Alternating Tylenol and Motrin for fever

Many parents ask whether it is okay to alternate Tylenol (acetaminophen) and Motrin (ibuprofen) when their child has a fever. This concern usually stems from a parent who worries that the fever is dangerous. It's not. It's just the body's way of mounting an immune response. We promise your child will not self-destruct if he has a fever.

Is it okay to alternate fever reducing medicine? Yes. Is it helpful? No. A new study from the British Medical Journal looked at this question and found the following results: Giving ibuprofen AND acetaminophen in rotating doses over a 24 hour period only brought the body temperature down for 1.5 hours more than giving just ibuprofen around the clock for 24 hours.

Since it doesn't make a huge difference, we continue to suggest the recommendations in both our Baby 411 and Toddler 411 books: For babies over six months of age, stick with ibuprofen for fever, dosed every 6-8 hours. It works better and lasts longer than acetaminophen. And there is really no need or use to alternate two fever reducing medications.

Comments

[Jeannette Martin, M.D.]

I have grave concerns about giving children ibuprofen for fever. Often the sick child is dehydrated or marginally hydrated and the risk of kidney failure secondary to the ibuprofen is scary. We've seen this complication in our hospital.

[Jeannette Martin, M.D.]

I have grave concerns about giving children ibuprofen for fever. Often the sick child is dehydrated or marginally hydrated and the risk of kidney failure secondary to the ibuprofen is scary. We've seen this complication in our hospital.

[Julie]

First of all, my father is a doctor and has told me that Tylenol is much more dangerous to use than Motrin. (Of coarse you have to wait until the child is old enough to use the Motrin at all.) Secondly, when my child gets sick, he really gets sick. His temperature has even been as high as 105.2! When his temp. gets this high, Motrin and Tylenol do not bring it any lower that 103.5 -104.5 when used alone. He needs to alternate Tylenol and Motrin. I agree that people should not alternate medicine as a general rule, but if a child's temperature gets dangerously high you do need to get it under control.

[Jen]

Just a note for parents who have children with kidney problems or, like mine, a solitary kidney - do not give your child ibuprofen or any type of NSAID.

[jason hester, m.d., pharm.d]

Actually, there is evidence to suggest that the alternation of tylenol and ibuprofen may be damaging to your kidneys. There is a growing community of pediatricians and especially pediatric nephrologists who recommend against this practice. Using the appropriate dose of ibuprofen and waiting at least ninety minutes is generally sufficient to relieve fever. More importantly, fever is a symptom not a disease and even high fevers are not harmful to your child. There is a great article about parental knowledge of fever and dangerous behaviors www.nymetroparents.com/newarticle.cfm?colid=6955

[Ajlouny]

Little bit of statistics to think about...Overdoses of acetaminophen, the active ingredient in Tylenol, send 56,000 people to emergency rooms every year and kill roughly 200. It's the leading cause of liver failure in the U.S. Now is that something you want to give to your children?

[J.J.]

Wow. So many different comments...I happen to pull up this page as my 3&1/2 yr old son lays next to me w a ear ache/cold and fever, and I alternate because he had a febrile seizure another 2 yrs ago and i was told to alternate from his pediatrician and hospital. Must research more.