Review of antipyretic drugs for adults and children: types, how they work, how to choose

An increase in body temperature is a symptom that expresses the body's response to an inflammatory process, the invasion of an infectious agent or toxin. You should take an antipyretic if the thermometer shows more than 38.5°C. For chronic diseases and poor health, intake is also indicated at a lower value.

Pharmacy chains offer a wide range of medications for fever. We will look at which of them are most effective for adults and children in the article.

How to lower an adult's fever: 8 best drugs

September 14, 2021
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Content

• How to choose fever pills
• Why does the temperature rise
• What to do at elevated temperatures
• How to reduce fever without medication
• The best antipyretics
• Paracetamol
• Nimesil
• Nurofen Long
• Theraflu ExtraTab
• Ibuklin
• Maxicold
• Rinza
• Aspirin

An increase in temperature is a signal from the body that there is an inflammatory process somewhere. An increase in temperature is a protective response of the immune system, the purpose of which is to eliminate the problem. But there are situations when the temperature urgently needs to be brought down. We will tell you which antipyretic pills are best to choose.

Fever in an adult

As mentioned above, it is not recommended to lower the temperature if it does not exceed 38 °C and lasts no more than 3 days. The immune system fights the infection and will cope on its own.

How can you help your body reduce its temperature? There are several tried and tested methods that can help reduce your thermometer reading.

The doctor can prescribe the correct treatment

How to choose fever pills

Antipyretic drugs come in two categories:

• antipyretics
  (such drugs have a good antipyretic effect, they relieve pain a little, but do not in any way affect the source of inflammation). These are mainly paracetamol-based drugs;
• NSAIDs
  (these drugs relieve inflammation, reduce pain and reduce fever). In this category, the most famous drug is aspirin, but it has a lot of side effects. Today, instead of aspirin, there are many other, safer drugs for fever. One of them is ibuprofen.

How to dose?

The easiest way to dose Nurofen is: syrup dose (ml) = 1/2 weight (kg). This is based on a single dosage of 10 mg/kg ibuprofen.

Paracetamol is dosed at 15 mg/kg. If you dose the most popular syrup - Panadol - you can multiply the child’s weight in kg by 0.625.

A single dose can be given no more than once every 4 hours, but preferably no more than 3 times a day.

You should not use the dosage according to age, which is often placed on the packaging of drugs. This is dangerous because children of the same age weigh very differently. Correctly dose medications by weight or body surface area, but not by age.

Why does the temperature rise

The temperature can rise for various reasons. All of them can be divided into the following groups:

1. Infectious diseases caused by viruses (ARVI, influenza, intestinal infections, coronavirus, etc.).
2. Infections caused by bacteria (tonsillitis, bronchitis, pharyngitis, pneumonia, skin inflammation and intestinal infections).
3. Complications after operations, post-traumatic complications due to infection and tissue inflammation.
4. Autoimmune diseases.
5. Oncological processes (including blood diseases).

Also, body temperature may increase after overheating, against the background of endocrine diseases, due to problems with metabolism or taking certain medications. Non-pathological causes of fever also include: stress, premenstrual syndrome, menstruation, pregnancy, teething in babies.

By the way, a slightly elevated temperature can sometimes be a variant of the norm - as an individual feature of the body.

Why measure temperature?

The measurement has primarily diagnostic value. We approach conditions in which the temperature is above or below the conventional limit of 38 degrees Celsius a little differently. Since most fevers in our latitudes go away on their own within 3 days, in the absence of threatening symptoms, I recommend observation for 72 hours after the first rise in temperature above 38. If after this period it rises again above 38, a doctor’s examination is necessary to decide whether whether this is a lingering virus (and we continue to observe) or whether more aggressive intervention is required. Thus, we measure temperature to determine treatment tactics, but not to resolve the issue of antipyretic treatment.

What to do at elevated temperatures

If you have a slight fever, do not rush to immediately swallow an antipyretic. If the numbers are 38-38.5, just try to have a good rest, drink a lot of warm liquids and get some sleep. Give the body the opportunity to cope with the infection on its own.

If you feel normal at an elevated temperature (up to 38.5 degrees), you are at home, you can try to lower the temperature without pills: wipe your body with a damp towel moistened with water at room temperature.

But if you do not tolerate an increase in temperature, it has risen above 38.5 degrees, be sure to take an antipyretic. Especially if you have a headache, general weakness or convulsions (in this case you need to call an ambulance).

Take any medications (including antipyretics) with caution if you are prone to allergies. Often tablets or syrups for fever contain flavorings and dyes.

Often the dose of fever medication is calculated based on body weight. If a child’s temperature has risen, it can only be brought down with certain medications, so be sure to check the instructions for contraindications.

Tablets for fever, as we wrote above, are divided into two groups: NSAIDs and antipyretics. Drugs based on NSAIDs in combination with antispasmodics are good at reducing fever, which does not decrease for a long time (usually emergency doctors give such injections). But before using drugs with NSAIDs, it is necessary to assess the general health of the patient - NSAIDs are contraindicated for gastrointestinal diseases.

At elevated temperatures, it is imperative to look for the cause and fight it. This is usually a viral or bacterial infection. If it is bacterial, antibiotics are prescribed, but if it is a virus, then there is no special treatment, only symptomatic. Antiviral drugs are ineffective here. It is important to immediately consult a doctor if antipyretic drugs do not reduce the temperature well or the condition only worsens.

What temperature should be lowered in a child with influenza and ARVI?

High temperature forces the child's body to turn on its protective function. In this case, there may be a general deterioration in the form of malaise and headaches. The child becomes lethargic and whiny, which brings a lot of anxiety to parents. Before bringing down a child’s high temperature, you need to clarify significant nuances.

A slight increase in temperature does not lead to serious consequences and does not require any measures to be taken. Parents need to have reliable information about what temperature should be lowered. Improper actions can cause weakened immunity. There is a risk of developing possible complications and the disease may become protracted.

Cases when you need to bring down the temperature in children:

• 37.2-37.9°C (low-grade fever) – should be taken for newborns up to 2 months of age if indicated;
• 38.0-38.9°C (febrile) – antipyretics must be given in all cases;
• over 41.0°C (hyperthermic) - you need to call an ambulance if the drugs do not lower the readings on the thermometer.

It is necessary to call an ambulance if febrile spasms appear - this is intolerance to high temperature, an individual feature of the child’s body. This condition usually does not occur in children over 6 years of age (provided there are no pathologies in the central nervous system).

Chronic or acute diseases in cardiology, neurology or lung disease require lowering the temperature in children if the readings are above 38°C. Otherwise, complications from the heart, nervous system and respiratory organs cannot be ruled out.

If you have difficulty lowering your temperature, you should immediately seek medical help. If the thermometer has barely reached 37°C, and the child looks lethargic and his health is only getting worse, you should not expect a further increase in the readings on the thermometer.

How to reduce fever without medication

There are non-drug methods of reducing fever that can be used either alone or while taking antipyretics.

1. If you are feeling chilly, you should not wrap yourself up too much, so as not to disrupt heat transfer - this will only aggravate the condition. You need to cover yourself until you are comfortable, but not too hot.
2. Don't forget to have enough liquid. The body tries to cool down - the body sweats and loses fluid. If there is little water in the body, the condition will worsen. The liquid also helps remove waste products of pathogenic microorganisms from the body.
3. If you don't have an appetite, don't force yourself (or your child) to eat. During illness, all the body's strength is spent fighting infection.
4. To reduce your temperature without medication, wipe your body with a towel moistened with water at room temperature.
5. At elevated temperatures, ice can be applied to large vessels. First you need to crush the ice and put it in a bag. An ice pack should be applied through a towel - to the groin folds, armpits, forehead, popliteal fossa.
6. Raspberry, cherry, currant, and strawberry jam are considered folk remedies for fever (you can add tea or simply stir with warm water).

If the above methods of reducing fever do not work, be sure to take an antipyretic.

The concept of normal for body temperature

Normal body temperature is considered to be 36.6°C, but this figure can fluctuate. The lowest value is observed in the morning, the maximum in the evening. An increase in temperature is facilitated by eating, drinking alcohol, exercising, stimulating the nervous system, being under the sun, or in a steam room. It is considered normal if a person’s temperature is 36.2°C in the morning and 36.7°C in the evening. A peculiarity of the female body is that the temperature decreases a few days before ovulation and increases when ovulation occurs.

The norm for an adult is considered to be between 35°C and 37°C, for children under 3 years of age – up to 37.5°C. In summary, a temperature of 35°C should not cause panic.

How to measure temperature:

• if you measure under the armpit, then a value of 36.6°C is considered normal;
• if in the mouth, then the indicator is half a degree higher;
• if in the rectum, then to get the result subtract 1 degree from the value on the thermometer.

The range from 37.1°C to 38°C is considered to be above normal. If low-grade fever persists for a long time, measures must be taken. An indicator of 38.1°C is already a high temperature that requires urgent help for the body.

Paracetamol

You can buy Paracetamol in tablets, capsules, syrup, suspension and in the form of rectal suppositories. The active substance is paracetamol. The antipyretic is available without a prescription. This is the safest remedy, effective and prescribed for ARVI. Compared to other drugs, Paracetamol is weaker because it does not have an anti-inflammatory effect - for bacterial infections it is better to choose other tablets for fever. Paracetamol moderately reduces headaches and reduces general malaise. The temperature begins to drop 30-40 minutes after taking the drug, the effect lasts for 4-6 hours. Paracetamol is safe for both children and the elderly, pregnant and lactating women. The only exception is people with severe liver disease and chronic alcoholism. Paracetamol should not be taken with alcohol, for prophylaxis or as a course - only at high temperatures.

Paracetamol MS

Medisorb, Russia

Paracetamol is used for: relieving moderate or mild pain (headache, toothache, migraine, sore throat, neuralgia, myalgia);
reducing elevated body temperature during colds and other infectious and inflammatory diseases. Paracetamol is intended for symptomatic therapy, reducing pain and inflammation at the time of use, does not affect the progression of the disease. from 4

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How to help a child’s body fight infection?

Regardless of whether you follow the recommendations on what temperature to lower in children, you must take care to create the necessary conditions for the patient. All family members should improve the quality of personal hygiene: wash their hands, wear disposable gauze bandages, etc. You also need to provide the child with separate cutlery and dishes.

Recommendations for a speedy recovery:

1. A sick child must remain in bed.

2. It is necessary to ventilate the room in which the baby is located (the influenza virus and other microorganisms are concentrated in musty air).

3. Care should be taken to humidify the air (at the same time, the mucous membranes of the nose and larynx do not dry out; this improves local immunity and promotes well-being).

4. You should ensure that you drink plenty of fluids (virus breakdown products are eliminated through the kidneys, which reduces the load on the body).

5. The baby’s clothes should be light, preferably made from natural fabrics.

6. It is considered normal for a baby to have no appetite. You should avoid spices, citrus fruits, and dairy products, which can cause irritation of the gastric mucosa. A hot bath at a high temperature is not the most pleasant feeling, but cool (not cold) water can help normalize the indicators.

7. It is recommended to use the bath together with antipyretics, and not instead of them. You can also get some relief by applying a cool compress to your forehead.

Nimesil

The active ingredient of the antipyretic drug is nimesulide. These are NSAIDs with pronounced anti-inflammatory, antipyretic and analgesic effects. You can buy Nimesil at the pharmacy in individual sachets. Among the contraindications to taking Nimesil are diseases of the gastrointestinal tract (the full list is listed in the instructions, so be sure to read it before taking the drug). "Nimesil" should be used only after consultation with a doctor.

Nimesil

Berlin-Chemie/Menarini, Germany

Treatment of acute pain (back pain, lower back pain; pain syndrome in the musculoskeletal system, including injuries, sprains and dislocations of joints, tendonitis, bursitis; toothache);
— symptomatic treatment of osteoarthritis with pain syndrome; - algodismenorrhea. The drug is intended for symptomatic therapy, reducing pain and inflammation at the time of use. from 24

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Literature

1. Yewale VN, Dharmapalan D. Promoting appropriate use of drugs in children // Int J Pediatr. 2012; 2012: 906570. Epub 2012 May 8.
2. Allan GM, Ivers N., Shevchuk Y. T reatment of pediatric fever: Are acetaminophen and ibuprofen equivalent? // Can Fam Physician. 2010, Aug; 56(8):773.
3. Sullivan JE, Farrar HC Fever and antipyretic use in children // Pediatrics. 2011, Mar; 127(3):580–587.
4. Zakharova I.N., Zaplatnikov A.L., Tvorogova T.M., Machneva E.B. Pediatricians – about febrile conditions in children: what you need to know and be able to do. Text of a scientific article in the specialty “Fundamental Medicine”/216.
5. Baranov A.A., Tatochenko V.K., Bakradze M.D. Feverish syndromes in children. Recommendations for diagnosis and treatment. M., 2011.

Nurofen Long

"Nurofen Long" for fever is sold in tablets, capsules, syrup. You can also buy a combination drug "Nurofen" with paracetamol. Nurofen does not require a prescription, and its active substance is ibuprofen (NSAID). Nurofen Long perfectly reduces the temperature literally 20 minutes after taking the tablet, and the effect lasts for 8 hours. The drug also reduces muscle pain, relieves headaches and inflammation, relieves nasal congestion, and relieves pain. Nurofen Long is recommended for bacterial infections and exacerbation of chronic diseases. The drug helps with elevated temperature due to ARVI. Contraindications include intolerance to ibuprofen and fructose, gastrointestinal diseases (including gastritis and ulcers), liver and kidney diseases. You should not drink alcohol while taking Nurofen. Nurofen is prescribed during pregnancy only if there is an urgent need.

Nurofen Long

Reckitt Benckiser, Netherlands

Backache;
joint pain; muscle and rheumatic pain; neuralgia; headache; migraine; toothache; painful menstruation; a sore throat; feverish condition; cold and flu symptoms. The drug is especially indicated for the symptomatic treatment of pain requiring a more pronounced analgesic effect than ibuprofen or paracetamol alone. from 137

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Choosing the optimal antipyretic drug in pediatric practice

Fever is one of the main reasons for seeking medical care in pediatrics, accounting for up to 30% of all doctor visits by children in general and up to 2/3 of visits by children under three years of age [1, 2].

Depending on the etiological factor, it is customary to distinguish two main groups of fever: infectious and non-infectious (with aseptic immune inflammation, tissue damage and dysfunction of the autonomic and central nervous system (CNS)) [3].

In Russia, fever in children is most often associated with infectious diseases, especially acute respiratory viral infections (ARVI). Most children with ARVI are treated at home; parents often resort to self-medication using over-the-counter analgesics [4].

Meanwhile, moderate fever is an important protective and adaptive reaction of the body, promoting the death of pathogens of infectious diseases, the production of antibodies, and the activation of phagocytosis and immunity. The use of antipyretics is sometimes undesirable due to the fact that they can mask the clinical manifestations of severe infections, delay the establishment of the correct diagnosis, which increases the risk of complications and deaths [5]. When a child receives antibacterial therapy, regular use of antipyretic medications may mask the insufficient effectiveness of the antibiotic [3].

On the other hand, an increase in body temperature to very high values ​​(> 40 °C) can contribute to the development of cerebral edema and dysfunction of vital organs [6]. A rise in temperature above 38 °C is dangerous for children in the first two months of life due to imperfect thermoregulation processes, for children aged 6 months to 3 years who are at risk for the development of febrile seizures, as well as in the presence of severe respiratory and cardiovascular diseases. vascular systems, the course of which can worsen with fever [7].

In children with central nervous system pathology (perinatal encephalopathy, epilepsy, etc.), seizures may develop against the background of elevated body temperature [8]. Febrile seizures occur in 2–4% of children, most often at the age of 12–18 months [6].

The purpose of prescribing antipyretic drugs to children is not only to prevent the above complications and dehydration, but also to reduce the discomfort associated with fever [9, 10]. Moreover, some experts consider the elimination of discomfort to be the main goal of treating fever in pediatrics [11].

The question of using an antipyretic for fever in a child should be decided individually. Children at risk for developing complications from febrile reactions include:

• under 2 months of age with a temperature above 38 °C;
• with a history of febrile seizures;
• with diseases of the central nervous system;
• with chronic pathology of the circulatory system;
• with hereditary metabolic diseases [12].

Russian pediatricians recommend prescribing antipyretic drugs to children in the first 3 months of life at a temperature > 38 °C, and to children over 3 months (previously healthy) at a temperature > 39 °C and/or for muscle aches and headaches [13].

In addition, antipyretics are recommended for all children with a history of febrile seizures at temperatures > 38–38.5°C, and for severe heart and lung disease at temperatures > 38.5°C.

Antipyretic therapy should be carried out against the background of etiological treatment of the underlying disease, and in children with allergic diseases (atopic dermatitis, allergic rhinitis) against the background of the use of antihistamines [4].

When choosing an antipyretic drug, it is always necessary to weigh its benefit/risk ratio for a given pathology, assessed on the basis of the results of adequate randomized controlled trials. It is necessary to give preference to the most well-studied drugs in pediatrics, of which there are very few today - 75% of drugs on the pharmaceutical market have never been studied in adequate clinical studies in children [14, 15]. An important factor when choosing a drug for children is also the availability of pediatric dosage forms and their organoleptic properties (taste, smell), as well as ease of dosing and use, which allows increasing adherence to pharmacotherapy and preventing medical errors.

Among the drugs with analgesic and antipyretic effects, the most well studied in pediatrics are ibuprofen and paracetamol. These drugs are recommended by the World Health Organization; they are the only representatives of their group approved for over-the-counter use for fever and pain in children in most economically developed countries, including the Russian Federation. Paracetamol and ibuprofen can be prescribed to children from the first months of life both in a hospital and at home [3]. The use of other non-opioid analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) in pediatric patients is limited due to both the lack of data on effectiveness in this population and the risk of serious side effects. Some NSAIDs are only available by prescription for the treatment of arthritis in children and adolescents.

It should be noted that there are significant differences between paracetamol and ibuprofen that must be taken into account when choosing antipyretics (Table).
Ibuprofen, unlike paracetamol, has not only antipyretic and analgesic, but also anti-inflammatory properties, so its use is more preferable in children with fever accompanied by inflammatory processes, for example, sore throat, otitis media, arthritis, etc. [16]. Table. Regimens for the use of paracetamol and ibuprofen for the treatment of fever in children [8]

Evidence of the effectiveness of ibuprofen for fever in children

The effectiveness and safety of ibuprofen in children with fever has been studied in more than 120 clinical trials, most of which included paracetamol as a comparator [17].

The results of these studies indicate that, both in single doses and in repeated doses, ibuprofen is at least as effective as or superior to paracetamol.

For example, in an open-label, randomized, three-parallel group study of children aged 6–24 months, ibuprofen at a dose of 7.5 mg/kg was superior to paracetamol and acetylsalicylic acid (both at a dose of 10 mg/kg) [18]. ].

A more pronounced antipyretic effect of ibuprofen at doses of 7.5 and 10 mg/kg compared with paracetamol at a dose of 10 mg/kg has been demonstrated in a number of other clinical studies in children [19–23]. Additionally, in a double-blind, placebo-controlled, randomized clinical trial of 127 children 2–11 years of age, ibuprofen was shown to be better at reducing high fever (>39.2°C) than paracetamol [24].

The higher efficacy of ibuprofen as an antipyretic in children when used at a dose of 5–10 mg/kg compared with paracetamol at doses of 10–12.5 mg/kg was confirmed by the results of a meta-analysis that included 17 blinded randomized clinical trials [17]. The superiority of ibuprofen was observed at all time intervals studied (2, 4 and 6 hours after administration) and was most pronounced between 4 and 6 hours after the start of treatment, when the effect of ibuprofen was more than 30 points higher than the effect of the comparison drug. When studies in which ibuprofen was used at a dose of 5 mg/kg were excluded from the analysis, its advantage over paracetamol increased even more (the effect was approximately 2 times stronger than that of paracetamol). The incidence of side effects, including gastrointestinal and renal side effects, was similar.

The conclusion about the superiority of ibuprofen over paracetamol in terms of antipyretic and analgesic efficacy in adults and children was also made in the latest published meta-analysis, which included data from 85 comparative clinical studies of these drugs, including 35 studies comparing antipyretic activity [26].

Analysis of published data allows us to recommend ibuprofen as the drug of choice for the treatment of fever in children, since it causes a more pronounced decrease in body temperature than paracetamol, without increasing the risk of adverse events [27].

Very interesting data were obtained in a study by Autret-Leca et al. (2007): Although ibuprofen and paracetamol were found to be comparable in effectiveness and tolerability, significantly more parents in the ibuprofen group than in the paracetamol group rated the drug their children were receiving as “very effective” both open-label and in the blinded phase of the study [28]. The authors believe that this assessment may be explained by some additional benefit of the drug, which could not be measured in this study, but reduced parents' anxiety about their children's treatment.

Another study focused on parental satisfaction when their children (n = 490) received ibuprofen suppositories as an antipyretic at a dose of 5–10 mg/kg/dose [29]. The average rating of parents' satisfaction on a 5-point scale was 4.5 ± 0.47; 92.2% of parents said they would use this drug in the future.

There are fewer comparative studies of ibuprofen with other antipyretics, since the use of the latter (for example, acetylsalicylic acid and metamizole sodium) in children is limited due to safety concerns. However, available evidence suggests that ibuprofen is also superior in effectiveness. As mentioned above, ibuprofen at a dose of 7.5 mg/kg was superior in effectiveness to acetylsalicylic acid at a dose of 10 mg/kg [18].

In a comparative study of 80 children aged 6 months to 8 years, a single dose of ibuprofen 10 mg/kg had a greater antipyretic effect than a single dose of Dipirone (metamizole sodium) 15 mg/kg [30]. The benefit of ibuprofen was particularly pronounced in children with high (>39.1°C) body temperature. In other comparative clinical studies, ibuprofen was not inferior in effectiveness to metamizole sodium preparations for intramuscular administration, which allowed the authors to recommend giving preference in pediatrics to ibuprofen as an oral drug, the use of which is not associated with pain and other undesirable consequences of injections [31, 32].

The advantage of ibuprofen over other antipyretics is the rapid (within 15 minutes) development of the antipyretic effect [32, 33] and its long duration (8 hours) [25].

Ibuprofen has been shown to be effective for the treatment (at a dose of 7.5 mg/kg) and prevention (at a dose of 20 mg/kg/day, divided into 3 doses) of post-vaccination reactions, including fever [34]. The preventive effect of the drug against post-vaccination reactions was especially pronounced in children aged 3 months [34].

Although relief of the discomfort associated with fever is considered to be the main purpose of antipyretic administration, targeted research on this issue is virtually absent. As mentioned above, one randomized trial showed a more favorable effect of ibuprofen on this indicator compared to paracetamol and acetylsalicylic acid [18].

In a small domestic study involving 30 children aged 3 months to 2 years with fever due to ARVI, the use of Nurofen suppositories for children (60 mg) led to a more rapid improvement in well-being, normalization of sleep and appetite than the use of paracetamol suppositories (80 mg) [35 ].

This may be explained by both the wider spectrum of pharmacological action of ibuprofen and its more favorable effect on the temperature curve (speed of onset of effect, duration of action). It is possible that the reason may be the variable bioavailability of paracetamol when administered rectally [36].

Thus, evidence-based medicine data indicate that ibuprofen has advantages over paracetamol and other antipyretics in terms of effectiveness as an antipyretic in children with fever. Many experts believe that ibuprofen should be considered the drug of choice for fever in children and adults [10, 25–28, 37, 38].

The attitude of experts towards combination therapy with ibuprofen and paracetamol is contradictory. In the recent double-blind clinical trial PITCH, which compared the effectiveness of the combination of paracetamol (15 mg/kg) and ibuprofen (10 mg/kg) with monotherapy for fever in children aged 6 months to 6 years with a temperature of 37.8–41, 0 °C or more, the combination of drugs made it possible to normalize body temperature 23 minutes faster than paracetamol alone, but not faster than ibuprofen [38].

A systematic review that analyzed data from 7 randomized clinical trials failed to show any significant benefit or harm from combination therapy [25]. In this regard, the review authors consider the use of combination therapy inappropriate. Most other experts also recommend avoiding combination therapy due to safety concerns, including potential drug overdose [10, 11, 38–41]. In the case of combined or alternate use of paracetamol and ibuprofen, to prevent overdose, it is recommended to record the time of administration of each dose of the drugs [38]. Based on the results obtained, the authors recommended starting treatment of young children with ibuprofen monotherapy as the drug of choice.

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2. Porth CM, Kunert MP Alteracoes na regulacao da temperatura. In: Porth CM, Kunert MP Fisiopathology. 6a ed. Rio de Janeiro: Guanabara Koogan; 2004. P. 190–201.
3. Korovina N.A., Zakharova I.N., Zaplatnikov A.L. Acute fever in children // RMZh. 2005, no. 17, 1165–1170.
4. Geppe N. A. The place of ibuprofen in antipyretic therapy for children with allergic conditions // Consilium medicum. 2003, no. 6.
5. Niven DJ, Leger C., Kubes P., Stelfox HT, Laupland KB Assessment of the safety and feasibility of administering anti-pyretic therapy in critically ill adults: study protocol of a randomized trial // BMC Res Notes. 2012, Mar 16; 5:147.
6. Cremer OL, Kalkman CJ Cerebral pathophysiology and clinical neurology of hyperthermia in humans // Prog Brain Res. 2007; 162:153–169.
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8. Timchenko V.N., Pavlova E.B. Modern approaches to the treatment of fever in children with infectious pathology // RMZh. 2008, No. 3, p. 113–117.
9. Lava SA, Simonetti GD, Ramelli GP et al. Symptomatic management of fever by Swiss board-certified pediatricians: results from a cross-sectional, Web-based survey // Clin Ther. 2012, Jan; 34(1):250–256.
10. Chiappini E., Principi N., Longhi R. et al. Management of fever in children: summary of the Italian Pediatric Society guidelines // Clin Ther. 2009, Aug; 31(8):1826–1843.
11. Sullivan JE, Farrar HC Fever and antipyretic use in children // Pediatrics. 2011, Mar; 127(3):580–587.
12. Zaplatnikov A.L. Rational use of antipyretic drugs for ARVI in children // RMZh. 2009, no. 19, 1223–1236.
13. Tatochenko V.K., Uchaikin V.F. Fever // Pediatric pharmacology. 2006; 3:43–44.
14. Carleton BC, Smith MA, Gelin MN, Heathcote SC Paediatric adverse drug reaction reporting: understanding and future directions // Can J Clin Pharmacol. 2007, Winter; 14(1):e 45–57.
15. Yewale VN, Dharmapalan D. Promoting appropriate use of drugs in children // Int J Pediatr. 2012; 2012: 906570. Epub 2012 May 8.
16. Timchenko V. N., Pavlova E. B. Experience of using the drug “Nurofen for children” in the treatment of infectious diseases in children. Information mail. St. Petersburg, 2006. 8 p.
17. Perrott DA, Piira T., Goodenough B., Champion GD Efficacy and safety of acetaminophen vs ibuprofen for treating children's pain or fever: a meta-analysis // Arch Pediatr Adolesc Med. 2004, Jun; 158(6):521–526.
18. Autret E., Reboul-Marty J., Henry-Launois B. et al. Evaluation of ibuprofen versus aspirin and paracetamol on efficacy and comfort in children with fever // Eur J Clin. 1997; 51: 367–371.
19. Wilson JT, Brown RD, Kearns GL et al. Single-dose, placebo-controlled comparative study of ibuprofen and acetaminophen antipyresis in children // J Pediatr. 1991 Nov; 119(5):803–811.
20. Autret E., Breart G., Jonville AP et al. Comparative efficacy and tolerance of ibuprofen syrup and acetaminophen syrup in children with pyrexia associated with infectious diseases and treated with antibiotics // Eur J Clin Pharmacol. 1994; 46(3):197–201.
21. Van Esch A, Van Steensel-Moll HA, Steyerberg EW et al. Antipyretic efficacy of ibuprofen and acetaminophen in children with febrile seizures // Arch Pediatr Adolesc Med. 1995, Jun; 149(6):632–637.
22. Czaykowski D., Fratarcangelo P., Rosefsky J. Evaluation of the antipyretic efficacy of single dose ibuprofen suspension compared to acetaminophen elixir in febrile children // Pediatr. Res, 1994, 35, Abstr. 829.
23. Goldman RD, Ko K., Linett LJ, Scolnik D. Antipyretic efficacy and safety of ibuprofen and acetaminophen in children // Ann Pharmacother. 2004; 38 (1): 146–150.
24. Walson PD, Galletta G., Braden NJ, Alexander L. Ibuprofen, acetaminophen, and placebo treatment of febrile children // Clin Pharmacol Ther. 1989, July; 46(1):9–17.
25. Pursell E. Treating fever in children: paracetamol or ibuprofen? // Br J Community Nurs. 2002; 7: 316–320.
26. Pierce CA, Voss B. Efficacy and safety of ibuprofen and acetaminophen in children and adults: a meta-analysis and qualitative review // Ann Pharmacother. 2010, Mar; 44(3):489–506.
27. Allan GM, Ivers N., Shevchuk Y. T reatment of pediatric fever: Are acetaminophen and ibuprofen equivalent? // Can Fam Physician. 2010, Aug; 56(8):773.
28. Autret-Leca E., Gibb IA, Goulder MA Ibuprofen versus paracetamol in pediatric fever: objective and subjective findings from a randomized, blinded study // Curr Med Res Opin. 2007, Sep; 23(9):2205–2211.
29. Hadas D., Youngster I., Cohen A. et al. Premarketing surveillance of ibuprofen suppositories in febrile children // Clin Pediatr (Phila). 2011, Mar; 50 (3): 196–199.
30. Magni AM, Scheffer DK, Bruniera P. Antipyretic effect of ibuprofen and dipyrone in febrile children // J Pediatr (Rio J). 2011, Jan-Feb; 87(1):36–42.
31. Prado J., Daza R., Chumbes O. et al. Antipyretic efficacy and tolerability of oral ibuprofen, oral dipyrone and intramuscular dipyrone in children: a randomized controlled trial // Sao Paulo Med J. 2006. May 4; 124(3):135–140.
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1 This drug is not registered in the Russian Federation.

E. A. Ushkalova, Doctor of Medical Sciences, Professor

FSBI NTsAGiP im. V. I. Kulakova Ministry of Health and Social Development of Russia, Moscow

Contact information about the author for correspondence

Theraflu ExtraTab

These fever tablets contain paracetamol, which reduces fever well. In addition, Theraflu ExtraTab contains phenylephrine (a vasoconstrictor) and chlorphenamine (an antihistamine). Therefore, the drug has a complex effect - it relieves swelling during a runny nose and reduces fever. Contraindications to taking Theraflu ExtraTab include stomach ulcers.

Theraflu extratab

Novartis Pharma Services AG (Novartis Pharma), Switzerland

Symptomatic treatment of infectious and inflammatory diseases (ARVI, including influenza), accompanied by high fever, chills, headache, runny nose, nasal congestion, sneezing, muscle pain.
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What to do if your child has a fever?

Does your baby have a fever? Then you can’t hesitate - you need to urgently consult a doctor. Especially if it is accompanied by:

• rash;
• neck muscle tension;
• abdominal pain;
• vomiting.

But don’t panic: fever is typical for most common viral respiratory infections and high temperatures - about 40 degrees. This is how our body responds to infection. The pediatrician will simply examine the child and select the right treatment for him, taking into account the severity of the disease.

Ibuklin

This is a complex antipyretic drug - here paracetamol and ibuprofen (antipyretic and NSAID). You can buy Ibuklin without a prescription; the product reduces fever well, relieves cold symptoms, reduces inflammation and body aches, and improves overall well-being. “Ibuklin” begins to act 20 minutes after administration, and the effect lasts 6-8 hours. Contraindications: liver and kidney diseases, gastrointestinal problems (ulcers, gastritis). Ibuklin should not be taken with alcohol.

Ibuklin

Dr. Reddy's Laboratories, India

- symptomatic treatment of infectious and inflammatory diseases (colds, flu), accompanied by fever, chills, headache, muscle and joint pain, sore throat;
- myalgia; - neuralgia; - back pain; — joint pain, pain syndrome in inflammatory and degenerative diseases of the musculoskeletal system; - pain from bruises, sprains, dislocations, fractures; — post-traumatic and postoperative pain syndrome; - toothache; - algodismenorrhea. The drug is intended for symptomatic therapy, reducing pain and inflammation at the time of use, and does not affect the progression of the disease. from 78

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Temperature does not go down - when to call an ambulance

After using paracetamol or ibuprofen, body temperature should decrease at a rate of 0.5–1 0 C per hour. However, sometimes the fever remains at the same level, while the patient’s well-being worsens. In what cases should you call an ambulance or go to the hospital yourself if:

• taking medications according to the regimens described above did not produce any effect;
• for “white” fever, analgin had no effect;
• fever is combined with concomitant pathologies: epilepsy, intracranial hypertension, hydrocephalus, congenital heart defects;
• against the background of fever, the patient refuses to drink and eat, has difficulty breathing and cannot sleep;
• fever is accompanied by severe abdominal pain and incessant vomiting.

If the temperature rises, even despite taking medications, most likely this is a pathological variant of fever - hyperthermic syndrome, in which antipyretic drugs are not effective. This is also one of the reasons to call an ambulance and be hospitalized.

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Author: Atamanenko Alena Valerievna

General practitioner, endocrinologist, physiotherapist. Second category. Work experience more than 9 years.

Maxicold

The drug "Maxicold" contains paracetamol. This antipyretic drug perfectly relieves all symptoms of ARVI. In addition to Maxicold, you can buy Maxicold Rhino at the pharmacy, which will effectively relieve a runny nose and swelling of the nasal mucosa thanks to phenylephrine and pheniramine (vasoconstrictor and antiallergic effects). Maxicold contains vitamin C, a natural antioxidant that strengthens the immune system and helps the body fight colds.

Maxicold

JSC Pharmstandard-UfaVITA, Russia

- symptomatic treatment of infectious and inflammatory diseases (including influenza and other acute respiratory viral infections (ARVI)), accompanied by fever, chills, nasal congestion, headache, pain in the bones and muscles, in the throat and sinuses.
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Maxicold Rhino

OJSC Pharmstandard-Leksredstva, Russia

- symptomatic treatment of colds, acute respiratory viral infections, flu, accompanied by high fever, chills, headache, runny nose, pain in the sinuses and throat, nasal congestion, sneezing and pain in muscles and joints.
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What to do if your baby gets chickenpox?

Has your child caught chickenpox? Of course, this acute viral disease can also cause high fever. How to proceed in this case?

The most important thing is to choose an antipyretic drug for your baby. Under no circumstances should you use Nurofen. To combat high fever during chickenpox, medications containing Paracetamol are suitable.

Rinza

Rinza tablets are a complex drug. The product contains caffeine, which enhances the antipyretic effect and improves metabolic processes. Paracetamol helps reduce fever and relieve muscle pain. Phenylephrine relieves swelling of the nasal mucosa, chlorphenamine is an antihistamine against inflammation. "Rinza" relieves cold symptoms for 12 hours. This drug is contraindicated for pregnant women, hypertensive patients, patients with atherosclerosis, those treated with antidepressants, people with kidney and liver diseases; alcohol should not be taken while being treated with Rinza.

Rinza

Unique Pharmaceutical Laboratories, India

- symptomatic treatment of “colds”, acute respiratory viral infections (including influenza), accompanied by fever, pain, and rhinorrhea.
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Aspirin

Aspirin can be bought both in regular tablets and in effervescent form. This is an NSAID whose active substance is acetylsalicylic acid. Aspirin has a strong antipyretic effect, it is an excellent pain reliever, while the anti-inflammatory effect of the drug is very weak. After taking Aspirin, relief occurs within 15 minutes (faster if these are effervescent tablets). But you need to remember that Aspirin is not the safest drug for fever. Allergies often occur to it; asthmatics, allergy sufferers and those who have problems with the gastrointestinal tract and liver should not drink it. It is prohibited for children under 15 years of age and pregnant women to take Aspirin with alcohol.

Aspirin

Doctor's advice

Herbal preparations are often used to reduce temperature, for example, linden flowers, chamomile, rose hips, plantain, coltsfoot. Blackcurrant drinks help bring down the temperature.

Rosehip infusion is good for reducing fever, especially if the fever is associated with colds. It is recommended to drink this drink regularly during fever, as this remedy helps to quickly lower it and improves immunity.

Drinks with honey or lemon are also very beneficial. In addition, they contain vitamin C, which is essential for colds and flu.

It is not recommended to consume these drinks hot, as this can lead to overheating of the body. It is worth remembering that lemon can have an acid-forming effect on the stomach, so tea with lemon is not recommended for people with stomach diseases.

How to bring down the temperature?