Can I use Ibuprofen (Nonsteroidal Anti-Inflammatory Drug (NSAID)) for fever reduction?

Using Ibuprofen for Fever Reduction

Ibuprofen is effective and appropriate to use specifically for fever reduction. 1

Efficacy of Ibuprofen for Fever

• Ibuprofen is more effective than acetaminophen (paracetamol) in reducing fever in children 2, 3
• Ibuprofen (5-10 mg/kg) reduces temperature more effectively than acetaminophen at 2,4, and 6 hours after treatment 2
• For symptomatic fever treatment, ibuprofen can be used at a dose of 0.2g orally every 4-6 hours, not exceeding 4 doses in 24 hours 1

Dosing Considerations

• For fever reduction in children, the recommended dose is 4-10 mg/kg per dose 2
• In adults with fever, such as in COVID-19 patients, ibuprofen can be used when temperature exceeds 38.5°C 1
• Temperature reduction below 38°C is not necessary and may not be beneficial for recovery 1

Safety Profile

• Single doses of ibuprofen and acetaminophen have similar safety profiles when used as antipyretics 2, 4
• Short-term use (7-10 days) of ibuprofen for fever does not appear to pose substantial risks 1
• For fever management, ibuprofen with a short half-life is preferred at the lowest effective dose for short duration 1

Special Considerations

In Children

• Ibuprofen is superior to paracetamol for reducing fever in children 5, 3
• In children with febrile seizures, antipyretics alone (including ibuprofen) have not been shown to reduce seizure recurrence risk 1
• For children with Kawasaki disease taking aspirin, ibuprofen should be avoided as it can antagonize aspirin's antiplatelet effects 1

In Pregnancy

• For fever during pregnancy, ibuprofen can be used in the first and second trimesters (up to gestational week 28) 1
• Ibuprofen should be discontinued after gestational week 28 due to increased risk of fetal complications 1
• Short-term use (7-10 days) during the second trimester appears to have minimal risks 1

Important Cautions

• Ibuprofen should be discontinued after gestational week 28 in pregnant women due to risks of oligohydramnios and narrowing/occlusion of the fetal ductus arteriosus 1
• In patients with Kawasaki disease who are on aspirin therapy, ibuprofen should be avoided as it antagonizes aspirin's irreversible platelet inhibition 1
• In malaria patients with hyperpyrexia, ibuprofen is superior to paracetamol for reducing fever but should be used with caution in cases of impaired renal function 1

Duration of Treatment

• Fever is typically a short-lived symptom, and prolonged use of antipyretics is generally unnecessary 5
• If fever persists beyond 5-7 days of ibuprofen treatment, the patient should be reassessed rather than continuing NSAID therapy long-term 6