Should You Alternate Paracetamol and Ibuprofen in Children?

Fever is the most frequent cause of going to the doctor during childhood. However, in reality it's our body's defense mechanism against infections.
Should You Alternate Paracetamol and Ibuprofen in Children?

Last update: 03 August, 2019

Alternating paracetamol and ibuprofen in children with a fever is a very common practice. However, it has little scientific evidence to back it up. Let’s learn more about it in this article.

Paracetamol and ibuprofen are two common medications in any family home. Consequently, they’re usually the first thing we turn to for any medical problem, and especially with fever.

However, we mustn’t forget that they’re still drugs and, because of that, aren’t without side effects, especially if we misuse them. Let’s look at each of them in more detail.

Paracetamol and ibuprofen

What paracetamol is and how to use it

Paracetamol is a drug with analgesic and antipyretic properties. We can use it for the symptomatic treatment of fever and for mild to moderate pain.

It works by inhibiting the synthesis of prostaglandins in our central nervous system. However, unlike ibuprofen, it has no anti-inflammatory properties.

Should You Alternate Paracetamol and Ibuprofen in Children?

Adverse reactions caused by the use of paracetamol are rare. The only people at risk are children with liver problems, or people who are allergic to this medicine.

What is ibuprofen and what is it used for?

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) with anti-inflammatory, analgesic and antipyretic properties. It works in a similar way to paracetamol by inhibiting prostaglandin synthesis, which plays an essential role in the onset of fever, pain and inflammation.

Doctors prescribe it for symptomatic relief of occasional mild to moderate pain, and for fever. However, it should only be for occasional use and for limited periods of time.

The most frequent adverse reactions of ibuprofen are gastrointestinal in nature. Peptic ulcers, perforation or gastrointestinal bleeding may occur. In order to minimize adverse effects, doctors recommend that you take the medication with meals or with milk.


Fever is undoubtedly the most frequent cause of medical consultation in childhood. It’s a topic that creates a lot of concern in parents, and is often treated more as a disease than as a symptom.

However, in reality, fever is only a symptom, not a disease. The aim of a doctor shouldn’t only be to eliminate the fever, but to find out what has caused it. Only then will they be able to treat it successfully.

Fever is our body’s way of defending us against infections. When we have a temperature, it’s nature’s way of telling us that our immune system is working and is fighting invading microorganisms.

Because of that, eliminating fever can sometimes be harmful, as we won’t be aware that our body is warning us.

We should only administer this treatment on doctor’s orders, and depending on the child’s condition. If there is no relief from pain, then the doctor may change to another medication.

Should You Alternate Paracetamol and Ibuprofen in Children?

Should paracetamol and ibuprofen be alternated in children?

There is no scientific evidence to show the benefits of combining or alternating antipyretic agents. Currently, there is no research to show that combining both these drugs produces a greater benefit than only taking one of them.

In fact, the simultaneous administration of paracetamol and ibuprofen does increase the risk of error and possible side effects.

It’s advisable, in cases of fever and discomfort, to administer paracetamol every 4 to 6 hours, since it has fewer adverse effects than ibuprofen.

Paracetamol is usually the first-choice drug in these cases. However, occasionally, ibuprofen may be preferable, especially when an anti-inflammatory effect is sought, in addition to the analgesic and antipyretic effect.

You should always follow the pediatrician’s instructions, both with regard to the dosage and frequency, as well as the duration of the treatment. Every child and every situation is different and it’s the doctor who should prescribe the medication.

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This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.