Bend over and take your medicine: rectal acetaminophen

Child refusing fever medicine? What to do when not even a spoon full of sugar will make the medicine go down.

Most kids can vomit on command as many parents have witnessed after politely begging a child to take their medicine. Vomiting is no special trick. But I’ve yet to meet a kid who can bear down and push out a rectal suppository. So, if you’ve got an uncooperative medicine-taker at home, there are options.

Rectal acetaminophen (FeverAll) comes in 3 strengths and is an ideal way to treat an uncomfortable child who has fever, vomiting, mouth sores or pharyngitis. Kids with mouth sores don’t want to drink anything and certainly aren’t going to be logical and swallow a liquid that will make their mouth feel better. Rectal forms are easier to give than you think and are the perfect option if a child is vomiting and can’t keep anything down. Suppositories absorb directly across the intestinal lining into the veins so they skip metabolism in the liver and often work faster than an oral dose.

Get a child’s pain and fever under control with one rectally administered dose of medication and they just might take the next dose by mouth. Children over 22 pounds also can take chewable tablets if they won’t swallow liquid medicine. Chewable tabs and suppositories can be found on the shelves in most pharmacies or ask your pharmacist if you don’t see them. The suppositories need to be stored at less than 80°F so some pharmacies keep them behind the counter in a refrigerator.

Suppository History

Rectal medications date back to antiquity. The Old Testament refers to ‘Magerarta’ – a suppository made of silver – and Hippocrates describes compounds of acorns given via the rectum. The first mention of adding a known active substance was in 1841 and was a suppository of opium pellets in a molten cocoa butter base. Brilliant.


If you’ve got a medicine-spitter, jaw-clencher or on-command vomiter at home, you can try sitting on your child, and bribery will sometimes get the job done. For antibiotics and other medications you don’t have many options. Though drug developers are working on ways to mask the bad flavors in medicine, and several drugs are being developed that are directly absorbed into the blood from the lining of the mouth so they don’t need to be swallowed. Help is on the horizon, until then, kids can shove it up their hinnies.

Too far?

Read more about what causes fever, how to treat it, and the best option for rehydrating a vomiting child:

Calculating kids’ medication dose is rocket science

Popsicles are legit stomach flu treatment

Fever has a mind of its own Parenting Team Contributor

Author: Wendy Hunter, MD

Pediatrician at Children's Primary Care Medical Group, La Jolla, CA

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