Q: When my child has a fever, is it better to alternate Tylenol (acetaminophen) and Advil (ibuprofen)? And if so, how often should each one be given?
Fever is one of the most common symptoms of illness in children. When discussing fever, it is important to stress that fever is a part of the body's immune system. Fever is not dangerous but is a sign of an underlying illness. Typically, children may experience some discomfort with a fever. For this reason, fever reducers or "antipyretics" may be beneficial by improving a child's level of comfort.
The two most commonly used fever reducers are acetaminophen and ibuprofen. Studies comparing the two products have shown that when used at correct doses, the two products are similar in efficacy and safety. Therefore, one product is not recommended over the other.
Many times, parents are advised to alternate these two products in attempt to lower stubborn fevers that are not responding to acetaminophen or ibuprofen alone. Studies show that nearly 50 percent of parents have been advised by a health care provider to alternate ibuprofen and acetaminophen at some point. The specific dosing instructions varied greatly between providers.
There is some evidence that alternating the two products may be more effective at lowering temperature than a single agent; however, it is unclear whether this practice is safe. Also, the risk of giving a child an inaccurate or excessive dose of medication increases when attempting to alternate medications. Also, reducing a fever does not change the overall course of the underlying illness.
For these reasons, using a single type of fever reducer at the appropriate dosage and interval is recommended in most cases. If a parent is considering alternating acetaminophen and ibuprofen, then it is important to consult with a health care provider to verify the proper dosage and recommended interval.
