Help please - children’s pain relief

[HaudYerWheeshtYaWeeBellend]

Ds1 - 14 broke his arm and wrist today and currently in awful pain.

Clean but impacted breaks (possibly on growth plate / Snr surgeon looking at x-rays in the morning) and we are awaiting to see if he needs surgery.

He was given an 1 ibuprofen and 1.5 paracetamol tablets at 4.45pm and I can kick myself as I didn’t ask what dosage they gave him.

They have advised however he can have 3 doses of each meds in 24 hours.

Am I right I thinking I can give him 2 x 5ml of ibuprofen and 4 x 5m of paracetamol?

One and a half paracetamol is 750mg and in 120mg/ml that’s a lot of liquid did hospital give you that bottle?

The brufen is fine as we give liquid in
100mg/ml but really should have been given dosing instructions. Go back to hospital if you can’t manage his pain at home he may be able to get stronger meds

4 x 5ml of that paracetamol is 4 x 120mg = 480mg
2 x 5ml of the ibuprofen is 2 x 100mg = 200mg

From reading the bottles/packet

If you have tablets would he have them dissolved in a little water/juice? Tastes minging but will do the trick. Sounds like adult dose will be fine.

That would be
2 para tabs now then 3am, 7am, hospital
1 ibuprofen tab in half an hour (or two if he can manage) then 6hrs later.

He is two hours past his last meds running out so must be miserable, give him Right instructions say 4 x 5ml of paracetamol for Age 10-12 plus while you are waiting to get through and at least that takes the edge off whilst you make an overnight plan.

No more paracetamol after that for four hours though.

get 6+ calpol or fast melts. Don't forget that own brand is much cheaper but the same thing.

My dh can't take tablets, let alone the kids!

if you want to use adult tablets, you can use soluble, but then you have to drink the disgusting drink.

Check the strength of the tablets/calpol. Adults paracetamol is usually 500mg, whereas kids are 250 mg for same amount (eg for one teaspoon)

@steppemum

you can give them both at the same time.

I had a child who needed large amount sof pain relief.

This is what I was told:

1. do it by weight, you can check the dose on-line. The dose on the box is very conservative. If your child is tall for their age, it means you can give them more, so more effective.
2. You can give both at once
3. The best way to give it is to alternate, so you give Ibuprofen, then 2 hours later paracetamol, then 2 hours later ibupofen again if needed. But check the gaps on the packet. The reason for this is that when one wears off the other one is still active.

Hope that helps.

Sort of correct. You can't alternate every two hours though

3 x max dose ibuprofen in 24 hrs (every 8 hours, and with food where possible)

4 x max dose paracetamol in 24 hrs, so every 6 hours.

I had to write it down

I have no idea why UK medicine is like that. It's like they think people are too stupid to understand dosages so they make it really hard to work out. Compare the pack of UK children's ibuprofen to the German one!

Please note my bottles are two different strengths so absolutely of no use to you op, just thought it was interesting as a comparison.

Paracetamol was brought today, naively I said I’d just buy some instead of waiting for a prescription

However apparently children’s meds are hard to come by says the chemist.

Ibuprofen I got from my SIL as unable to get some from our chemist.

I could get tablets but he can’t take them.

@HaudYerWheeshtYaWeeBellend

5ft 2 that should say, my face is because he can’t swallow a tablet yet eats chicken nuggets whole x

Sorry getting worked up, been a stressful day x

Oh I'm sorry! I misread 😂 whoops.

Haha, ok. Give him a full dose of both now, whatever it says on the bottle.

I can work out proper doses tomorrow.

(btw, height is irrelevant, weight is the important one)

Sorry, there's just so much misinformation on this thread.

I imagine that's the OPs own pain relief they had already.

Stick the tablet in a spoon of jelly - that's how I got my son taking tablets. He should be on adult dose, you'll go through that tiny bottle of calpol in no time, it's for infants!!

Yes, but you can take paracetamol every 4 hours, as long as you don't take it more than 4 times in the 24 hours. It doesn't mean the doses have to be 6 hours apart, although it's sensible to do that if you're expecting the pain to last longer than 24 hours and that it will wake you from sleep.

Generally if I am in such pain I'm taking both I take them every 4 hours (6 if the ibuprofen pack says so) but skip one dose overnight so it doesn't exceed the maximum daily dosages.

He'll take tablets if that's all on offer.

Tell him to put to back of tongue and drink a large gulp of flavoured water/juice/milk. Tell him he needs to start taking adult tablets now so it is effective with the pain

4 x 5ml of that paracetamol is 4 x 120mg = 480mg. 2 x 5ml of the ibuprofen is 2 x 100mg = 200mg

Right I’ve given him this dosage, until dh comes off the phone, he’s white and shaking.

Agree Bertie, it’s unbelievable.

Honestly, 12 weeks of shielding (his brother)/lockdown and he take a bad fall on his bike and this. I could scream with it all.

It should have on the bottles how much he can have but if not you can find doses via NICE website where the bnfc is accessible (basically what drs use to prescribe meds). Just google bnfc and it should be the first link. From typical doses of tablets he had 750mg of paracetamol and 200mg of ibuprofen. So of the bottles you have he'll need 31mls of paracetamol as you have 120mls/5mg and 10mls of ibuprofen. Paracetamol can be given every 4-6hours but no more than 4 doses in 24 hours. Ibuprofen is every 6-8 hours but no more than 3 doses in 24 hours. Did you not get a discharge summary with doses of meds on or a number of the ward to ring?

also, get a piece of paper, and pen, put both boxes, paper and pen in one place and ALWAYS write down what you have given and the time given.
You will forget, especially in the middle of the night

If you have adult tablets (not the capsules, but the white tablets) you can crush them and mix in a teaspoon of jam/honey

Try a big supermarket tomorrow for the older children's medicine, it's more concentrated, plus has adult dosing on the side. The age 10-12 dose is usually a bit less than the adult dose.

If no luck get tablets, the kind that are coated with a smooth/sweet flavour, not the intensely bitter ones.

Get some frozen chicken nuggets. Cook one at a time. Stick the tablet in the nugget for him :o

Right double checking meds here for dosing, tablets and all up to date.

Age 12-15 yrs 500mg paracetamol max 4x day (so every 6 hrs)

Age over 12yrs 400mg ibuprofen max 3x day after food (says every 4-6 hrs but pp is correct about that meaning every 8 hours around the clock)

Hope that helps OP.

@BertieBotts

Yes, but you can take paracetamol every 4 hours, as long as you don't take it more than 4 times in the 24 hours. It doesn't mean the doses have to be 6 hours apart, although it's sensible to do that if you're expecting the pain to last longer than 24 hours and that it will wake you from sleep.

Generally if I am in such pain I'm taking both I take them every 4 hours (6 if the ibuprofen pack says so) but skip one dose overnight so it doesn't exceed the maximum daily dosages.

Yeah, I know.

Lots and lots think you can just take it every 4 hours though, which is what I was trying to clarify.

If you need to take it over several days, for something like a broken arm, it makes sense to stagger it properly (and write it down).

Not being an arse, it's just confusing sometimes

If you had a bottle of 250mg in 5ml of paracetamol the dosing is for 10/15 ml for his age group which is 500mg/750mg of paracetamol and in 120ml/5 ml (The bottle you have) 500 mg is 20ml or 750mg is 31ml If he was given a tablet and a half in hospital did he manage? Did it help him? You could give 2 more doses over night spaced 4 hourly and if it combined with ibuprofen doesn’t help phone back for further advice,

Ibuprofen would be 200mg so 20 ml of the liquid you have or one tablet, 6hourly.

Really though if you’re not happy and he’s sore seek further medical advice as I don’t feel ypire happy with him and no one would have issue with you taking him back to get more pain relief as often if it’s a bad break they are kept overnight for pain management and csm checks but obs things are different just now but that doesn’t mean your son needs to be in pain/upset and you worried

User he can’t take them, they tried at the hospital and he vomited.

I’m assuming the hospital says no more than 3 x per day because of the dosage they gave him?

The bottles say no more than 4 x per day

Hopefully we can have a settled night and tomorrow il ask the surgeon/who ever calls more clarity.

Ds still on to 111

Or set up an alarm on your phone and add it on a piece of paper.

Would he manage a Calpol 6+ fast melt?

Ibuprofen cream might give some relief as well as Arnica cream.

@steppemum

also, get a piece of paper, and pen, put both boxes, paper and pen in one place and ALWAYS write down what you have given and the time given. You will forget, especially in the middle of the night

If you have adult tablets (not the capsules, but the white tablets) you can crush them and mix in a teaspoon of jam/honey

Agreed, and just one adult takes charge of meds. It is really easy to double dose if both parents are getting up at night to do meds.

Agreed, some - I was just wanting to clarify where the alternate one each every 2 hours thing came from.

Atalune I think you can't use the ibuprofen cream while taking it orally as well. That's not allowed as can increase the dose.

Just be careful with the paracetamol. Overdose is very serious.