From the FDA Drug Label
In cases of acute overdosage, the stomach should be emptied by vomiting or lavage, though little drug will likely be recovered if more than an hour has elapsed since ingestion.
If a child with coxsackie virus cannot keep down ibuprofen or Tylenol, induction of vomiting or lavage may be considered to empty the stomach in cases of acute overdosage. However, this should only be done under medical supervision.
- The use of oral activated charcoal may also help to reduce the absorption and reabsorption of the drug.
- Supportive measures should be taken, and the child should be monitored closely. 1
From the Research
If a child with coxsackie virus cannot keep down oral fever reducers like ibuprofen or acetaminophen (Tylenol), contact your pediatrician immediately for guidance, as they may recommend intravenous ibuprofen as an effective option for reducing fever in hospitalized pediatric patients 2.
Key Considerations
- The child's inability to keep down oral medications poses a risk of dehydration and worsening of symptoms, emphasizing the need for alternative administration methods or medical attention.
- Rectal suppository forms of acetaminophen (Tylenol) can be considered as an alternative method of administration that bypasses the digestive system, but the most recent and highest quality study suggests intravenous ibuprofen may be more effective 2.
- Keeping the child hydrated with small, frequent sips of clear fluids or ice chips is crucial, along with using lukewarm baths or cool compresses to reduce fever physically.
- Monitoring for signs of dehydration, such as decreased urination, dry mouth, no tears when crying, and unusual lethargy, is vital, and if these symptoms appear, seeking immediate medical attention is necessary.
Management Strategies
- Intravenous ibuprofen has been shown to provide a significant reduction in temperature for febrile pediatric patients compared to acetaminophen, making it a viable option for hospitalized children 2.
- Maintaining a comfortable room temperature and dressing the child in lightweight clothing can help in managing fever.
- The primary goal should be to improve the child's overall comfort rather than focusing solely on normalizing body temperature, as fever is a physiologic mechanism with beneficial effects in fighting infection 3.
Important Notes
- Current evidence suggests there is no substantial difference in the safety and effectiveness of acetaminophen and ibuprofen in the care of a generally healthy child with fever, but the choice of medication and administration route should be guided by the most recent clinical evidence and the child's specific condition 4, 3.
- Combining antipyretic drugs may be more effective but also risks unsafe use, highlighting the need for careful consideration and professional guidance 3.