Alternating anti-pyretics (Fever Medications) in Children

Jarrod Beachum, PA-C

Fever in children is a common occurrence that can cause great concern in parents. As a parent myself, knowing when and how to treat a fever can be confusing. In general, children are able to tolerate higher fevers than adults, and most pediatricians recommend allowing temperatures below 102°F to go untreated as long as the child is comfortable. Fever is a natural response by the body to kill invading pathogens, so stopping low-temperature fevers is actually making it harder for the body to protect itself.

One question I often get from parents is about alternating medicines. While there are no particular studies that show this is better than sticking with one medicine, it does have practice-based evidence of use. In general, pediatricians will recommend using just one medication, either acetaminophen or ibuprofen generally, which are just two types of anti-pyretics. A common brand of acetaminophen is Tylenol, and a common brand of ibuprofen is Motrin. Acetaminophen is normally dosed as 10 or 15 milligrams per kilogram of the child’s weight every four hours, while ibuprofen is dosed as 10 milligrams per kilogram every six hours. Again, it is perfectly fine and generally advised to pick one and stick with that, ensuring that the child is comfortable and drinking plenty of water.

So when do we recommend alternating? Well, alternating medicine is typically used when treating a higher or stubborn fever. Alternating means giving one medicine at the normal dose, and three hours later giving the other type of medicine at it’s normal dose. For example, if I gave my son 10 milliliters of Tylenol at 7 am, I would need to recheck his temperature at 10 am, and give him 10 milliliters of Motrin. It is important to keep a log of your child’s temperature readings, time and dosage of medications, and how your child is feeling. One reason for the log is to ensure you don’t accidentally give medicine too often, and the other is to give your provider an accurate account of the fever’s progression throughout the day.

If after one day the fever has not subsided, you should seek medical care to evaluate the child. Some other tips include the following:

• Always check the medication label for exact dosage
• Dosage is based on weight, not age
• Do not give children aspirin
• Use accurate medication cups that come with the medication. Do not use regular spoons.
• Speak to you pediatrician before giving medication to children <2 years old

If you have any questions, come see us at 45 Urgent Care. Merry Christmas!