Alternate administration of ibuprofen and paracetamol is not recommended. We describe correct dosage, advice and side effects, for effective use in the treatment of pain and fever
THE’ibuprofen It is a drug widely used to relieve pain and reduce fever in children, e It is part of the fans (non-steroidal anti-inflammatory drugs, that is, drugs other than cortisone-based those), well known precisely for their antipyretic and analgesic effects.
Ibuprofen performs his anti -inflammatory, pain -relieving and antipyretic activities through the inhibition of the synthesis of prostaglandins (our body’s molecules). This drug is also available in a form known as “listed“Or“lysine rooms“, Which is absorbed more quickly in gastro-intestinal tract Compared to the “free” hybuprofen, leading to a faster start of analgesia.
As antipyretic and painkiller, it is Currently recommended for use in pediatric age – pediatric ibuprofen – together with paracetamol, while the use of the two drugs in association (administration “alternating“) Is generally not recommended because it increases the risk of side effects. Therefore, although it is generally considered a safe drug, the administration must be done With attention and awareness of the parents.
In this article, we will explore when e How to administer ibuprofen to childrenwhat are its main characteristics and possible side effects.
When to give ibuprofen to children?
The first question that we pediatricians have to answer is: When it serves ibuprofen to children? Ibuprofen performs its function by inhibiting the activity of an enzyme, known as COX (cycle-oxygenase), which involves the reduction of the synthesis of the prostaglandins, molecules similar to fat and derived from arachidonic acid, which are involved in mediation of fever, inflammatory reactions and pain. Let’s analyze them individually.
Let’s start from the fever: it is one of the most common symptoms in childrenbeing responsible for a significant part of the consultations at the pediatrician of primary care and in the emergency departments. In most cases it is a physiological defense mechanism against the infectious agents who “attack” our body and all the guidelines available today agree on the administration of antipyretics only with the aim of check the discomfort of the child, regardless of the type of infection below.
The other possibility is to be faced with inflammation and/or mild or moderate pain. Examples are muscle or joint pains, headache, throat pain, ear pain, post-operative or post-traumatic pain and so on. For the treatment of pain, ibuprofen can be used instead of paracetamol in children starting 3 months of age. However, it should be remembered that paracetamla is not an anti -inflammatory, but has only analgesic and antipyretic effects.
Given the anti -inflammatory action combined with the pain reliever, ibuprofen it is also indicated in all those situations in which The two conditions are present At the same time, as it acts on both pain and on the components of inflammation, such as swelling.
About the dosage of hybuprofen in childrenthis depends on body weight and age, so it is essential to follow the pediatrician’s indications or the instructions shown on the drug packaging. In general, the recommended daily dose is of 20-30 mg per kilogram of body weight (equal to about 5-10 mg/kg/dose), administered no more than 3 times a day at intervals of 6-8 hours and always taking into account the indications provided by your doctor.
To give a practical example, we start from a widespread formulation of “Pediatric” ibuprofenthe syrup, which generally Contains 100 mg of ibuprofen every 5 ml of product. If the child weighs 10 kg, the single dose to be administered will be between 50 and 100 mg (2.5-5 ml), for a maximum of 150-300 mg per day of ibuprofen. Other examples are shown in the table below on the basis of the formulations available in Italy:
| Single dose of ibuprofen to be administered | ||||
| Weight | Indicative age | Suppository (60 mg and 125 mg) |
100mg/5ml syrup | Syrup 200mg/5ml |
| 6-8 kg | 3-9 months | 1 from 60 mg | 2.5 ml | 1.25 ml |
| 8-10 kg | 1-2 years | 1 from 60 mg (up to 12.5 kg) |
4 ml | 2 ml |
| 10-15 kg | 2-3 years | 1 from 125 mg (from 12.5 kg) |
5 ml | 2.5 ml |
| 15-20 kg | 4-6 years | 1 from 125 mg | 7.5 ml | 3,75 ml |
| 20-28 kg | 7-9 years | – | 10 ml | 5 ml |
| 28-43 kg | 10-12 years | – | 15 ml | 7.5 ml |
As far as giving ibuprofen? Generally it is recommended to Do not exceed 3 days of therapy, after which it is appropriate to contact the pediatrician.
What is ibuprofen for?
How to give children to children? The ibuprofen, as seen before, is available in different formulations, of which the most used in pediatrics are the syrup and the suppositorywhile the chewable soft capsules, the sachets and the gold-dispersible tablets are generally intended for teenagers, who have weight> 43 kg (see table).
There Oral administrationin the most suitable form to the different age groups, is generally from preferas for paracetamol. Only when it is not possible, for example in the event of vomiting, is it appropriate to resort to suppositories. The oral route allows you to dose the drug with greater precision, guaranteeing a more precise absorption than the rectal route, which, among other things, is sometimes more “traumatic” for the child.
To ensure a correct administration of hybuprofen Orally in the form of a syrup, the most used formulation in pediatric age, it is recommended to shake the syrup well before use and use the dosing syringe or the meassel supplied with the product in order to ensure an accurate dosage, above all avoiding administer a dose higher than the recommended one.
Among the main characteristics of the Ibuprofen for children, we remember that, like all the drugs destined for them, it comes formulated to be well tolerated from small patients. Therefore, it usually has a pleasant taste of fruit to facilitate its administration and can be taken both on a full stomach and empty, even if it is preferable to administer it during meals To reduce the risk of gastric irritation. The duration of the treatment with ibuprofen must be as short as possible, compatibly with the management of symptoms, precisely to limit the risk of possible side effects.
Albeit administration “alternating“Of ibuprofen and paracetamol is currently not recommended, some recent studies suggest that the association in the same medicine of the two active ingredients “Ibuprofen” and “Paracetamolo” can provide a Best pain control with respect to single use under certain conditions. For example, ibuprofen has anti -inflammatory properties that paracetamol does not have, therefore their combination could theoretically offer a greater response to the painful symptomatology.
For this reason, it exists on the market today an association of ibuprofen and paracetamolointended for children aged 2 and 12 years. This formulation is suitable for short -term treatment of Smart pain from mild to moderate which is not attenuated by paracetamol or hybuprofen alone, after appropriate medical prescription.
Possible side effects of IBUPROFENE FOR CHILDREN
About side effectsamong these the most common are vomiting, diarrhea, rash skingenerally of mild entity and often at spontaneous resolution. However, abdominal pains are also possible, erosion bleeding of the gastric mucosa and renal toxicity, which are rare and usually only occur with high and prolonged dosages of ibuprofen.
For this reason, as for the paracetamol, in order to limit the risk of possible side effects, if the symptoms do not improve within 3 days, it is necessary to contact the pediatrician, in any case avoiding to continue the therapy without the appropriate prescription beyond 5 days medical.
To the same, it is generally from Avoid the alternation of ibuprofen and paracetamolsince this increases the risk of side effects, just as before taking it, it is necessary to consider if the child is taking other medicines that could interfere with the action of the drug. Furthermore, it is necessary to consider carefully if the child presents conditions that The risks of adverse reactions related to the hiring of ibuprofen increasein particular asthma, liver diseases, kidneys and chronic intestinal inflammatory diseases.
For these reasons, it is essential that the drug is administered after consulting the pediatrician and the child is carefully monitored during the treatment, and theimmediately give administration in case of suspicious symptoms. In addition, in addition to the cases in which the child has shown a suspected or ascertained allergic reaction to the drug, ibuprofen, such as paracetamol, should not be used only to lower the fever in the absence of specific malaise or to prevent feverish convulsions, since Specific effectiveness has not been demonstrated in these cases.
In conclusion, ibuprofen can be a precious ally in the management of fever and pain in children, as long as it is used correctly. It is good to also consult the pediatrician before starting the treatment and scrupulously follow the indications provided to ensure the safety and well -being of the child.
