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Fever Relief

In the United States, there are three medications used for fever control:acetaminophen, aspirin, and ibuprofen. They are all available without a prescription and they can all be taken orally. There is no “stronger” or more effective anti-fever medication available in the hospital or emergency room. Alleve brand of the drug naprosyn, is chemically similar to ibuprofen and also reduces fever, but is not approved for that purpose. Alleve is approved for pain relief.

Fever is best thought of as an indicator of body inflammation, usually infection. There is some thought that fever may be beneficial in fighting infection and thus some controversy over whether anti-fever medications should be given. However, fever itself can be harmful to the body. The metabolic demands of mounting a fever can worsen heart failure or respiratory illnesses. Further, fever lowers the threshold for seizure in those with seizure disorders. Even in young children without seizure disorders, fever may result in febrile seizures. Fever results in increased water loss, poor oral intake and possibly vomiting–resulting in poor nutrition and dehydration.

Thus, especially in children, most physicians recommend using anti-fever medications (antipyretics). Some physicians reserve their use for temperatures over 39 degrees C (102.2 degrees F), or when the child is uncomfortable. Remember that reduction of the fever does not mean that the infection has been cured.

When choosing anti-fever medications, consider the following:

  • Aspirin should not be used for children under 14 years of age unless directed by a physician because of the risk of Reye’s syndrome.
  • Aspirin should not be given with ibuprofen, but ibuprofen and acetaminophen can be given together.
  • For fever associated with chickenpox, it is currently recommended that only acetaminophen be used.

Acetaminophen

(the solitary active ingredient in some Anacin 3, Feverall, Panadol, Tempra and Tylenol products, otherwise found as one of several active ingredients in many brands).

Acetaminophen is chemically known as N-acetyl-p-aminophenol. It has been used as a pain and fever medication since 1949. It is an extremely safe medication when properly dosed. It can be taken orally or as a suppository (Feverall), and will be working within 30 minutes.

Unfortunately, accidental overdose may occur due to confusion between liquid products made for infants (generally in a concentration of 80 milligrams per 0.8 milliliters) and those made for children (generally 160 milligrams per 5 milliliters). Chewable tablets come in 80 milligram and 160 milligram sizes. Adult strength tablets and caplets come as 325 and 500 milligram sizes. It is important to check the dosing on the bottle before giving any medication to your child.

Overdose can also occur when two different products are given without checking to see if they both contain acetaminophen. (For example, it is not safe to give Tylenol and Nyquil together because they both contain acetaminophen).

Overdose can result in serious, even fatal, liver damage. Additionally, kidney damage and hypoglycemic coma may occur. At the usual doses it is generally well tolerated. Allergic reaction and suppression of the bone marrow are extremely rare side effects.

Aspirin

(the solitary active ingredient in some Bayer and Ecotrin products otherwise one of several active ingredients in many Brands).

Aspirin is chemically known as acetylsalicylic acid. Theoretically it is an effective medicine for fever and pain, however, it is never recommended for these purposes in children because of the association with Reye’s syndrome. (This syndrome is a serious, sometimes fatal illness, involving the liver.)

Ibuprofen

(the solitary active ingredient in some Motrin, Advil, and Nuprin products).

Ibuprofen is the best known of a class of medications known as “non-steroidal anti-inflammatory medications”. Like acetaminophen this product is very effective for pain and fever reduction, but has the added advantage of decreasing inflammation. The same chemical attributes that make it a potent anti-inflammatory medication, however, also reduce mucus production in the stomach, sometimes leading to gastrointestinal side effects. Taking the medication with food or a full glass of water may reduce the side effects. Very rarely, ibuprofen can cause low platelet counts (platelets are necessary for normal clotting), skin rashes, and visual problems.

Ibuprofen is available over-the-counter in the following formulations

  • liquid for infants (50 milligrams per 1.25 milliliters)
  • liquid for children (100 milligrams per 5 milliliters)
  • chewable tablets (50 and 100 milligrams)
  • various adult sized tablets and caplets (200 milligrams)

Children should take 7-10 milligrams per kilogram of body weight, (roughly 4 milligrams per pound) up to a maximum of 200 milligrams per dose.