a boy holding his hand over his mouth because he said something he shouldn't have, kids with anxiety

Q. I am a pediatrician concerned about parents’ use of two over-the-counter medications. I often feel like a “one-woman army” trying to combat simultaneous use of acetaminophen (Tylenol) and ibuprofen (Motrin, etc) for children with fever.

Parents sometimes alternate doses as often as every two hours. Some parents are giving these medications together to bring down a fever.

Clearly, fever is a physiologic function that helps the body fight infections. I try to educate parents about this, but there seems to be an almost irrational fear of fever in our culture.

I am also alarmed about recent case reports of kidney failure in children who had received this combination. I am very concerned that as this practice spreads, so will the incidence of kidney failure.

A. “Fever phobia” is a concern of many pediatricians. A mild elevation in temperature is part of an immune reaction to infection. Lowering such a fever may be counterproductive.

There is no evidence that alternating acetaminophen and ibuprofen or administering both drugs together lowers fever faster or helps children recover more quickly. You are not the only pediatrician who has expressed concern that this combination may increase the risk of toxicity, such as kidney damage.

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  1. Estella
    San Antonio,tx

    Dr.said rotate tylenol and ibroprofen but if they fall at same time which should i give had convoltion fever flew up 102

  2. Samantha

    I have two children- ages 6 & 7. They are healthy, active children. Occasionally they’ll bring home a bug from school or something will spike a fever (new teeth, the once in a blue moon ear infection… things come up.)

    Tylenol and Ibuprofen work Completely differently within the human body. If you will read about these medications and educate yourselves you will see that an initial dose of both Ibuprofen along with Tylenol to treat a ‘hard to break’ fever is very effective, and when used correctly there is no damage to the liver or anything else. Instead you have a child that no longer has to deal with the uncomfortable, sometimes awful side effects of a fever.

    If the combination of the two does not bring the fever down, then your child needs to see a medical professional to rule out other things.

    Every doctor I have been to, and I have been ALL over this country, has nothing negative to say about combining the two for the initial treatment and then alternating medications every so many hours for a couple of days.

    From what I am reading here in the comments, sounds like these are very ill informed individuals. If you’re unsure- Ask a reputable doctor with good reviews. Go to Babycenter, Motherhood web sites, this is a tried and true remedy.

  3. samantha

    My child has a fever of 102.9
    She seen the doctor today and he diagnosed her with sinus infection and prescribed her with cefdinir and he said she might have a cold with it
    He said I can give e her Tylenol and Motrin which I have been giving her but she keeps vomiting and won’t keep it down
    I keep putting her in the tub with lukewarm water and that seem to help for a little while then her temperature keeps going up
    What more can I do to help or do I need to take her to the emergency room?

  4. Heather M.
    United States

    I have a daughter with 2 anomalies of the heart and a feeding tube who is running a fever of 102.6 how can I break her fever when Tylenol nor ibuprofen will work tried the shower trick need another idea please.

  5. J.R

    My son is 1 year 5 months and has a fever of 103 axillary. Advice nurse said to combine Motrin with Tylenol but I’m to fearful to do so. I’m an lvn and although I have only 2 years experience as a nurse. My motherly instinct told me not too.

  6. Donna Nurse

    Question: As a pediatric home health nurse, I work with medically fragile patients we often alternate Motrin and Tylenol some times for extreme fevers but mostly for pain. Recently we had a nurse give both at the same time to a patient, I have to tell you this concerned all the other nurses in the home. It was done several days in a row before it was caught?
    My question is even though we as rule we are alternating the drugs and it is not given for long periods of time maybe a couple of days when needed would that and what was done by the other nurse cause serious damage? Should we have pediatrician test for both liver and kidney damage?

  7. AS

    I have found with my son (3 1/2yrs) that ibuprofen works better at bringing down fever. I prefer ibuprofen in myself – maybe it is body type that seems to make it more effective? When I did switch between both acetaminophen & ibuprofen for my toddler I make sure to follow the dosing instructions and to not give at the same time. If you give full doses of both at the same time you will be overdosing!

  8. SD

    I’m not a very smart person in this field. I am I licensed Pharmacy Tech though, this scares me that parents will go and introduce drugs to their kids. The mixing of these 2 drugs can and will hurt the child.
    I give my kids teething gel from their Dr. If, there is a discrepancy with 2 Dr’s, get a third opinion! There’s no reason why 2 Dr’s should say 2 different things. Talk to a Pharmacist, they’re the ones with degrees in the field, and are the ones who MUST know what their talking about. Dr’s determine what’s wrong, Pharmacists know what dosages and how much, how often. Thanks!

  9. cs

    I have a niece that is 19 mths. old, I have told the parents not to give her tylenol and motrin at the sametime, they say it is o.k. the doctor said to. They give her both meds. when she even is teething. I have told them tell I am blue in the face the grandfather of the baby is a pharmacist and they tell me he says it is ok. My son sees the same doctor i asked him and he said noway.
    What else can I do or say to them.

  10. v.l

    My baby is now 2 years old. she has a fever of 103 for 3 days now. i was told to do tylenol and motrin every 2 hrs. i’m afraid to do so. what should i do to bring her temp down

  11. CC

    My daughter (16 mnths) has febrile seizures (she has had 8 or 9 all together). We have been alternating the tylenol w/ motrin b/c it is fever induced… We just received infor. from Pediatric Dr. in the emergency room.. He prescribed Motrin only and use other methods, (eg. bath, cold compresses) to bring the fever down in between dosages. Also noticed that the tylenol does not seem to bring the fevers down. They don’t necessarily have to be very high.. Normally her temp is around 101.5 when she has a seizure.

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