Review of antipyretic drugs for adults and children: types, how they work, how to choose

An increase in body temperature is a symptom that expresses the body's response to an inflammatory process, the invasion of an infectious agent or toxin. You should take an antipyretic if the thermometer shows more than 38.5°C. For chronic diseases and poor health, intake is also indicated at a lower value.

Pharmacy chains offer a wide range of medications for fever. We will look at which of them are most effective for adults and children in the article.

Signs of a high fever

The following signs (symptoms) may indicate that the temperature is rising:

• a feeling of weakness, sudden fatigue, a general painful state;
• chills (mild chills at slightly elevated temperatures and severe chills at high temperatures);
• dry skin and lips;
• headache, body aches;
• loss of appetite;
• sweating (“breaks into a sweat”);
• arrhythmia.

If you are experiencing any of these symptoms, it would be a good idea to take a thermometer.

special instructions

When Paracetamol is used simultaneously with certain medications, the harmful effects on the liver increase. For this purpose, it is not recommended to prescribe together such groups of substances as ethanol, sleeping pills, antidepressants, the antibiotic rifampicin - when interacting with Paracetamol, the drugs increase the level of liver enzymes, which negatively affects the organ. Important! The required dosage and duration of the course should be determined by the attending physician. Interaction with alcohol. Paracetamol should not be combined with alcoholic beverages. In addition, the instructions for the drug indicate that persons prone to frequent alcohol consumption should not take this drug. In people who abuse such drinks, liver cells are replaced by connective tissue, which leads to the development of fatty hepatosis or cirrhosis.

In this case, toxic damage to the liver occurs, which manifests itself as follows:

• General weakness, nausea and vomiting appear.
• The patient feels pain in the right hypochondrium, his condition worsens.
• Yellowing of the skin and sclera is noted, confusion and convulsions may occur.

When taking the drug for a long time, it is recommended to monitor the condition of the liver and blood tests.

What is considered a high temperature?

Normal temperature is generally considered to be 36.6°C. But in fact, temperatures within a fairly wide range are normal.

During the day, body temperature fluctuates quite a bit. The lowest temperature is observed in the morning, immediately after waking up; maximum - in the evening, at the end of the day. The difference can be somewhere around 0.5°C. Physical activity, stress, ordinary meals, drinking alcohol, staying in a bathhouse or on the beach can raise the temperature. In women, temperature fluctuations are also associated with ovulation. A few days before ovulation, the temperature decreases, and when ovulation occurs, it increases.

On average, a normal temperature is considered to be between 35° and 37°C. In children under 3 years of age, a temperature of up to 37.5°C is also considered normal. Where you take your temperature matters. You can focus on 36.6°C if you place a thermometer under your arm. If the thermometer is held in the mouth ( oral temperature

), then the normal temperature will be 0.5°C higher (36.8-37.3°C).
In order to obtain normal values ​​when measuring the temperature in the rectum ( rectal temperature
), you will need to add another half a degree (the norm is 37.3-37.7 ° C). Based on the measurement of the temperature under the arm, an elevated temperature is a temperature in the range of 37-38°C, a high temperature is above 38°C.

Worrying is either a temperature that rises above 38°C or a temperature of up to 38°C that persists for a long time ( low-grade fever

).

Bibliography

1. The role of combination drugs in etiopathogenetic pharmacotherapy of acute respiratory viral infections. Mubarashkina O. A. Medical Council. 2014. No. 11. pp. 14-17.
2. Infectious diseases. Budanov B.V., Marushkin I.I., Filimonov V.V. E-Scio Journal. 2022.
3. Modern view on the problem of symptomatic treatment of acute respiratory viral infections. Lazareva N. B. Medical Council. 2014. No. 1. pp. 35-38.
4. Modern approaches to the prevention and treatment of acute respiratory viral infections. Mubarashkina O. A. Remedium. Magazine about the Russian drug market and medical equipment. September 2014. pp. 42-22.
5. Possibilities of pathogenetic therapy of influenza. Tsvetkov V.V. Medical Council. 2014. No. 17. pp. 14-17.
6. Comparative study of the antipyretic effect of non-steroidal anti-inflammatory drugs when administered intragastrically and rectally. Orlova T.V., Pankrusheva T.A., Pokrovsky M.V. et al. Kuban Scientific Medical Bulletin. 2012. No. 2 (131). pp. 134-137.
7. The use of non-steroidal anti-inflammatory drugs in therapeutic practice. Lysenko N.V., Soldatenko I.V., Kartvelishvili A.Yu. Bulletin of V.N. Kharkov National University Karazin. Series "Medicine". 2010. No. 918. pp. 114-125.
8. Instructions for use of the drug Motrin®.
9. Naproxen: a versatile analgesic with minimal risk of cardiovascular complications. Karateev A.E. Modern rheumatology. 2016. No. 10(2). pp. 70–77.
10. Pharmacology, under. ed. Yu. F. Krylova and V.M. Bobyreva. - Moscow, 1999.
11. Clinical effectiveness of non-steroidal anti-inflammatory drugs in some ENT diseases in children. Sergeev M.M., Kovalenko S.L. Issues of modern pediatrics. 2009. pp. 81-84.
12. Instructions for use of the drug Naproxen.

When is an increase in temperature dangerous?

High body temperature is an undoubted sign that some pathological process, usually of an inflammatory nature, is developing in the body. The higher the temperature, the faster it rises or the longer it lasts, the more serious the problem that caused it may be. This is why high temperatures are scary.

Meanwhile, in itself, an increase in temperature in most cases is a protective reaction to the penetration of infection. At high temperatures, the activity of pathogenic microorganisms decreases, and the body’s defenses, on the contrary, intensify: metabolism and blood circulation accelerate, and antibodies are released faster. But this increases the load on many organs and systems: cardiovascular, respiratory. High temperature depresses the nervous system and leads to dehydration. Possible circulatory disorders in internal organs (due to increased viscosity and blood clotting). Therefore, a high temperature that lasts for a long time can pose a danger in itself. Extremely high temperatures (above 41°C) are also dangerous.

Symptom treatment

To figure out how to bring down the temperature, you need a correct diagnosis. An experienced doctor, based on the results of tests and studies, determines the cause of the fever, prescribes medications, procedures, or refers to a specialist for additional research. The goal is to identify the source of the inflammatory process in order to find the right treatment complex. Treatment for high fever depends entirely on the underlying cause and may include antipyretics, antibiotics, probiotics, etc.

Symptom during pregnancy

The temperature in pregnant women rises above the normal limit due to acute respiratory viral infections and influenza. It can harm the baby, especially if the mother takes medications containing aspirin. Therefore, pregnant women with fever need urgent consultation with a doctor to prescribe the correct dose of medications. If the temperature jump is small, you can take homeopathic remedies prescribed by your doctor.

Along with the tablets in the 1st trimester, you can drink herbal teas, fruit drinks, compotes, and juices. At later stages, drink concentrated herbal infusions, which are not consumed in large quantities to avoid swelling. Decoctions of leaves, raspberries, coltsfoot, plantain, and infusion of white willow bark have healing properties. Rubbing with a vinegar solution helps.

Treatment at home

If you find cold symptoms and a temperature above 37°C and weakness, you can start taking home remedies to support the body. If the value on the thermometer does not exceed 38.5°C and the body feels more or less well, there is no need to lower the temperature. At this time, harmful bacteria die, and the immune system works at full capacity.

However, if the patient’s condition is serious, he does not tolerate the temperature well, it needs to be brought down. At 40°C the blood begins to thicken and coagulate, so you should take antipyretics. In order not to cause negative effects on internal organs, many patients prefer folk remedies with a mild effect.

Folk remedies for fever for children:

• children's enemas with a soda solution (1 tsp of soda for 1 glass of water) or chamomile decoction;
• wipe the child’s body with green grape juice;
• put on socks moistened with a solution of water and vinegar in a 1:1 dilution for 15 minutes;
• Infants and children under 3 years of age can be briefly wrapped in a wet sheet or towel to relieve the condition.

If the temperature is 39°C or 40°C in adults, it must be brought down:

• wiping and a cold compress - a cotton cloth is moistened with water at room temperature or a solution of water and vinegar;
• drinking plenty of fluids - it is necessary to prevent dehydration of the body by taking drinking water, freshly squeezed juices or warm herbal infusions, honey water (1 tsp of honey for 1 glass of warm water);
• fasting - give the body a rest (food is a load), concentrate energy on fighting inflammation.

Should I lower the temperature or not?

There is no need to rush to lower the temperature. First of all, the patient must be examined by a doctor. You should follow the doctor’s recommendations: if he advises you to lower your temperature, then you should lower it. The doctor makes decisions based on the general picture of the disease and assessment of the patient’s condition, that is, recommendations are always individual.

However, if the patient has a severe fever and the temperature is high (39°C or higher), then he can be given an antipyretic drug, strictly following the instructions on the package. At the same time, you need to understand that you are fighting a symptom, not a disease.

The correct course of treatment involves identifying the cause of the high temperature and carrying out a set of measures aimed at treating the disease that caused its increase.

Theraflu ExtraTab

These fever tablets contain paracetamol, which reduces fever well. In addition, Theraflu ExtraTab contains phenylephrine (a vasoconstrictor) and chlorphenamine (an antihistamine). Therefore, the drug has a complex effect - it relieves swelling during a runny nose and reduces fever. Contraindications to taking Theraflu ExtraTab include stomach ulcers.

Theraflu extratab

Novartis Pharma Services AG (Novartis Pharma), Switzerland

Symptomatic treatment of infectious and inflammatory diseases (ARVI, including influenza), accompanied by high fever, chills, headache, runny nose, nasal congestion, sneezing, muscle pain.
from 148

384

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Causes of high temperature

Any inflammatory process can cause an increase in temperature. The nature of inflammation can be different - bacterial, viral, fungal. In most cases, the temperature is a concomitant symptom: for example, with otitis media, the ear hurts (“twitches”) and the temperature is elevated...

Temperature attracts special attention when no other symptoms are observed. Temperature against the background of standard signs of ARVI is ordinary, but only one high temperature is frightening.

Diseases that may cause a high fever without other symptoms

:

• ARVI and influenza. Flu, and in some cases other acute respiratory viral infections, can begin with a sudden rise in temperature. In this case, catarrhal symptoms begin somewhat later (in the late afternoon or the next day);
• angina. Along with fever, there is usually a sore throat when swallowing. The pain in the throat intensifies quite quickly, so that it cannot be ignored;
• chickenpox (chickenpox). The typical onset of chickenpox is high fever. Characteristic rashes may appear only on the 2-3rd day of illness;
• abscess (accumulation of pus in superficial tissues or internal organs). With an abscess, the temperature “floats”: temperature peaks can be interspersed with normal temperature during the day (in contrast to the typical temperature schedule for an “ordinary” infectious disease - when the lowest temperature is observed after waking up in the morning, and rises in the evening);
• inflammations of the genitourinary system (pyelonephritis, glomerulonephritis) are usually manifested by high fever and pain in the projection of the kidneys. But in some cases there may be no pain;
• appendicitis - can also occur without pain;
• meningitis and encephalitis (inflammation of the meninges of infectious origin). In this case, high temperature is accompanied by severe headache, nausea, and blurred vision. A characteristic symptom is tension in the neck muscles (the chin cannot be lowered to the chest);
• hemorrhagic fever (usually infection occurs through the bite of wild animals, for example, a field mouse). This also has its own characteristic symptoms - a decrease (even cessation) of urination, the appearance of subcutaneous hemorrhages (spotted redness of the skin, rash), muscle pain.

Elevated temperature (up to 37.5-38°C) without pronounced other symptoms

may be observed with:

• tuberculosis;
• oncological diseases;
• diseases of the thyroid gland (thyrotoxicosis);
• neurological disorders;
• allergic reaction (this is how individual intolerance to medications may manifest itself).

The following diseases also occur with an increase in temperature:

• inflammation of the lungs (pneumonia). Pneumonia is a common cause of high fever. In this case, chest pain, shortness of breath, and cough are usually observed;
• infectious diseases of the gastrointestinal tract (gastroenterocolitis). Here temperature is a side symptom. Main complaints: abdominal pain, diarrhea, nausea, vomiting;
• viral hepatitis A, which is characterized by the appearance of a jaundiced coloration of the skin and whites of the eyes;
• other viral diseases - measles, rubella, mumps (mumps), mononucleosis, polio, etc.;
• chronic diseases of the urinary system (chronic pyelonephritis, cystitis), in women - chronic salpingoopharitis. Along with low-grade fever, abdominal pain and urination problems may occur;
• sexually transmitted diseases (gonorrhea, syphilis, urogenital infections - toxoplasmosis, trichomoniasis, ureaplasmosis, etc.);
• chronic myocarditis and endocarditis. In this case, the usual symptom is pain in the heart area;
• autoimmune diseases (rheumatism, systemic lupus erythematosus, etc.).

This, of course, is not a complete list of diseases that can cause fever

Rinza

Rinza tablets are a complex drug. The product contains caffeine, which enhances the antipyretic effect and improves metabolic processes. Paracetamol helps reduce fever and relieve muscle pain. Phenylephrine relieves swelling of the nasal mucosa, chlorphenamine is an antihistamine against inflammation. "Rinza" relieves cold symptoms for 12 hours. This drug is contraindicated for pregnant women, hypertensive patients, patients with atherosclerosis, those treated with antidepressants, people with kidney and liver diseases; alcohol should not be taken while being treated with Rinza.

Rinza

Unique Pharmaceutical Laboratories, India

- symptomatic treatment of “colds”, acute respiratory viral infections (including influenza), accompanied by fever, pain, and rhinorrhea.
from 64

680

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High temperature in a child

The child will not say that he has a high temperature. Even relatively older children, including students in elementary school, as a rule, cannot correctly assess their well-being. Therefore, parents need to closely monitor the child’s condition. You can suspect an increase in temperature based on the following signs:

• the child becomes unexpectedly lethargic or, conversely, restless and capricious;
• he is tormented by thirst (he asks for a drink all the time);
• mucous membranes become dry (dry lips, tongue);
• bright blush or, conversely, unusual pallor;
• eyes become red or shiny;
• the child is sweating;
• pulse and breathing increase. The normal heart rate is 100-130 beats per minute while sleeping and 140-160 while awake. By two years, the frequency decreases to 100-140 beats per minute. The normal breathing rate also depends on age; for a two-month-old child it is 35-48 breaths per minute, for an age from one to three 28-35 breaths.

You can measure body temperature in the armpit or groin cavity with a mercury thermometer (it most accurately shows the temperature), rectally - only with an electronic one. It is possible to measure the temperature rectally only in a small child (up to 4-5 months); older children resist the procedure, as it is unpleasant. To measure the temperature rectally, the tip of the thermometer is lubricated with baby cream, the child’s legs rise, as if washing. The tip of the thermometer is inserted into the rectum to a depth of 2 cm.

We should not forget that in children under one year of age, a normal temperature is considered to be a temperature of up to 37.5°C, and even up to 3 years of age, such a temperature does not always mean that the child is sick. You cannot measure the temperature when the child is very worried, crying, or is tightly wrapped up - the temperature in these cases will be expected to be higher. A hot bath or too high a room temperature can also increase your body temperature.

In young children, the temperature can rise up to 38.3°C for reasons unrelated to illness, such as:

• overheating (due to excessive wrapping, exposure to direct sunlight or poor drinking habits), especially before the age of 3 months;
• scream;
• constipation (if the child pushes, the temperature may rise);
• teething (one of the most common causes).

If it does not seem that the temperature is caused by one of these reasons, it persists and does not subside, or, moreover, increases, it is necessary to urgently consult a doctor. If the temperature is above 38°C, you should consult a doctor in any case.

Aspirin

Aspirin can be bought both in regular tablets and in effervescent form. This is an NSAID whose active substance is acetylsalicylic acid. Aspirin has a strong antipyretic effect, it is an excellent pain reliever, while the anti-inflammatory effect of the drug is very weak. After taking Aspirin, relief occurs within 15 minutes (faster if these are effervescent tablets). But you need to remember that Aspirin is not the safest drug for fever. Allergies often occur to it; asthmatics, allergy sufferers and those who have problems with the gastrointestinal tract and liver should not drink it. It is prohibited for children under 15 years of age and pregnant women to take Aspirin with alcohol.

Aspirin

Interaction with other drugs

When using Paracetamol, interactions with other drugs should be taken into account.

• When this drug is used simultaneously with inducers of microsomal liver enzymes, the risk of liver damage increases, so their combined use is not permissible.
• When used together with drugs that affect hematopoiesis, an increase in some indicators (prothrombin time) is possible.
• When the drug is used simultaneously with anticholinergics, the effect of the former is reduced.
• When taken together with oral contraceptives, the analgesic effect of paracetamol is reduced.
• When used simultaneously with uricosuric drugs, their effectiveness decreases.
• When using sorbents (activated carbon) with the drug paracetamol, the effect of the latter is reduced.
• When this medicine is combined simultaneously with the drug zidovudine, a negative effect on hematopoiesis and the liver is possible.
• When used simultaneously with carbamazepine, phenytoin, phenobarbital, primidone, the effectiveness of paracetamol is reduced, since the latter affects metabolic processes in the body.
• When the drug paracetamol is used together with anticonvulsants (lamotrigine), the removal of the latter from the body is accelerated.
• When used simultaneously with certain drugs (rifampicin, sulfinpyrazone), the metabolism of paracetamol in the liver increases.
• The simultaneous use of the drug paracetamol with antiviral drugs (for example, arbidol, kagocel) is acceptable.
• Concomitant use with broad-spectrum antibiotics (for example, amoxiclav) is permitted.

Contraindications

Like any medicine, paracetamol has some contraindications.

Paracetamol Extratab

It is not recommended to use Paracetamol in the following cases:

• if you are hypersensitive to paracetamol,
• elderly people over 65 years old,
• children under two years old,
• if a person has liver and kidney diseases,
• for blood diseases (for example, hemophilia).

Use with caution

• jaundice (Gilbert's syndrome),
• congenital increase in blood bilirubin.

Before taking the drug, you should definitely consult your doctor if:

• if you have severe liver or kidney disease,
• you are taking drugs against nausea and vomiting (metoclopramide, domperidone), as well as drugs that lower blood cholesterol (atorvastatin),
• you are taking anticoagulants and need painkillers every day for a long time. In this case, paracetamol can be taken occasionally.