Acetaminophen or Ibuprofen?

Did you know that “Powdered Willow Bark” was one of the earliest painkillers and fever reducers? It has been used to treat fever and pain for over 2000 years! In 1897, The Bayer Company discovered a way to modify the active ingredient in willow bark, salicylic acid, to reduce side effects, especially stomach irritation. They named their product Aspirin. Acetaminophen (Tylenol) has been on the market since 1956, and Ibuprofen (Motrin and Advil) since 1962. These have largely replaced the use of aspirin to treat fever and pain, especially in the pediatric population.

Acetaminophen and Ibuprofen are both good medications, and both give relief from fever and pain. However, these medicines are not interchangeable. They have different chemical structures and work differently in the body. Both medicines are considered safe when used as directed, however, one could be more helpful than the other depending on what you are treating.

Acetaminophen reduces fever and raises the pain threshold so that lower levels of pain are relieved. The brain’s fever center (the hypothalamus) responds to Acetaminophen, thus reducing body temperature. Acetaminophen can be given for pain or fever every four to six hours but not more than five times in a twenty four hour period. Acetaminophen is easy on the stomach and can be given with or without food. A concern with this medication is liver toxicity so don’t give it unless it is needed and be sure to keep it out of your child’s reach.

Ibuprofen is a nonsteroidal anti-inflammatory drug, or NSAID. This means that ibuprofen can help decrease the body’s inflammatory responses (redness and swelling) to illness or injury, as well as reduce fever and pain. It is important to remember that ibuprofen may cause stomach upset so it is best given with a meal or snack. Ibuprofen may have a slight edge over Acetaminophen in reducing fever. Ibuprofen should only be given every six hours. Prolonged use of Ibuprofen can lead to stomach ulcers and possibly kidney damage, so again, only use it when necessary or as directed by your doctor. One important thing to remember is that Ibuprofen should not be used until your child is 6 months of age.
Be careful when choosing “over-the-counter” (OTC) medicines for colds or flu, as these medications often include Acetaminophen or Ibuprofen in combination with other drugs. Read labels thoroughly to avoid a potentially fatal overdose. Medicine droppers or syringes are often included in the packaging of these drugs. Carefully measure each dose to insure that your child is treated according to their age and weight as indicated on the directions of these medicines. When in doubt, contact your doctor’s office for instructions on proper dosage. Mistakes in dosing are easy to make, so read and measure carefully. There is a big difference between 1ml and 1 tsp.

Individuals react differently to these medications, so you may need to try both to learn which one will work best for your child. Generics work just as well as name brands and are less expensive. Now, back to that Aspirin. Never use aspirin for your child unless you have been instructed to do so by your physician. The use of aspirin in pediatrics has been linked to serious diseases and side effects. Always choose your child’s medications wisely and use sparingly. Have a happy and healthy season!

Professional Pediatrics