Systematic review and meta-analysis of the clinical safety and tolerability of ibuprofen compared with paracetamol in paediatric pain and fever

  title={Systematic review and meta-analysis of the clinical safety and tolerability of ibuprofen compared with paracetamol in paediatric pain and fever},
  author={Elizabeth R Southey and Karla Soares-Weiser and Jos Kleijnen},
  journal={Current Medical Research and Opinion},
  pages={2207 - 2222}
ABSTRACT Objective: The main aim of this review was to compare the tolerability and safety between ibuprofen and paracetamol when used as anti-pyretic and analgesic agents in children up to 18 years of age. Methods: MEDLINE (1950 to November 2008), EMBASE (1980 to November 2008), The Cochrane Library (2007, Issue 3), ACP Journal Club (1991 to November 2007) and Pascal (1987 to November 2007) were searched for randomised controlled trails (RCTs) (comparing ibuprofen and/or paracetamol with… 

Efficacy and Safety of Ibuprofen Plus Paracetamol in a Fixed-Dose Combination for Acute Postoperative Pain in Adults: Meta-Analysis and a Trial Sequential Analysis

The ibuprofen plus paracetamol FDC is conclusively an effective analgesic against placebo in acute postoperative, moderate to severe pain in adults and it is also superiorly well tolerated, including at the higher dose of 292.5 mg; however, safety outcomes were inconclusive.

Prescribing Controversies: An Updated Review and Meta-Analysis on Combined/Alternating Use of Ibuprofen and Paracetamol in Febrile Children

Findings are not robust enough to encourage combined or alternating paracetamol and ibuprofen instead of monotherapy to treat febrile children, reinforcing the current recommendation of most of the international guidelines.

Risk of asthma in children treated with paracetamol versus ibuprofen: A systematic review and meta-analysis of randomised controlled trials

It is suggested high quality trials with clear definition of asthma outcomes after receiving ibuprofen or paracetamol at varying doses with longer follow-up are warranted for any conclusive finding.

Effects of acetaminophen and ibuprofen monotherapy in febrile children: a meta-analysis of randomized controlled trials

Introduction When a child presents with fever in the clinical encounter, parents are usually concerned about alleviating the fever. However, the indications for selecting an appropriate drug from the

A Meta-Analysis of the Analgesic Efficacy of Single-Doses of Ibuprofen Compared to Traditional Non-Opioid Analgesics Following Third Molar Surgery

In conclusion, ibuprofen 400 mg appears to have good analgesic efficacy and a safety profile similar to other traditional non-steroidal anti-inflammatory drugs after third molar surgery.

Prescribing patterns, indications and adverse events of ibuprofen in children: results from a national survey among Italian pediatricians

The reported adverse events related to ibuprofen administration in children were mild in most of the cases and often related to errors in dosage, frequency and treatment duration, emphasizing the need for a major caution of both practitioners and patients in their use.

Combined and alternating acetaminophen and ibuprofen therapy for febrile children.

The Cochrane Review on combining and alternating acetaminophen and ibuprofen for treating fever in children found some evidence that both alternating and combined antipyretic therapy may be more effective at reducing temperatures than monotherapy alone.

A multicenter, randomized, open-label, active-comparator trial to determine the efficacy, safety, and pharmacokinetics of intravenous ibuprofen for treatment of fever in hospitalized pediatric patients

A single 10mg/kg dose of intravenous ibuprofen provided a significant reduction of temperature for febrile pediatric patients compared to those that received 10 mg/kg acetaminophen at 2 h and 4 h post-treatment.

Antipyretic Efficacy and Safety of Ibuprofen Versus Acetaminophen Suspension in Febrile Children: Results of 2 Randomized, Double-Blind, Single-Dose Studies

IBU pediatric suspension provided greater temperature reduction versus acetaminophen in febrile children, with a comparable safety profile, and individual and pooled secondary efficacy outcomes supported significant advantages of IBU over APAP.

Ibuprofen, paracetamol, and steam for patients with respiratory tract infections in primary care: pragmatic randomised factorial trial

Overall advice to use steam inhalation, or ibuprofen rather than paracetamol, does not help control symptoms in patients with acute respiratory tract infections and must be balanced against the possible progression of symptoms during the next month for a minority of patients.



Efficacy and safety of acetaminophen vs ibuprofen for treating children's pain or fever: a meta-analysis.

In children, single doses of ibuprofen and acetaminophen have similar efficacy for relieving moderate to severe pain, and similar safety as analgesics or antipyretics.

A randomized, double‐blind, multicentre controlled trial of ibuprofen versus acetaminophen and placebo for symptoms of acute otitis media in children

There is no argument to emphasize the utility of nonsteroidal anti‐inflammatory drugs (NSAIDs) in treating the inflammatory signs of the tympanic membrane in otitis and the efficacy of IBU was evidenced on the relief of pain, the symptom that most disturbs the child.

Paracetamol plus ibuprofen for the treatment of fever in children (PITCH): randomised controlled trial

Parents, nurses, pharmacists, and doctors wanting to use medicines to supplement physical measures to maximise the time that children spend without fever should use ibuprofen first and consider the relative benefits and risks of using paracetamol plus ib uprofen over 24 hours.

[Ibuprofen in childhood: evidence-based review of efficacy and safety].

Ib uprofen is not recommended for the treatment of fever or moderate pain during chickenpox or during a disease with a risk of dehydration, until other pharmacoepidemiology studies more accurately quantify the risk of adverse events of ibuprofen in children.

Paracetamol versus placebo or physical methods for treating fever in children

Trial evidence that paracetamol has a superior antipyretic effect than placebo is inconclusive and there is insufficient evidence to show whether par acetamol influenced the risk of febrile convulsions.

An assessment of the safety of pediatric ibuprofen. A practitioner-based randomized clinical trial.

The risk of hospitalization for gastrointestinal bleeding, renal failure, or anaphylaxis was not increased following short-term use of ibuprofen in children, and data provide no information on the risks of less severe outcomes or the risk of prolonged ib uprofen use.

Comparing efficacy and tolerability of ibuprofen and paracetamol in fever.

Ibuprofen suspension was as effective and well tolerated as paracetamol in treatment of fever in young children and median score for overall efficacy was 'good effect'.

Treating fever in children: paracetamol or ibuprofen?

  • E. Purssell
  • Medicine
    British journal of community nursing
  • 2002
Both drugs are effective antipyretics but the longer action of ibuprofen may make it preferable in some circumstances, and no evidence of difference in short-term adverse effects was observed.

Safety profile of ibuprofen suspension in young children

Overall, ibuprofen exhibited an AE profile similar to acetaminophen in both younger and older children, consistent with the excellent profile observed in children ⩾ 2 yrs.