Some adult painkillers can be carefully measured for children's dosage, doctor says

Children's medication shortages continue Dr. Marla Shapiro speaks on how to cut up adult doses of painkillers for younger children.

For desperate parents looking for children’s painkillers amid a country-wide shortage, they have the option to use a pill cutter on adult-sized pills to create smaller doses, according to a Toronto-based family doctor.

But the process has to be done very carefully using a proper tool, and can’t be done roughly by hand, said Dr. Marla Shapiro, CTV News medical specialist and associate professor in the Department of Family and Community Medicine at the University of Toronto.

Though one million bottles of children’s medication are being imported into Canada this week, many parents don’t have time to wait for those to show up on pharmacy shelves and need remedies now for children battling fevers, said Shapiro on CTV News Channel Tuesday.

"This has been going on for months now, with no immediate answer in sight, we're hearing there'll be a million boxes on the shelves within a week, but yet it is still ongoing," she said.

The federal government announced Thursday that it has tapped into foreign supply chains to bring one million bottles of pain relievers to Canada. The supply, including liquid ibuprofen and liquid acetaminophen, will be given to hospitals, community pharmacies and retailers.

Parents are being reminded children not in respiratory distress should not be admitted to the emergency room due to an influx of patients across the country. The pressure applied to hospitals is due to what some experts are calling, a "multi-demic" of respiratory syncytial virus (RSV), influenza and COVID-19.

Children's hospitals across the country are stretched thin as many are operating at or over 100 per cent occupancy with wait times sometimes exceeding 24 hours. Some non-emergency surgeries had been delayed to alleviate pressure.

"If you can't keep your fever down it leaves parents really feeling quite desperate and anxious," Shapiro said.

In the absence of children's medication to wane the fever, Shapiro says parents can carefully convert adult dosages to younger kids.

She says children under 12 pounds are the most difficult to give medication to since there is no adult conversion. In those instances, she advises parents to speak to pharmacists.

"We do these conversions for infants, and then in the older children, we actually can take adult preparations either acetaminophen or ibuprofen and do an appropriate weight check to see how do I convert these medications," Shapiro said.

She stressed the importance of doing the conversions accurately and with the proper tools to avoid overdoses.

"You really have to get an appropriate pill cutter, don't try and do this by hand, because it's going to be inaccurate," Shapiro said.

For children between 50 to 70 pounds, she said parents can give one adult dose to curb a fever. Shapiro said there are differences in doses per weight with both acetaminophen and ibuprofen.

"If you're looking at ibuprofen …six to eight hours (in between), if you're looking at acetaminophen, you're looking at four to six hours in terms of dosing, but a maximum dose per day must be observed," she said.

Experts say more children (and adults) are getting sick this year because their immune systems have not been exposed over the last two years. This coupled with three viruses circulating, parents want to understand how to boost immune response.

"It is about exposure and building your immunity," Shapiro said. "With the exception of vitamin D, unless there's a particular reason your child has malabsorption or something like that, there really is no magic bullet to boost the immune system here."

Shapiro said most vitamins can be absorbed through a healthy diet of fruits and vegetables and to ensure children are sleeping and exercising, to boost immune systems.

To prevent becoming sick, she encourages everyone to continue wearing masks, to frequently wash hands and to social distance.