin or Advil). In recent times, it has become commonplace to administer these two medications in tandem alternating their use over a 3-4 hr period. For example, first a child may receive Tylenol and then 3-4 hours later receiving Motrin or Advil. This schedule for treating fever has been studied in only a few unsubstantiated clinical trials and the outcome of these trials is not enough to accept this as a safe method. The tandem use of these medications has not appeared in a few trials to lower fever more than the use of monotherapy (using acetaminophen or ibuprofen alone) anyway.

The science of using both of these medications is complex, however the medication and its broken down byproducts appear to concentrate in the kidneys. Of course for our littlest patients and for those with kidney compromise the synergistic use of these medications poses a major concern. Please refrain from alternating these medications in the future with your children.

Howard Rice, M.D.
Jennifer Hartman, CPNP
Town and Country Pediatrics
email: jenniferh@townandcountrypeds.com
phone: 773-929-2260
web: http://www.townandcountrypeds.com