Why it is not good to mix paracetamol with ibuprofen

Paracetamol and ibuprofen are the substances found in the most commonly used medicines for children. Many parents receive the recommendation to alternate these two drugs every four hours to reduce fever, but toxicology doctors say that we should not combine them, especially in the case of little ones.

Fever, a nightmare for parents – Photo cdc

Dr. Sandra Alexiu, president of the Association of Family Doctors Bucharest – Ilfov, explained to “Adevărul” why it is not good to mix these substances.

The two substances, ibuprofen and paracetamol, have a similar effect and are used in children who have a cold because they have an effect on fever“, says doctor Sandra Alexiu.

But the effects of the two substances differ from one person to another, in some cases a decrease in fever is not obtained with ibuprofen, as there are also cases in which paracetamol does not help relieve pain.

It is not good to combine them because they have similar effects and should be used carefully for children because there is a temptation to treat any temperature spike, however small, which is not correct. Fever is a protective mechanism, which triggers immune defense phenomena from the body, it triggers the cascade of antibody formation, so it is not good to fight it until it exceeds a certain threshold. This threshold is 38 degrees in children up to three months and 38.5 in the rest of the ages. We don't give anti-thermic medicine unless this threshold is exceeded, to give the body time to react and defend itself“, explains the specialist.

Ibuprofen and paracetamol have an effect on both fever and pain, inflammation.

We also need to carefully calculate the dose. For children, the dose is calculated per kilogram/body, so the leaflet must be read carefully. It is the responsibility of the parent administering the medication to correctly calculate the dose, given that we are talking about over-the-counter medications“, adds the family doctor.

Doctor Sandra Alexiu says that family doctors often face overdoses in their offices. “It is very important to read the leaflets, because there we find the contraindications, but also the maximum allowed dose“, says the doctor.

Fever, parents' baubau

These treatments are used to get rid of fever, most parents have received, at least once, the suggestion to alternate paracetamol and ibuprofen, and many have put it into practice, scared of the moment when the little one has a high temperature.

Family doctor Sandra Alexiu says that the recommendation to alternate the two substances, in the case of children, appears very often, but “it is not provided in any guide“.

In all the guidelines for the treatment of fever in the child under five, and we are talking about established guidelines, from the American Academy or from the NHS, in Great Britain, it is specified that alternative treatment is not used to fight the fever. Fever is combated only if necessary, i.e. if the threshold is exceeded. We don't have to administer these drugs to prevent something, they are symptomatic treatmentsare used when you have a symptom“clarifies the doctor.