Alternating Motrin & Tylenol for kids

[cgcw]

When my kids are sick with a fever of 102, I've always given them alternating doses of tylenol and motrin to keep the fever under control.

I just had one of my daycare families call - their child is sick. They told me that their pediatrician told them to never alternate doses of motrin/tylenol because it causes medication overdose. I've never heard of this.

I don't know if maybe they didn't understand or if maybe I misunderstood what our pediatrician instructed us to do. I think if that was the case, my kids would have already been overdosed as I've used this combination several times over the years.

Does anyone else alternate doses of the two medicines? I'm going to give my pediatrician a call later today. I'm sure they will think I've lost my mind questioning this.

 

[marymouse]

My Dr. says to do the same thing. That way they can have medication every 4 hours, to help keep the fever down.

 

[dg39]

Yes, mine also told me the same thing as yours. I forget his reasonings for this, but, when my older ones were young, there college kids now, I did the same thing.

 

[PlutoPony]

Did same thing for DS 8 yrs ago when temp reached 104. Recently was talking w/ pediatrician about this and she said they don't recommend that now. Maybe people did this too much when it wasn't really necessary so they're afraid to suggest it?

 

[Kaycee]

My pediatrician always told me to do the same thing. But my guys are 13 and 15 now, so maybe the medical reasoning has changed. I'd go with what your pediatrician (or in the case of their child, their pediatrician) recommends.

 

[janette]

I've alternated does before, on advice of the Dr. Only when the fever was high and couldn't be controlled any other way.

 

[Pin Wizard]

When DS was 3 and had a fever that was 106, I was told to alternate them. But I haven't used tylenol in years. Does nothing for DS...motrin does it for him.

 

[Sleepy]

My pediatrician always told me to do the same thing. But my guys are 13 and 15 now, so maybe the medical reasoning has changed.

My son is also 13. I think I was told to do this alternating thing when he was 3 years old. I looked at the doc like he had 2 heads. I did as instructed since my son previously has a febrile seizure. not something you want to happen again. Never had an overdose issue, but always wondered why it is acceptable to give a child 2 different pain meds 4 hours apart when they don't even suggest an adult to do something like that.

 

[jel0511]

My ped told me the same thing, NOT to alternate doses with Tylenol and Advil. He said that it can cause too much medication to be in the system, and can cause an overdose. He said that they (my practice) don't think this is an effective method of controlling fever and as long as a fever can be kept to below 102 with medication, you are effectively controlling the fever. They feel that fevers are a normal process during a body fighting an infection and completely eliminating it can make it longer for a person to fight off what ever they are fighting off. If I can't get a fever below 102 with Advil (I don't use Tylenol) I then put them in the tub with warmer water. That always does the trick, and they are usually fine.

 

[elgerber]

They did this at the hospital, when my dd was 8 months old and had a fever of 106.5. The nurses alternated her dose every 3 hours until the antibiotics knocked the fever down. Of course she is 9 now, and this was in a controlled hospital enviroment, so they may have changed now.

 

[Kermit]

I don't give any medication for a fever unless there's some symptom that's really bothering the child that will be much better if he has medication. For example, I gave Jacob Tylenol every 5-6 hours when he had strep throat because the pain was so bad. But just the other weekend he had some mystery virus that caused him to have a fever that spiked up and down from about 101 to a little over 103. He slowed down a little bit when his fever was at its highest, but nothing was hurting him. I figure that there are always risks from every medication (Tylenol, specifically, is taxing on your liver, and Motrin is hard on your kidneys), but a fever isn't really a problem until it becomes uncontrolably high.

 

[janette]

My son is also 13. I think I was told to do this alternating thing when he was 3 years old. I looked at the doc like he had 2 heads. I did as instructed since my son previously has a febrile seizure. not something you want to happen again. Never had an overdose issue, but always wondered why it is acceptable to give a child 2 different pain meds 4 hours apart when they don't even suggest an adult to do something like that.

The first time I did this was for myself not one of the girls on advice from the Dr. I'd had a fever of 104 for about 4 days, couldn't get it down past 101 but I was finally able to break the fever after alternating medications.

It's acceptable because they are 2 different medications, if you gave them the same medication in double doses it would be an overdose. You do have to be careful that you are using 2 different ones and not just different versions of the same. Think of it as taking a decongestant and pain reliever this way, really the same thing they are just both pain relievers.

edited to add: I've only heard of using this in extreme cases where the fever is high causing discomfort and can't be controlled any other way. Most often for us anyway motrin by itself worked fine.

 

[issa]

you can alternate the medications because one gets proccessed in the kidneys, and the other in the liver

*quote*
It is safe - If you are using the correct dosage of each medicine at the correct times, The problem is that it is easy to get confused and give an extra dose of one or the other medicines. If you are alternating fever reducers, then write down a schedule with the times that you are giving the medicines so that the correct medicine is always given at the correct time.

 

[mtemm]

my sister, whose kids are 2 or 3 years older than mine, was told to alternate doses. however, our peds have said not to. I'm not sure if its something they once told and backed off of or if its different peds.

 

[mrsmom]

I have been doing this from friday until Yesterday for my ds who is 7 yrs old, The ped said do it only if the fever is over 102.0 His was 104.0 for three days. He has pneumonia and is on antibotics. I guess all drs are different.
Kim

 

[BuzznBelle'smom]

I have two out of three kids who lose conciousness and/or have febrile seizures, and I alternate the two meds. BUT--I always (ALWAYS!!!) write down who got what, when. This is especially important when you have more than one sick kid.

The problem isn't the meds per se, it's that you might mix up the dosages. We are really careful about this. I asked the doctor last week about long term effects with having a kid on either/both, since I tend to dispense both at the drop of a hat, and he said they shouldn't be on them 24/7, but there shouldn't be any problem with giving them fairly frequently. The first time the little one (20 months) passed out, I had given her Tylenol 5 minutes earlier, it just hadn't gotten into her system fast enough to stop the loss of conciousness.

If you're really having questions about this, a chat with your doctor might make you more at ease. To be honest, though, one febrile seizure would have been enough for me--I used to be a LOT slower on passing out meds!

 

[BuzznBelle'smom]

I should add, febrile seizures only occur in ~3% of the population. Why couldn't I have "luck" like this with the lottery?

 

[kellyann]

They just had this on our local NBC station in Boston. The doctor they interviewed had said you should not do this. This was his quote on the station's website:

David Stevens, M.D. Pediatrician, Albert Einstein College Montifore Medical Center
"Another important misconception is that if the fever doesn't seem to be responding well enough to one of the medications that it is okay to alternate say Tylenol and ibuprofen and we don't recommend that at all. In fact there… can be some additive side effects if you are giving both those at the same time. So we recommend choosing one or the other and sticking with that one."

That being said, when my children were younger, our pediatrician told us to alternate. So, maybe the side effects were only recently discovered so doctors are changing their position. Who knows?!

 

[nrsldy]

I work in an ER. We tell parents to alternate the doses until the fever comes down. You can not give motrin as often as tylenol. I have not heard this from the ped phy that I take my kids to. Parents need to use there best judgment and follow your dr orders.

 

[Annette_VA]

My ped advises to alternate them for high fevers.

And, my guru, Dr Sears also advises it's ok. From http://www.askdrsears.com/html/8/t082100.asp:


Medications
Acetaminophen– this fever reducer/pain reliever has been around a long time and is effective is most cases. It can be given every 4 hours. Click on it for dosing chart.
New research in 2001 has shown that giving an initial double dose of acetaminophen for high fevers is both safe and more effective to bring down that high fever fast. Only give a double dose if the fever is high. You can only give a double dose once every few days if needed. Any other doses should be the regular dose.
Ibuprofen– this newer medication is also effective for fever and pain. It often works better for higher fevers, and lasts longer too. It can be given every 6 hours. It was previously only approved for children 6 months and older. Recently it was approved safe and effective for infants down to two months of age. Click on it for dosing chart.
Using both medications – it is best to only use one of these two medications. However, if one by itself isn't enough or wears off too soon, then it is safe to give the other medication on top of the first without waiting. Another option is to alternate between them every 3 hours. Give acetaminophen at 8:00, ibuprofen at 11:00, acetaminophen at 2:00 and so on.