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Quick reference medical handouts used by Pediatric offices


Acetaminophen or Ibuprofen: Which is a better fever-reducing medication?


Acetaminophen or Ibuprofen: Which is a better fever-reducing medication?


Acetaminophen (tylenol, tempra)  and ibuprofen (motrin, advil) are among the most commonly used drugs in children, if not the most commonly used. Despite this commonality and years of experience with their use, questiond concrning their use still exist.  Which agent is most effective? What dose and dosing schedule should be used? Does it matter which agent and dose are used? Is alternating one agent with the other more effective than using one agent alone?

Parents are well aware that the main indication for use of acetaminophen or ibuprofen, fever, is in-and-of-itself, is not inherently concerning. The underlying cause of the fever, the overall health of the child and the adverse effects of the fever on the youngster  are more important.

Despite the fact that medical evidence indicates that fever plays a beneficial role in the immune response to infection, parents often view fever as a serious concern and an indication for immediate drug therapy. “Fever phobia” has been documented and described in the literature.

Acetaminophen has been available as fever reducing medication  for use in children for over 25 years. Ibuprofen has become available over-the-counter (OTC) only relatively recently.  Acetaminophen is usually mentioned as the medication of choice, while ibuprofen is also commonly recommended to be given for “high fevers,” implying it is more “potent." Acetaminophen may often be recommended initially perhaps because of the years of clinical experience we have with it, and because of its proven safety profile (when given in therapeutic doses).

The use of alternating doses of acetaminophen and ibuprofen is a common practice that has no published medical literature to support this practice as compared with the use of acetaminophen or ibuprofen alone

The treatment of fever remains controversial. Both acetaminophen and ibuprofen are effective fever reducing agents. They should be considered equal in their effectiveness . The use of alternating acetaminophen with ibuprofen has not been proven to be beneficial over the use of maximal doses of either agent by themselves. More important, parents should understand the natural course of fever, its meaning, and its function in fighting disease.  and its  Although both acetaminophen and ibuprofen are safe when used appropriately, the potential for serious liver damage with acetaminophen means that parents should know the proper dose and take necessary measures for poison prevention. 

Acetaminophen vs. Ibuprofen

Fever education

· fevers (even high) are not inherently dangerous
· the absolute temperature is less important than other clinical parameters
· goal of fever reducing therapy is to increase the comfort of the child, for example, increase nutritional intake)  and not necessarily reduction in absolute temperature

Which medication is most effective

· Acetaminophen and ibuprofen are equally effective as antipyretics

Sources of errors

· both acetaminophen and ibuprofen are available in numerous dosage forms and strengths, which may easily lead to confusion and dosing errors

Alternating doses of acetaminophen with ibuprofen

· not recommended
· no proven benefit
· may be confusing to caregivers

Source: Infectious diseases of Children

see also:

 

posted: 10/31/02 and adapted from an article in the journal Infectious Diseases of Children

 

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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