DEAR DR.PAUL: I am confused. There are
different types of medications available for fever. Which ones
are safe for using in children?
DR.PAUL ANSWERS: Very good question!
As a child, I remember the little pink baby Aspirins very well;
However times have changed. Today, there are 3 medications that
have an "anti-pyretic effect" meaning they can decrease fever:
Acetylsalicylic Acid (ASA) commonly known as Aspirin
Acetaminophen available as Tylenol, Tempra and Panadol
Ibuprofen available as Advil and Motrin
These medications can also control pain and inflammation. Let
me talk about ASA first, because we now do not use this medication
for fever control in children. Although my generation grew up
on Aspirin for fever and pain control, ASA use has been linked
to Reye's Syndrome, a dangerous and potentially fatal condition
that involves liver failure and brain damage. Reye's Syndrome
has been associated with the use of ASA during certain viral infections
including chicken pox and influenza. As a result, ASA should never
be used for fever/pain control in children. There are some uses
for ASA, especially in older men for prevention of heart attacks,
but this is a different age group and circumstance. Again with
a few very rare exceptions (medical conditions only upon medical
recommendation/supervision) ASA should not be used in children.
Acetaminophen, is a medication that has a long and favorable track
record and is considered to be appropriate for use in children
for fever and/or pain control.. Acetaminophen is available in
liquid, drop or pill form and is given every four to six hours,
as needed. Acetaminophen is also available in suppository form
which can come in handy when a child needs to take fever medication
but is throwing up, say with a "gastro" or stomach flu. Although
acetaminophen is considered safe when used as recommended, taking
it regularly, for more that a week at a time can be dangerous.
Over dosage of acetaminophen can result in liver damage. So it
is important to follow the dosage based on a child's age or weight
and not to give it regularly for more than 4 or 5 days.
Ibuprofen is a newer anti-inflammatory/fever medication which
has not been around as long as acetaminophen. Most experts agree
that ibuprofen is a relatively safe and very effective medication,
but still recommend acetaminophen as a first line fever medication
given its longer track record.
On a final note here are some general facts/points:
Overdosing by accidental ingestion of these fever medications
can be very serious. These medications, as all others, should
be stored well out of the reach of children.
Acetaminophen and ibuprofen are available in combined preparations
with decongestants or cough medicines. I believe that these combination
forms should be avoided.
If a child is on antibiotics for a bacterial infection(say an
ear infection) and has fever, then acetaminophen can be given
as well for fever control during the first 48 hours which is the
time usually needed for to antibiotics to start working.
The information provided in this site is
designed to be an educational aid only. It is not intended to
replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
