This concise consultation card was developed by Guidelines for Pharmacy in partnership with RB UK.
Many parents worry when their child has a fever. How can you support them to choose appropriate OTC medication to reduce the child’s distress?
This Guidelines for Pharmacy card summarises key professional guidance to help you advise parents and make confident recommendations.
What the guidelines say
“ Consider using either paracetamol or ibuprofen in children with fever who appear distressed – NICE1”
“When using paracetamol or ibuprofen in children with fever:
- continue only as long as the child appears distressed
- consider changing to the other agent if the child’s distress is not alleviated
- do not give both agents simultaneously
- only consider alternating these agents if the distress persists or recurs before the next dose is due – NICE1”
Advice and discussion points
Reassure parents that fever doesn’t always need to be treated but if the child is distressed, treatment is recommended.1
Refer to NICE’s traffic light system for identifying risk of serious illness:2
Please refer to the NICE document for the full list of indicators.
RECOMMEND NUROFEN FOR CHILDREN (IBUPROFEN)
What the studies show:
- Ibuprofen has a faster effect than paracetamol and reduces fever for longer3
- Ibuprofen at OTC doses has similar gastrointestinal tolerability to paracetamol4 and placebo5–7
- More children treated with ibuprofen see a return to normal activity, appetite, and sleep compared with children given paracetamol.3
- Suitable for babies from 3 months
- Starts to work in just 15 minutes to relieve fever8
- Long lasting: relieves fever for up to 8 hours.9
- NICE. Fever in under 5s: assessment and initial management. NICE guideline NG143. NICE, 2019. Available at: www.nice.org.uk/ ng143
- NICE. Traffic light system for identifying risk of serious illness. NICE, 2019. Available at: www.nice.org.uk/ng143/resources
- Hay AD et al. BMJ 2008; 337: a1302.
- Lesko SM and Mitchell AA. JAMA 1995; 273: 929–933.
- Southey ER et al. Curr Med Res Opin 2009; 25: 2207–2222.
- Pierce CA and Voss B. Ann Pharmacother 2010; 44: 489–506.
- Kanabar DJ. Inflammopharmacology 2017; 25: 1–9.
- Pelen F et al. Ann Pediatr 1998; 45: 719–728.
- Kelley MT et al. Clin Pharmacol Ther 1992; 52:181–189.
Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard. Adverse events should also be reported to Reckitt Benckiser Healthcare (UK) Ltd on: 0333 200 5345
Date of preparation: February 2021