Safety Tips About Fever Medications

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     Fever is one of the most common concerns that parents have, so it follows that fever medications are some of the most common medications parents give to their children.

     In February of 2012, I wrote an article on acetaminophen that discussed the use of acetaminophen and warned about over-dosing because so many cough, cold and fever medications contain acetaminophen. I recommended using ibuprofen instead.  This article is to give you a warning about ibuprofen (No one said that being a parent was easy!).

     Ibuprofen is a medication called a non-steroidal anti-inflammatory.  Steroids help everything from knee pain to asthma because they decrease inflammation – the swelling, pain and fever that is the body’s normal response to irritation, allergy or infection. Ibuprofen decreases inflammation, but it is “non-steroidal”- it isn’t a steroid but many of its actions are similar to steroids. One of those actions is to decrease substances called prostaglandins that cause inflammation. However, one certain prostaglandin also helps to control how much urine the kidney makes and, when it is suppressed by ibuprofen, it results in lower urine production. Most of the time, this slight decrease in urine production doesn’t cause a problem, especially in adults. But if someone is dehydrated, this added decrease in urine can put enough strain on the kidney to cause it to shut down completely. Children become dehydrated more rapidly than adults and young children can become dehydrated very rapidly, so, this is a problem parents need to be aware of.

     I have said in many articles that fever is a normal part of infection. There is no such thing as a “dangerous” fever with infection and it doesn’t cause brain damage or any other harm to the child. However, it does cause a lot of fear in parents and that fear can often lead to giving medications to “try to get the fever down”. That fear can cause parents to give too much acetaminophen, especially when given with other cold medications, and it can also lead to giving too much (or too often) ibuprofen. If a child has an intestinal flu virus with vomiting, diarrhea and fever, that child can easily become dehydrated and then the ibuprofen can cause kidney shut-down.

     The message, of course, is to give only enough fever medication to make the child comfortable. If you choose to give acetaminophen, check the bottles to be sure of the dose and to know if it is in any other medications you are giving. Don’t give ibuprofen for fever if your child has vomiting, diarrhea or decreased intake of liquids.