A report recently issued in France by the National Agency for the Safety of Medicines and Health Products (ANSM) alerts doctors and patients on the use of ibuprofen. This well-known medicine, as well as ketoprofen, the two best-selling anti-inflammatories in France, are being targeted by health authorities, who requested an investigation at European level.
According to the French agency, the well-known medicine could favor the appearance of complications in treatments of serious infections such as tonsillitis, rhinopharyngitis, otitis, lung infections and even skin lesions and chicken pox, which could worsen with its use.
French alert: ibuprofen under the magnifying glass
Since 2000, the Agency found 337 cases of infectious complications related to ibuprofen and 49 more cases related to ketoprofen. These were serious cases in children and young adults without risk factors or any other underlying disease. They found dermatological, sepsis, pulmonary and neurological diseases that led to hospitalizations, severe sequelae or even death.
Infectious complications (streptococcus or pneumococcus, especially) appeared without a clear pattern after very short treatments of two to three, even when anti-inflammatories were combined with an antibiotic treatment.
In conclusion, the French agency will ask for further investigation and recommends prioritize paracetamol in the treatment of pain derived from streptococcal infections. In case you need an anti-inflammatory, it is recommended to use the minimum dose in the shortest possible duration and limit treatment in case of fever to three days.
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Ibuprofen is the generic name of this medicine that we can find in Spain marketed under the name of Dalsy, Junifen, Pirexin, Nurofen or Gelofeno in 2% and 4% concentrations.
Ibuprofen is a medication with analgesic (for pain), antitheretic (for fever) and, unlike paracetamol, also anti-inflammatory. It is commonly used to reduce fever and relieve discomfort in children, and we can find it in the form of syrup and also in soft chewable capsules of 100 mg for children from seven years.
According to the package leaflet, ibuprofen can be given to babies after three months, but usually recommended after six months due to the immaturity of his renal system. Its use in children under 2 years should always be done by medical prescription.
Recommended dose of ibuprofen
The recommended daily dose is 20 to 30 mg per kg of weight, divided into three shots. It is recommended not to exceed the maximum dose of 40 mg per kg of weight per day of ibuprofen.
The dose is always calculated based on the child's weight (and not on age, because the weight is very variable from one child to another), and it is important to know the concentration of the medication.
For example, 2% syrup contains 20 mg of ibuprofen per ml of syrup (20 mg / 1 ml). That is, as they correspond to 20 mg / kg per day, in 2% syrup the rule is 1 ml / kg per day. If my child weighs 10 kg, he has to take 10 ml per day. All you have to do is divide the daily dose into three doses (given every 8 hours), which would give 3.33 ml per dose.
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According to the AEPap Decalogue, you only have to use fever medications if there is discomfort or pain.
Ibuprofen and paracetamol have the same efficacy in treating pain, but they should not be given at the same time, and according to the AEP it is not advisable to combine or alternate them when the fever does not go down, because there is no scientific evidence that it is more effective than always using it. Only do so if the discomfort is severe and persists or recurs before the next dose.
Paracetamol is safer. Ibuprofen can sometimes cause stomach upset, nausea, vomiting. Therefore, paracetamol is more appropriate when the child has vomiting or abdominal pain.
Recommendations for the use of ibuprofen
Manage under medical prescription.
Calculate the dose we administer well, as explained above.
In case of fever, look for natural methods to lower it and administer ibuprofen only in case of pain or discomfort.
Give it at the indicated intervals: every 6-8 hours, never less than 4 hours. We do not achieve a greater effect by giving it more often, instead we can produce poisoning.
Being a syrup in suspension, shake the bottle before loading the syringe.
Do not confuse syringe scales. Some measure in millimeters and others in millimeters and kilos.
Control concentration of ibuprofen containing the medicine. There are concentrations for children at 2 and 4%, if we change brands, always check the dose that we should administer to avoid confusion.
Use the smallest dose to relieve / control pain
Use it for the shortest possible time and always follow the instructions in the leaflet.
Keep out of reach of children: many children like its taste and it is better to avoid temptations.
It is not a health alarm, just an alert from the French authorities to continue investigating whether Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, one of the medications most used by children and adults, could hinder recovery from certain infections.
