Ibuprofen for kids
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Ibuprofen for Kids: Efficacy and Safety
Introduction to Ibuprofen Use in Children
Ibuprofen is a widely used non-steroidal anti-inflammatory drug (NSAID) for treating inflammation, mild-to-moderate pain, and fever in children. It is approved for use in children aged three months and older and is available over-the-counter in many countries3 4. This article synthesizes research findings on the efficacy and safety of ibuprofen for children, comparing it with other common medications like acetaminophen.
Efficacy of Ibuprofen for Pain Relief
Acute Pain Management
Ibuprofen has been shown to be effective in managing acute pain in children. Studies indicate that ibuprofen is more effective than acetaminophen and comparable to acetaminophen-codeine combinations for controlling musculoskeletal pain, toothache, and inflammatory diseases of the oral cavity and pharynx2 5. In a randomized clinical trial, ibuprofen provided analgesia equivalent to acetaminophen-codeine for children with acute traumatic extremity pain, with both drugs showing similar pain score reductions and minimal adverse effects5.
Postoperative Pain
Ibuprofen is also effective in managing postoperative pain in children. A study involving children aged one to four years undergoing elective surgery found that ibuprofen provided superior pain relief during the first hour post-surgery and significantly reduced the need for morphine9. This suggests that ibuprofen can be a safe and effective option for postoperative pain management in young children.
Migraine Relief
For children suffering from migraines, ibuprofen has been found to be more effective than acetaminophen. In a study evaluating the efficacy of these drugs for acute migraine treatment, ibuprofen was twice as likely as acetaminophen to abort migraines within two hours6. This makes ibuprofen a preferred choice for managing severe or moderate migraine attacks in children.
Safety Profile of Ibuprofen
General Safety
The safety profile of ibuprofen in children is generally positive. A meta-analysis comparing single doses of ibuprofen and acetaminophen found that both drugs had similar safety profiles, with no significant differences in the incidence of minor or major harm10. However, it is important to note that ibuprofen should not be given to children with dehydration, diarrhea, vomiting, or those sensitive to NSAIDs, as these conditions can increase the risk of adverse effects3.
Adverse Events
While serious adverse events are rare, they can occur. A study comparing the incidence of serious adverse clinical events among children younger than two years old found that the risk of hospitalization for gastrointestinal bleeding was slightly higher in children treated with ibuprofen compared to those treated with acetaminophen, although the difference was not statistically significant1. Additionally, ibuprofen should be used cautiously in children with asthma or during varicella, as it can exacerbate these conditions3.
Combined or Alternating Use with Acetaminophen
The combined or alternating use of ibuprofen and acetaminophen for treating fever in children has been a topic of debate. A meta-analysis found that combined or alternating therapy was more effective than monotherapy in reducing body temperature, but the benefit was modest and not clinically significant7. Therefore, current guidelines generally recommend monotherapy based on the child's individual characteristics.
Conclusion
Ibuprofen is a well-studied and effective medication for managing pain and fever in children. It is generally safe when used appropriately, although caution is needed in certain conditions. For acute pain, postoperative pain, and migraines, ibuprofen often provides superior relief compared to acetaminophen. However, parents and caregivers should always follow dosing guidelines and consult healthcare providers to ensure the safe use of ibuprofen in children.
Sources and full results
Most relevant research papers on this topic
The Safety of Acetaminophen and Ibuprofen Among Children Younger Than Two Years Old
The risk of serious adverse events in children 2 years old receiving short-term treatment with either acetaminophen or ibuprofen suspension is small and does not vary by medication choice.
RCT
Large Human Trial
Highly CitedIbuprofen for Pain Control in Children
Ibuprofen is a safe and effective treatment for acute pain in children, with potential benefits in musculoskeletal, oral, and pharynx conditions, and postoperative pain management.
Systematic ReviewWorking Towards an Appropriate Use of Ibuprofen in Children: An Evidence-Based Appraisal
Ibuprofen is a safe and effective treatment for inflammatory pain in children, but it should be used cautiously, especially in cases of dehydration, sensitive individuals, and during fever symptoms.
Literature ReviewHighly CitedIbuprofen as an antipyretic and analgesic drug in pediatric practice (a literature review)
Ibuprofen is a safe, effective, and well-tolerated drug for lowering fever and pain relief in children, with a positive benefit-risk ratio compared to other medications.
Systematic ReviewIbuprofen provides analgesia equivalent to acetaminophen-codeine in the treatment of acute pain in children with extremity injuries: a randomized clinical trial.
Acetaminophen-codeine and ibuprofen are equally effective in treating acute traumatic extremity pain in children aged 5-17 years, with minimal adverse effects.
RCTIbuprofen or Acetaminophen for the Acute Treatment of Migraine in Children
Ibuprofen is more effective than acetaminophen for treating severe or moderate migraine attacks in children, providing the best relief.
RCTHighly CitedPrescribing Controversies: An Updated Review and Meta-Analysis on Combined/Alternating Use of Ibuprofen and Paracetamol in Febrile Children
Combined or alternating use of ibuprofen and paracetamol in febrile children showed a modest but clinically relevant benefit in reducing body temperature, but the evidence is not robust enough to recommend this alternative to monotherapy.
Meta-AnalysisA randomized, double‐blind, multicentre controlled trial of ibuprofen versus acetaminophen and placebo for symptoms of acute otitis media in children
Ibuprofen is more effective than acetaminophen for relieving pain in children with acute otitis media, but not significantly better than placebo.
RCTHighly CitedIbuprofen in the treatment of postoperative pain in small children. A randomized double–blindplacebo controlled parallel group study
Rectal ibuprofen is a safe analgesic for children aged 1 to 4 years and reduces the need for opioids for postoperative pain relief.
RCTEfficacy and safety of acetaminophen vs ibuprofen for treating children's pain or fever: a meta-analysis.
In children, single doses of ibuprofen (5-10 mg/kg) and acetaminophen (7-15 mg/kg) have similar efficacy for relieving moderate to severe pain, with ibuprofen being more effective as a fever reducer at 2, 4, and 6 hours posttreatment
Meta-AnalysisHighly Cited