If they are still in some pain after giving ibuprofen you can alternate between doses of paracetamol and ibuprofen. Only give 1 medicine at a time. It may help to keep a diary of the time and dose of each medicine you give.
Remember that: Paracetamol can be given every 4-6 hours - MAXIMUM FOUR DOSES IN 24 HOURS. Ibuprofen can be given every 6-8 hours - MAXIMUM THREE DOSES IN 24 HOURS.
Paracetamol and ibuprofen can be given together, but you can stagger them so that every few hours, if needed, the child can have some medication. For example, you can give paracetamol at 8am, ibuprofen at 11am and paracetamol again at 2pm (i.e. six hours after the first dose of paracetamol).
Giving your child both paracetamol and ibuprofen
So that your child's pain is well controlled, it is OK to alternate giving paracetamol and ibuprofen, or even to give both at the same time.
Nuromolb contains paracetamol 500 mg and ibuprofen 200 mg in a single tablet. The recommended dose (for people aged 12–65 years) is one tablet every 8 hours as necessary, to a maximum of three tablets per 24 hours – a total of 1500 mg of paracetamol and 600 mg of ibuprofen per day.
Compared to giving ibuprofen or paracetamol alone, giving both medications together is probably more effective at lowering temperature for the first four hours after treatment (moderate quality evidence).
Your doctor or pharmacist may advise that you take ibuprofen with paracetamol for additional pain relief. Paracetamol is not an NSAID and works differently to ibuprofen. If you take ibuprofen and paracetamol together, remember not to exceed the recommended daily doses for each pain reliever.
If they are still in some pain after giving ibuprofen you can alternate between doses of paracetamol and ibuprofen.
These medications do not interact with each other. So you can alternate between the two, or give both at the same time. However, the biggest risk with combining these medications is becoming confused with dosages and times resulting in an overdose. This is very common, and can be very dangerous.
The main difference between the two medications is that ibuprofen reduces inflammation, whereas paracetamol does not. According to Hamish, there's no advantage in taking ibuprofen or paracetamol brands such as Nurofen or Panadol over the cheaper chemist or supermarket versions.
Taking your medications at the proper intervals during the day. Try to divide up your dosing times as evenly as possible throughout the day: for example, every 12 hours for a drug that needs to be taken twice a day, or every 8 hours for a drug that needs to be taken three times a day.
For severe or acute pain paracetamol and ibuprofen may be combined, doses of each may be taken together or alternately. To minimise confusion, it is recommended that doses of ibuprofen and paracetamol are taken together.
Important. Adults can take two, 500mg tablets, 4 times in 24 hours. You must wait at least 4 hours between doses. Do not take more than 8 tablets in 24 hours.
Why is double dosing dangerous? Double dosing can temporarily boost the amount of medication in a patient's system, causing an increase in both symptoms and side effects. This is especially dangerous if the patient is taking multiple medications.
Specifically, drugs that slow down breathing rate, such as opioids, alcohol, antihistamines, CNS depressants, or general anesthetics, should not be taken together because these combinations increase the risk of life-threatening respiratory depression.
Taking ibuprofen with other painkillers
It's safe to take ibuprofen with paracetamol or codeine. But do not take ibuprofen with similar painkillers like aspirin or naproxen without talking to a pharmacist or doctor.
Ibuprofen:"Ibuprofen can also be used for treatment of joint pain or osteoarthritis, and it's generally seen as safer than paracetamol," Dr Ralph Rogers, London Sports Injury Clinic.
The primary difference is that ibuprofen is a non-steroidal anti-inflammatory drug (NSAID), meaning that it treats inflammation. Paracetamol does not. For example, paracetamol can be taken to treat the pain of arthritis, but it will not treat the inflammation which is causing the pain.
If you've given your child ibuprofen and they're still in pain 1 hour later, you could try giving paracetamol. If they're still in some pain after giving paracetamol you can alternate between doses of paracetamol and ibuprofen. Only give 1 medicine at a time.
In studies of antipyretic effects, acetaminophen has a peak effect at approximately 2 hours and ibuprofen at 3 hours. The recommended dosing intervals are every 6 and every 8 hours for acetaminophen and ibuprofen respectively10; thus, theoretically they might be alternated every 3 hours.
Indeed, most packets of Nurofen and ibuprofen tablets contain the exact same dose of the same active chemical, so are virtually the same product but at a hefty price difference. Both products are effective anti-inflammatory agents, offer relief for mild to moderate pain and are antipyretic (fever reducing).
Co-codamol is much less strong than codeine on its own, but it's stronger than ibuprofen, aspirin and paracetamol and shouldn't be used for more than 3 days. Co-codamol is the best pain relief for moderate to severe pain, including muscular pain, migraines and pain following surgery.
You should start to feel better 20 to 30 minutes after taking ibuprofen tablets, capsules, granules or liquid. For some types of long-term pain, you'll need to take ibuprofen regularly for up to 3 weeks for it to work properly. If you're applying ibuprofen to your skin, it should start to work within 1 to 2 days.
Paracetamol can be taken on an empty stomach, while it is best to take ibuprofen with food, or soon after. Abuse of paracetamol can cause damage on your liver, while abuse of ibuprofen can cause damage to your stomach or liver. It's safer to take paracetamol if you are pregnant than ibuprofen.