Children have a fever, and there are only two commonly used and recommended antipyretic drugs: acetaminophen and ibuprofen.
How to choose these two commonly used antipyretics?
Let’s talk about the difference between acetaminophen and ibuprofen for children’s antipyretics? What should I pay attention to when using these two drugs?
What is the difference between acetaminophen and ibuprofen?
Although both drugs have antipyretic and analgesic effects, a careful comparison reveals the following differences:
1. Different anti-inflammatory effects
Ibuprofen has anti-inflammatory effects whereas acetaminophen does not.
2. Different cooling effect
Ibuprofen’s antipyretic effect is relatively stronger, and the cooling maintenance time is relatively long.
Acetaminophen (compared to ibuprofen) has a relatively weak antipyretic effect, but within half an hour of oral administration, the cooling rate is faster than that of ibuprofen.
3. Different usage
Acetaminophen has less adverse intestinal reactions and does not irritate the gastric mucosa. It can be taken before meals.
Ibuprofen has a strong gastrointestinal reaction and is recommended to be taken with or after meals.
4. Not suitable for different people
Ibuprofen is not suitable for people:
(1) Medical studies have shown that ibuprofen and aspirin have cross allergies, so those who are clearly allergic to aspirin should not use ibuprofen.
(2) Patients with a history of peptic ulcer, gastrointestinal bleeding, cardiac insufficiency, liver and kidney insufficiency, hypertension, coagulation mechanism or platelet dysfunction (such as hemophilia) Children should not use ibuprofen.
(3) The use of ibuprofen to reduce fever in children with hypovolemia such as dehydration symptoms or insufficient water supplementation will increase the risk of renal damage.
Acetaminophen is not suitable for people:
Taking acetaminophen mainly restricts liver and kidney function, and there are relatively few restricted groups.
(1) Acetaminophen cannot be used in patients with severe hepatic and renal insufficiency.
(2) Not suitable for children with liver disease or viral hepatitis, mild to moderate liver and kidney insufficiency, or severe heart and lung disease. If the child has jaundice symptoms, liver function tests should be performed immediately.
How to choose the right ibuprofen and acetaminophen?
Infants under 6 months with fever should choose acetaminophen for antipyretic.
Babies over 6 months with fever, without special circumstances or other diseases, can choose either ibuprofen or acetaminophen. There is no obvious advantage or disadvantage between the two.
Infants over 6 months of age with “chickenpox” are recommended to use paracetamol to reduce fever.
Infants over 6 months with “broad bean disease” have a fever and choose to use ibuprofen to reduce the fever.
Babies over 6 months who have kidney disease or other chronic diseases; or find that the baby is accompanied by dehydration symptoms during the fever, such as severe vomiting, diarrhea, etc. To draw attention. Paracetamol should be selected.
What should I pay attention to when taking antipyretic drugs?
1. Whether you use acetaminophen or ibuprofen, you need to pay attention, the interval between dosing should not be less than 6 hours, the drug should not be more than 4 times in 24 hours, and it should not be used more than 3 times for antipyretic. Day, used for analgesia not more than 5 days, to avoid liver damage caused by drug overdose. If this time is exceeded or symptoms worsen, seek medical attention immediately.
2. During the use of ibuprofen or acetaminophen, it is not recommended to use other combination cold medicines and antipyretics at the same time to avoid the risk of overdose.
3. Combination or cross-use of acetaminophen and ibuprofen is not recommended. However, if using one drug to reduce the fever does not work, you can switch to another drug. If symptoms such as persistent high fever, lethargy, repeated crying or even convulsions occur, parents should take the baby to the hospital for medical treatment in time.
4. Acetaminophen and ibuprofen are not recommended if used to prevent febrile seizures.
5. For babies with gastrointestinal discomfort caused by oral drugs, parents are advised to use suppositories. The suppository is administered rectally, absorbed through the intestinal mucosa, and enters the systemic circulation directly through the inferior vena cava, avoiding the first-pass effect of the liver.
6. During the period of the baby’s fever and medication, parents should pay attention to drinking more water for the baby to ensure that the child’s body has enough water, which is conducive to sweating and heat dissipation. At the same time, wear light and sweat-absorbing clothes for the baby, and do not cover the quilt. Open windows to ventilate your home to allow air convection to keep the air fresh.
How much fever should I use with antipyretics?
According to the 2016 Evidence-Based Guidelines for the Diagnosis and Treatment of Several Problems in the Diagnosis and Treatment of Acute Fever of Unknown Etiology in Children Aged 0 to 5 Years in China: ≥2 months old, rectal temperature ≥39.0℃ (oral temperature 38.5 ℃, axillary temperature 38.2℃), or children with fever who are uncomfortable and depressed due to fever, antipyretics can be considered.
The 2017 edition of the “Expert Consensus on the Diagnosis and Treatment of Fever to Be Checked” pointed out that for fever with a body temperature ≤ 39°C, as long as the child is in a good mental state and there is no discomfort, it can also be observed first.
Therefore, parents should not take the baby’s body temperature as the only criterion for determining whether to take antipyretics, but should pay attention to the observation of the child’s mental state and the doctor’s advice to determine whether the medicine is needed.
In short, we must be careful when using medicines. Before taking medicines, we must consult a doctor, abide by the doctor’s orders, and take medicines scientifically and safely. Only by scientifically reducing fever can the baby recover quickly and grow up healthily.