Alternating acetaminophen and ibuprofen for pain in children.

QUESTION: Because pain is a very common condition in children, such as after musculoskeletal injuries, many parents ask whether they can alternate over-the-counter analgesics to treat their children's pain. While some guidelines advise against this, it is common practice. Should alternating acetaminophen and ibuprofen be recommended for treating pain in children? ANSWER: Children who have unresolved pain despite the use of either ibuprofen or acetaminophen should have their medication regimen reviewed to ensure they are receiving the medication at an adequate dose and interval. If monotherapy has failed, a short trial of an alternating regimen could be implemented. However, there is a lack of evidence for safety with long-term use of alternating ibuprofen and acetaminophen.