Nurofen for children

Nurofen for children (active ingredient ibuprofen) is a nonsteroidal anti-inflammatory drug (NSAID) used in pediatric practice as an analgesic and antipyretic. The drug non-selectively blocks the enzyme cyclooxygenase types 1 and 2 (COX-1 and COX-2), as a result of which the process of synthesis of mediators of pain and inflammation, prostaglandins, is inhibited. In addition, ibuprofen inhibits platelet aggregation (sticking together). The effect of Nurofen for children lasts about 8 hours. It is necessary to note the special place of ibuprofen among all NSAIDs. The PAIN study, which compared the effectiveness and safety of ibuprofen, paracetamol and aspirin, found that patient tolerability of ibuprofen was similar to paracetamol and much better than aspirin. At the same time, the incidence of unwanted side reactions from the digestive tract when using ibuprofen was significantly lower than that of aspirin. The data obtained as a result of this study dispelled all doubts that ibuprofen (and Nurofen, as well as Nurofen for children, are the original preparations of ibuprofen) can be considered as a first-line drug for relieving pain and reducing elevated body temperature during febrile conditions . Before entering the pharmaceutical market, the drug Nurofen for children was carefully studied to identify possible side effects. As part of this large-scale research work, about 85 thousand children were examined. The results of the study demonstrated a favorable safety profile of the drug, which allows its widespread use in pediatrics.

Nurofen for children, as its name suggests, was developed exclusively for the youngest patients. The drug is available in two dosage forms: oral suspension and rectal suppositories. The dose is calculated based on the child’s body weight. For pain and febrile body temperature, Nurofen for children is prescribed 5-10 mg per 1 kg 3-4 times a day.

In this case, the daily maximum should not exceed 30 mg per 1 kg. Duration of the drug course: no more than three days as an antipyretic and no more than five days as an analgesic. If there is no proper therapeutic response within the specified period of time, you should consult a doctor. Nurofen for children in the form of a suspension must be shaken thoroughly before use. To ensure dosing accuracy, a measuring syringe is included in the package with the drug. In order to draw the suspension into the syringe, the bottle should be turned upside down and the piston should be carefully withdrawn. Before removing the syringe, the bottle returns to its original position. To administer the suspension, a syringe is placed in the oral cavity. The introduction should be done smoothly. After completing all the above manipulations, the syringe must be washed in warm water. The possibility of using the drug is considered by the doctor individually in the following cases: if there is a history of gastritis, arterial hypertension or heart failure; if the patient receives other painkillers, for kidney and/or liver diseases, for helicobacteriosis; during treatment with antihypertensive drugs, glucocorticosteroids, diuretics, indirect anticoagulants, antiplatelet agents; for bronchial asthma, defecation disorders, autoimmune connective tissue diseases. Combining Nurofen for children with anticoagulants can enhance the effect of the latter and lead to increased bleeding. Co-administration of the drug with antihypertensive drugs and diuretics reduces the effectiveness of the latter. In addition, diuretics may increase the nephrotoxicity of NSAIDs. Glucocorticosteroids in combination with Nurofen for children increase the risk of erosive and ulcerative lesions of the gastrointestinal tract. Concomitant use of Nurofen for children with cardiac glycosides may cause exacerbation of heart failure.

What is Nurofen syrup and tablets for?

The action of Nerofen is explained by the presence of ibuprofen in the composition, which, by acting on the thermostat in the brain, relieves fever and returns the temperature to normal values.

In addition, ibuprofen inhibits the synthesis of prostaglandins, which are mediators of pain. Which explains its analgesic effect. This is why Nurofen is indicated for:

high body temperature;
toothache;
headache;
muscle pain;
for adverse reactions after DTP.

Contraindications

Nurofen for children is contraindicated in the following cases:

with high sensitivity to ibuprofen and drug components;
for urticaria , bronchial asthma , rhinitis, which appeared after taking acetylsalicylic acid or other NSAIDs;
with high sensitivity to acetylsalicylic acid or other NSAIDs;
for erosions or ulcers of the gastrointestinal tract;
in case of inflammatory bowel diseases;
with active bleeding from the gastrointestinal tract;
in case of confirmed hyperkalemia;
with liver or kidney failure;
for blood diseases;
with hearing loss.

Nurofen for children should be taken with caution by those who take other analgesics and by children with liver and kidney diseases. The drug is also carefully prescribed to children who have a history of gastritis, peptic ulcer, bleeding from the gastrointestinal tract, or ulcerative colitis .

Treatment is carried out with caution in the presence of Helicobacter pylori, when the patient is taking antihypertensive drugs, indirect anticoagulants, antiplatelet agents, corticosteroids, diuretics, methotrexate, lithium preparations.

In such cases, before starting treatment, you must consult a doctor who will determine the optimal dosage and frequency of administration.

Nurofen suppositories are not prescribed for proctitis or for children whose body weight is less than 6 kg.

How many times can Nurofen be given to a baby?

The effect of the drug begins an hour after the first dose. The decrease in temperature can continue for up to half an hour until the values drop to normal levels. The antipyretic effect can last up to 8 hours. However, with severe inflammatory processes, the fever may return after 4-5 hours. An infant can be re-given a single dose of the drug both in the form of suppositories and in the form of syrup after 4 hours if the temperature begins to rise again. A baby can receive up to 5 permissible single doses per day.

Interaction with other drugs

The simultaneous use of Nurofen for children with the drugs listed below should be avoided.

Acetylsalicylic acid: with the exception of acetylsalicylic acid in low doses (no more than 75 mg/day) prescribed by a doctor, since combined use may increase the risk of side effects.

With simultaneous use, ibuprofen reduces the anti-inflammatory and antiplatelet effect of acetylsalicylic acid (an increase in the incidence of acute coronary insufficiency in patients receiving acetylsalicylic acid in small doses as an antiplatelet agent is possible after starting ibuprofen).

Other NSAIDs, including selective COX-2 inhibitors: The simultaneous use of two or more drugs from the NSAID group should be avoided due to a possible increased risk of side effects.

Use with caution concomitantly with the following medications.

Anticoagulants and thrombolytic drugs: NSAIDs may enhance the effect of anticoagulants, in particular warfarin and thrombolytic drugs.

Antihypertensive drugs (ACE inhibitors and angiotensin II receptor antagonists) and diuretics: NSAIDs may reduce the effectiveness of drugs in these groups. Diuretics and ACE inhibitors may increase the nephrotoxicity of NSAIDs.

GCS: increased risk of gastrointestinal ulcers and gastrointestinal bleeding.

Antiplatelet agents and selective serotonin reuptake inhibitors: increased risk of gastrointestinal bleeding.

Cardiac glycosides: simultaneous administration of NSAIDs and cardiac glycosides can lead to worsening heart failure, a decrease in glomerular filtration rate and an increase in the concentration of cardiac glycosides in the blood plasma.

Lithium preparations: there is evidence of the likelihood of an increase in the concentration of lithium in the blood plasma during the use of NSAIDs.

Methotrexate: there is evidence of the likelihood of an increase in the concentration of methotrexate in the blood plasma during the use of NSAIDs.

Cyclosporine: increased risk of nephrotoxicity when NSAIDs are administered concomitantly with cyclosporine.

Mifepristone: NSAIDs should be started no earlier than 8 to 12 days after taking mifepristone, as NSAIDs may reduce the effectiveness of mifepristone.

Tacrolimus: When NSAIDs and tacrolimus are coadministered, the risk of nephrotoxicity may increase.

Zidovudine: Concomitant use of NSAIDs and zidovudine may result in increased hematotoxicity. There is evidence of an increased risk of hemarthrosis and hematomas in HIV-positive patients with hemophilia who received concomitant treatment with zidovudine and ibuprofen.

Quinolone antibiotics: In patients receiving concomitant treatment with NSAIDs and quinolone antibiotics, the risk of seizures may be increased.

Overdose

In children, overdose symptoms may occur after taking a dose exceeding 400 mg/kg body weight.

In adults, the dose-dependent effect of overdose is less pronounced. T1/2 of the drug in case of overdose is 1.5-3 hours.

Symptoms: nausea, vomiting, epigastric pain or, less commonly, diarrhea, tinnitus, headache and gastrointestinal bleeding. In more severe cases, manifestations from the central nervous system are observed: drowsiness, rarely - agitation, convulsions, disorientation, coma. In cases of severe poisoning, metabolic acidosis and an increase in prothrombin time, renal failure, liver tissue damage, decreased blood pressure, respiratory depression and cyanosis may develop. In patients with bronchial asthma, exacerbation of this disease is possible.

Treatment: symptomatic, with mandatory maintenance of airway patency, monitoring of ECG and vital signs until the patient’s condition is normalized. Oral use of activated charcoal or gastric lavage is recommended within 1 hour after taking a potentially toxic dose of ibuprofen. If ibuprofen has already been absorbed, an alkaline drink may be prescribed in order to eliminate the acidic derivative of ibuprofen by the kidneys, forced diuresis. Frequent or prolonged seizures should be treated with IV diazepam or lorazepam. When bronchial asthma worsens, the use of bronchodilators is recommended.

Release form

The drug is produced in the form of a suspension and rectal suppositories.

Nurofen syrup for children is a whitish syrupy suspension that may have an orange or strawberry flavor. The product is contained in bottles of 100 ml or 150 ml. The kit also includes a special dispenser syringe.

Nurofen in suppositories for children is white, the suppositories are smooth, torpedo-shaped. Aluminum blisters contain 5 pieces each, cardboard boxes contain two such blisters.

Side effects

The risk of side effects can be minimized if you take Nurofen for children in a short course, in the minimum effective dose necessary to eliminate symptoms.

Side effects are predominantly dose-dependent. The following adverse reactions were observed with short-term use of ibuprofen in doses not exceeding 1200 mg/day. When treating chronic conditions and with long-term use, other adverse reactions may occur.

The incidence of adverse reactions was assessed based on the following criteria: very often (≥1/10), often (from ≥1/100 to <1/10), infrequently (from ≥1/1000 to <1/100), rarely ( from ≥1/10,000 to <1/1000), very rare (<1/10,000), frequency unknown (no data available to estimate frequency).

From the hematopoietic system: very rarely - hematopoietic disorders (anemia, leukopenia, aplastic anemia, hemolytic anemia, thrombocytopenia, pancytopenia, agranulocytosis). The first symptoms of such disorders are fever, sore throat, superficial oral ulcers, flu-like symptoms, severe weakness, nosebleeds and subcutaneous hemorrhages, bleeding and bruising of unknown etiology.

From the immune system: infrequently - hypersensitivity reactions (nonspecific allergic reactions and anaphylactic reactions), reactions from the respiratory tract (bronchial asthma, incl.

its exacerbation, bronchospasm, shortness of breath, dyspnea), skin reactions (itching, urticaria, purpura, Quincke's edema, exfoliative and bullous dermatoses, including toxic epidermal necrolysis, Lyell's syndrome, Stevens-Johnson syndrome, erythema multiforme), allergic rhinitis , eosinophilia; very rarely - severe hypersensitivity reactions, incl. swelling of the face, tongue and larynx, shortness of breath, tachycardia, arterial hypotension (anaphylaxis, Quincke's edema or severe anaphylactic shock).

From the gastrointestinal tract: infrequently - abdominal pain, nausea, dyspepsia; rarely - diarrhea, flatulence, constipation, vomiting; very rarely - peptic ulcer, perforation or gastrointestinal bleeding, melena, hematemesis, ulcerative stomatitis, gastritis; frequency unknown - exacerbation of ulcerative colitis and Crohn's disease.

From the liver and biliary tract: very rarely - liver dysfunction.

From the urinary system: very rarely - acute renal failure (compensated and decompensated), especially with long-term use, in combination with an increase in the concentration of urea in the blood plasma and the appearance of edema, papillary necrosis.

From the nervous system: infrequently - headache; very rarely - aseptic meningitis (in patients with autoimmune diseases).

From the cardiovascular system: frequency unknown - heart failure, peripheral edema, with long-term use there is an increased risk of thrombotic complications (for example, myocardial infarction, stroke), increased blood pressure.

From the respiratory system: frequency unknown - bronchial asthma, bronchospasm, shortness of breath.

Other: very rarely - swelling, incl. peripheral.

Laboratory parameters: hematocrit or hemoglobin may decrease, bleeding time may increase, plasma glucose concentration may decrease, QC may decrease; plasma creatinine concentration may increase; hepatic transaminase activity may increase.

If side effects occur, you should stop taking the drug and consult a doctor.

If Nurofen does not bring down the temperature: what to do

When the thermometer rises above 39˚C, absorption of substances from the stomach may stop. This means that taking medications orally may not have an effect. This happens especially often when the patient washes down the tablet or syrup with cold water. Once in the stomach, cold liquid forces the vessels of the gastric walls to contract, as a result of which they cannot fully pass substances through their walls.

In this case, doctors recommend giving preference to rectal suppositories at high temperatures exceeding 39˚C. The suppository, once in the rectum, quickly dissolves, and ibuprofen immediately enters the bloodstream through the intestinal walls. After 30-40 minutes, the patient’s temperature begins to decrease.

Analogs

Level 4 ATC code matches:
Artrum

Brustan

Ketonal Duo

Nurofen Plus

Nurofen Express

Nurofen Forte

Nurofen Express Lady

Nurofen

Ibuprom

Ibuprofen

Advil

MIG 400

Has

Ketoprofen

Vimovo

Naproxen

Flexen

Nalgesin

Flamax

Novigan

Analogues of the drug are Bofen , Brufen Forte , Ibunorm Baby , Ibufen for children , Orafen . When using any analogue, you should first agree with your doctor.

Which is better: Panadol or Nurofen for children

The drug Panadol contains another active ingredient - paracetamol . But the effect on the body of both drugs is similar.

Panadol is also available in suspension form, making it convenient to give to a child. The final decision on the choice of medication should be made by the doctor.