Q: My 8-year-old daughter has Influenza A, a high fever, and is vomiting. Can I cross-dose fever reducers on an empty stomach?

Medically reviewed by Sang Hyun Ahn, MD

Content edited by Myeongchan Kim, MD

This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.

Question:

My 8-year-old daughter (23kg) started coughing on Thursday morning without a fever, but her temperature rose over 38°C that night. On Friday, a flu test was negative, and her fever hovered around 37.7-38°C before dropping slightly at bedtime. On Saturday morning, she woke up coughing with a fever over 39°C. We gave her dexibuprofen and went to the clinic, where she tested positive for Influenza A. She received an acetaminophen-based fever-reducing injection and a Peramiflu IV.

She seemed fine after returning home, but the fever returned around 2 PM. We gave her dexibuprofen at 3 PM, but the fever isn't breaking. At dinnertime, she coughed, vomited, and now refuses to eat. Her cough is worsening, but her stomach is empty, so I haven't given her the prescribed cough medicine yet. Can I cross-dose fever reducers while monitoring her? Should I force the prescribed medication even on an empty stomach? Do we need to go to the ER if the fever continues?

Answer:

It is completely understandable that you are worried, as your child is struggling with a high fever, severe coughing, and vomiting after being diagnosed with the flu.

First, please monitor your child closely for any of the following immediate warning signs:

• Chest retractions (the chest sucking in) or nasal flaring when breathing.

• Pale or bluish lips and face.

• Decreased consciousness, extreme lethargy, or an inability to answer clearly.

Here is what you can do at home right now:

1. Cross-dosing fever reducers: You can alternate fever medications safely. If it has been at least 3 hours since she took the dexibuprofen, you can give her acetaminophen (Tylenol). For a child weighing 23kg, the appropriate dose of acetaminophen is about 10-11ml (approx. 345mg). Fever reducers can be given even on an empty stomach.

2. Prioritize hydration: Offer small, frequent sips of cold water or an electrolyte drink (a small sip every 5-10 minutes). Ice cream or ice chips can also be helpful if she cannot keep liquids down.

3. Prescribed cough medicine: Try waiting 1-2 hours and see if she can manage a few bites of food before giving the medicine. If she continues to refuse all food, you can mix the medication with a little water and administer it in small amounts so her cough can be treated.

When to visit the Emergency Room:

• She shows signs of difficulty breathing (breathing fast and struggling).

• She has not urinated for more than 8 hours (a sign of severe dehydration).

• She exhibits decreased consciousness or is unresponsive.

• Her fever remains over 40°C even after proper administration of fever reducers.

It is common for a flu-induced fever to last for 3 to 5 days. Even after receiving the Peramiflu IV, symptoms may persist for another 1 to 2 days before improving. For now, focus on keeping her hydrated and cross-dosing her fever reducers. If any of the emergency signs mentioned above appear, take her to the ER immediately. Otherwise, if there is no improvement by tomorrow morning, please revisit your pediatrician for an in-person evaluation.

For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.

fevercoach.us

Apple App Store

Google Play

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