Tylenol or Motrin?

[Raidra]

So, which is safer, Tylenol or Motrin?

I've always given Tylenol because I'm paranoid about Stevens-Johnson Syndrome. I know that both are processed in the liver and thus can cause liver damage if used too much. We don't use fever reducers very often at all, so between the two, I chose to use Tylenol.

However, what happened in the ER at work today has had me rethinking my decision to only use fever reducers if the kids are *really* sick.

Is Tylenol actually easier on the tummy, but more likely to cause liver damage than Motrin is? I know that Stevens-Johnson Syndrome has been hyped a bit, so it's hard for me to tell whether or not it's a serious concern. To me, though, when reading the side effects on the packaging, Motrin does seem to have the worst sounding side effects.

So which do you chose?

Thanks!

[Marisa6826]

Well, Tylenol hasn't ever worked for me, and it doesn't seem to do much for the girls.

I've been giving them Motrin from about 6m old. Not only is it a fever reducer, it also decreases pain and inflammation. The added bonus is that it lasts twice as long as Tylenol.

I had a long conversation about long term effects of both Tylenol and Motrin with my Ped when Sophia was getting her molars. The benefit of relieving her pain far outweighed the risk (in my mind) of any potential side effects.

-m

[elaineandmichaelsmommy]

we've always used motrin, tylenol doesn't work on dd's fevers and motrin has worked wonders for ds's teething(molars recently). there has been occasion when we've had to use both w/ one of dd's fevers though. but for every bottle of childrens tylenol i buy i probobly buy 3 bottles of motrin. I also love it because i don't have to get up in the middle of the night to give more medicine. never heard of stevens-johnson syndrome before though, I'll be discussing that w/ pedi next time we go.

[Radosti]

While I try to alternate for fever reducing optimization (as studies have shown that doing this is best), I really do not see any improvement from Tylenol until 35-45 minutes after I gave him the dose. Motrin works in 10 minutes. And when your kid is throwing up from fever brought on by an ear infection, that 10 minutes is long enough...

[shilo]

yup, i've read up and talked with our pedi on both. in general, tylenol doesn't bring down his fever as much and doesn't last nearly as long. but in general, my pedi prefers if i try it first. as pp stated, we have done alternating/overlapping doses under medical direction for really high fevers (as supported by the literature). DS was very ill last fall and had a fever that lasted over a week and spiked to 105.7 in a very short amount of time, despite fever reducers on board, so we've had extensive opportunity to talk all about them with multiple medical proffesionals, unfortunately. we've kind of settled on this as our 'plan' of action, YMMV...

-mild fever (102 or less -ish) that's staying stable, during the day we start with the tylenol
-fever over 102 or not responding to the tylenol after 2hrs (but not continuing to rise - i'd of course call my pedi for instructions or head in if it was still going up), we try the motrin.
-fever in the middle of the night, we usually start with the motrin b/c he gets faster/longer lasting relief.
-when we are having to overlap doses of both with high fever, we do try to time it so that the motrin is the dose he gets right before bed for reason above.
- just as a side note: when we got to the ER with the fever that hit 105.7 while we were waiting for them to triage us, they gave both tylenol and motrin at the same time once they _finally_ brought us back and panicked at his fever (and this was only after i basically started crying and begging for the triage nurse to prioritize us as i could feel him getting hotter and hotter, but that's a story for another time...).

my understanding from the pediatric hospitalist was that the liver toxicity really goes up after about 48hours of continuous use, especially with tylenol? so my pedi also has us switch over to the motrin after about 48 hours if we've been doing mostly tylenol but he's staying stable with it. i do try to stretch doses, so that he's not getting the max/24hrs, and as soon as his fever is staying down below 101 on it's own, i try to let his body do its thing unless he's obviously uncomfortable.

this makes it sound like he has fevers all the time, huh? no really, we've only had maybe 4x in almost 2 years where we've had to give tylenol/motrin on more than 1-2 consecutive day(s).

anyway, this is just what we do based on how DS reacts to the differnt drugs, on our pedi's and the hospitalist's advice. i'm sure there are many other thoughts/plans out there for this.

lori
Sam 5/19/05 How lucky I am that you chose me.

[LarsMal]

Our ped told me the other day to use Tylenol before 6 months and Motrin after that.

If I am giving DS Motrin for pain (teething mostly) I try to give him less than the recommended dosage- just to take the edge off. For a fever I'll give the full amount, though.

[Raidra]

Thanks so much for all the responses. Only Lachlann has ever had Motrin, and that was only once in the ER. I was amazed at how fast it worked, and how well.. he went from limp, hot, and wheezing to jumping on the hospital bed and playing patty-cake within 20 minutes. Obviously the breathing treatments helped, too, but it was really amazing.

So, for liver toxicity.. that's for continual doses of Tylenol, 4 hours around the clock, right? Normally when the kids have fevers, we only give them medicine at night to help them sleep. So I guess more than 2 days would be okay if it's only one or two doses a day.

I think I'll have to grab some Motrin next time I'm in the store.. it seems like the benefit of lowering the fever would outweigh the risk of side effects.

Thanks!

[shilo]

>"Thanks so much for all the responses. Only Lachlann has ever
>So, for liver toxicity.. that's for continual doses of
>Tylenol, 4 hours around the clock, right? Normally when the
>kids have fevers, we only give them medicine at night to help
>them sleep. So I guess more than 2 days would be okay if it's
>only one or two doses a day."

that was my understanding from the hospitalist. i clarified with my pedi at his next appt. and that's when we discussed that if we had started with tylenol and had been staying stable with that, but were needing to give it at the appropriate dosing intervals, to call in and talk with him before we reached that 48hr. mark. we're like you, we stretch during the day and only use it if he's really uncomfortable and don't wake him at night (except when he was running the really high one back in november, and that was at drs. orders). if he wakes up and is uncomfortable, then he gets more, but otherwise, i'd say we're well under the max doses per day pretty much all the time.

i'm not a physician, so definitely check with your own pedi to clarify... from reading the literature, the studies seemed to indicate it was most common in kiddo's who were getting the tylenol for fever PLUS a cold medicine that contained more tylenol. or tylenol everyday, around the clock for teething for a week and maybe mom didn't know the last time dad had given a dose and so the kiddo ended up with an extra dose each day. either one (the higher doseage of adding in the extra from something like a cold remedy, or the standard doses, over a prolonged period of time) can send a liver (adults too) into toxicity of the liver and then the kidneys. the body doesn't have the antioxidant reserves to continue to deal with the increased demand the drugs put on the liver or kidneys while being metabolized. i also read that this can be exacerbated by the fact that fever often accompanies vommiting or diarrhea and that the body being malnourished or dehydrated at the same time can also play a role.

anyway, hth, lori
Sam 5/19/05 How lucky I am that you chose me.