Antipyretic efficacy of ibuprofen versus acetaminophen

by Dr. Moshe Ipp

Studies comparing Acetaminophen and Ibuprofen? Use together? Dose of acetaminophen?

. When acetaminophen and ibuprofen are administered in equal doses (mg/kg), ibuprofen has been shown to provide greater temperature reduction and longer duration of antipyresis. However, according to a 1998 Canadian Pediatric Society Statement from the Drug therapy Committee, acetaminophen still remains the first line drug of choice for treating fever and mild to moderate pain in children, since it has a substantially greater volume of safety data available. Acetaminophen administered at a dose of 15mg/kg has a greater effect than at 10mg/kg with no alteration in it's safety profile. Physicians must remember that fever itself is not harmful and that the purpose of treating childhood fever is to make the child feel more comfortable, and not necessarily to reduce the temperature to normal. It is not advisable for physicians to recommend administering ibuprofen and acetaminophen together or as alternating doses, as this can be confusing to caregivers, potentially leading to incorrect dosing and increasing the risk of toxicity. There is no scientific evidence to support the safety of these combinations and no evidence that the combination achieves faster antipyresis or has greater efficacy than either product alone. Ibuprofen has the advantage of less frequent dosing (6-8 hours vs 4 hours for acetaminophen) and has anti-inflammatory properties but it must still stand the test of time before being placed on an equal safety footing with acetaminophen.

References::
  1. Kauffman RE, Antipyretic efficacy of ibuprofen versus acetaminophen. Am J Dis Child, 1992;146:622-625
  2. Canadian Pediatric Society position paper from the Drug Therapy and Hazardous Substance Committee. Paediatrics & Child Health 1998;3(4). l only. Pediatrics 1997; 99:54-58.

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