Managing Norovirus in Children: Safe Use of Suppositories for Fever and Vomiting

Q: Managing Norovirus in Children: Safe Use of Suppositories for Fever and Vomiting

Hello： 1. <br>The pharmacological effects of antipyretic suppositories and antiemetic suppositories are different and they generally do not have significant drug interactions, so there is no need for a specific interval between them. <br>However, since medications typically take

Norovirus

Hello, Dr.
Lin! I would like to ask about my 11-year-old daughter who had a fever and persistent vomiting during the night.
We rushed to the clinic in the morning, and the doctor said she was infected with norovirus.
We were advised not to give her water initially and to use an antiemetic suppository.
The doctor prescribed some medications, including antipyretic powder and antiemetic medication.
Shortly after returning home, she developed a high fever close to 40 degrees Celsius.
I gave her the antipyretic powder, but within five minutes, she vomited it back up.
After waiting half an hour, I tried giving it to her again, but the same thing happened.
I quickly went to the pharmacy to buy antipyretic suppositories and used them.

My question is, when using both antipyretic and antiemetic suppositories, how long should we wait between administering them? Also, will using both suppositories at the same time put too much strain on her body? I have heard that suppositories can be harmful to children, and now I am concerned about using two types at once.
My daughter is getting older and is starting to resist using suppositories, but with her vomiting the antipyretic medication and her high fever not subsiding, I feel really anxious and worried.

Jia Ying, 30~39 year old female. Ask Date: 2023/04/05

Dr. Lin Zhebin reply Family Medicine

Hello: 1.
The pharmacological effects of antipyretic suppositories and antiemetic suppositories are different and they generally do not have significant drug interactions, so there is no need for a specific interval between them.
However, since medications typically take about 30 minutes to start working, it is recommended to wait 30 minutes after the first suppository to allow for complete absorption and effect before using the other suppository.
2.
Short-term use of antipyretic and antiemetic suppositories is generally not harmful to the body, but suppositories are typically used only when necessary, meaning when oral medications are ineffective or cannot be used.
3.
Older children often resist the use of suppositories, but if there is persistent high fever and vomiting, it is necessary to use them.
However, if high fever and vomiting continue, there is a concern for dehydration and nutritional deficiency, at which point it would be more appropriate to consider seeking medical attention for intravenous fluids or even hospitalization.

Reply Date: 2023/04/05

More Info

Managing Norovirus in children, especially when it involves symptoms like fever and vomiting, can be quite challenging for parents. Your concern about the safe use of suppositories for fever and vomiting in your 11-year-old daughter is valid, particularly given her recent diagnosis of norovirus.
First, it’s important to understand that norovirus is a highly contagious virus that can cause gastroenteritis, leading to symptoms such as vomiting, diarrhea, and fever. In children, these symptoms can lead to dehydration, which is a significant concern. When oral medications are not tolerated due to vomiting, suppositories can be a useful alternative.

Regarding your specific questions about the use of fever and anti-nausea suppositories:
1. Timing Between Suppositories: Generally, there is no strict requirement to space out the administration of fever-reducing suppositories (like acetaminophen) and anti-nausea suppositories (like ondansetron). However, it is advisable to wait about 30 minutes after administering one suppository before giving the other. This allows time for the first medication to be absorbed and start working, minimizing the risk of potential interactions and ensuring that your child’s body can handle the medications effectively.

2. Concerns About Body Burden: The concern about using multiple suppositories at once is understandable, especially since suppositories can sometimes be uncomfortable for children. However, when oral medications are ineffective due to vomiting, suppositories can be a safe and effective alternative. Short-term use of these medications, when necessary, typically does not pose significant harm. It’s crucial to monitor your child for any adverse reactions and to ensure that she is not experiencing excessive discomfort.

3. Resistance to Suppositories: It’s common for children, especially older ones, to resist using suppositories. If your daughter is refusing them, it may help to explain the situation to her in a way that she can understand, emphasizing that these medications are necessary to help her feel better. You might also consider discussing with her doctor alternative methods of administration or other medications that might be available in liquid form if she can tolerate them.

4. Hydration and Monitoring: Given that norovirus can lead to dehydration, it’s essential to keep your daughter hydrated. If she is unable to keep fluids down, you may need to seek medical attention for intravenous fluids, especially if her vomiting persists or if she shows signs of dehydration (such as dry mouth, decreased urination, or lethargy).
5. When to Seek Further Medical Attention: If your daughter continues to have a high fever (above 104°F or 40°C), persistent vomiting, or if she shows signs of dehydration, it is crucial to seek medical attention. In some cases, hospitalization may be necessary to manage her symptoms and prevent complications.

In summary, while using suppositories for fever and vomiting can be a safe and effective method of treatment for norovirus in children, it is essential to monitor your daughter closely and consult with her healthcare provider if you have any concerns. Managing her hydration and being vigilant about her symptoms will be key in ensuring her recovery.

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