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Which Painkillers Are Safe for Your Child?

There is a variety of medications that can be safely used to treat pain and reduce fever in children. Drugs that provide relief from pain are commonly known as analgesics. Analgesics either prevent pain signals from reaching the brain or alter the brain’s interpretation of such signals. The two main types of analgesics include:

Non-narcotic analgesics. These pain medications are also known as non-opioids and they represent a milder form of the painkillers, such as paracetamol (acetaminophen), the most frequently used OTC non-narcotic analgesic. Some other medications, which are not chemically related to the analgesic family, are nonetheless viewed as analgesics in practice. Examples include nonsteroidal anti-inflammatory drugs, such as ibuprofen and aspirin.

Narcotic analgesics. These drugs, also known as opioids, are stronger analgesics and are prescribed for severe pain that cannot be managed by non-narcotic analgesics. Some of the best known opioids include morphine and codeine.

Drugs that are generally used to treat fever are called antipyretic agents. They only affect the body’s mechanisms that cause fever but do not treat the cause of the fever. The most frequently used antipyretics include paracetamol (acetaminophen), ibuprofen and aspirin. Aspirin should not be used in children, because it can cause Reye syndrome, a rare but extremely dangerous condition that can be even fatal.

For mild fever (39 degrees Celsius or less or 102 degrees Fahrenheit or less) children may not require any treatment at all. The exception are infants less than two months old, when parents should seek medical advice if the baby has a fever over 38 degrees Celsius or 100.4 degrees Fahrenheit. Although it may be advisable to let the fever run its course, provided that the child is drinking plenty of fluids and behaving normally, there are situations when an antipyretic can relieve a child’s discomfort.

The most frequently recommended drugs for relieving fever and pain in children are acetaminophen (paracetamol) and ibuprofen. Since these drugs have only few side effects, they are also considered safe for infants, who may take them in drop form. Liquids are suitable for toddlers, whereas chewable tablets are designed for older children. When giving these medications to your child, always follow the doctor’s recommendations.

Types of Medications for Relieving Pain and Fever

There are various over-the-counter and prescription medications that can be used to relieve a child’s fever and pain. Parents should not give any medication to a child without first consulting a doctor and all drugs should only be used as recommended. Some of the most common medications for controlling a child’s pain or fever include:

Paracetamol or acetaminophen is suitable for treating mild-to-moderate pain and fever in children. However, paracetamol is not suitable for treating inflammatory conditions caused by infections and injuries, for which ibuprofen may be a better alternative. The weight of the child is the most important factor in determining dosage levels. Paracetamol should not be given to children without first consulting a doctor because overdose is toxic to the liver and can be life-threatening. Children should not take paracetamol for longer than five days.

Ibuprofen is a popular pain reliever that also reduces fever and inflammation. It is a nonsteroidal anti-inflammatory drug used to treat different types of pain, such as headaches, muscle aches and pain related to acute musculoskeletal injuries. In addition, it is considered to be especially effective for treating high fevers. Ibuprofen should not be given to babies younger than six months old and to children of any age who are dehydrated or vomiting repeatedly.

Other analgesics. There are also some other medications for reducing pain and fever that are considered safe for children of certain age groups, such as naproxen. However, with the exception of naproxen, other pain and fever medications are generally only recommended for older children over the age of 12. As it was mentioned earlier, aspirin, though a popular analgesic for adults, should never be used in children for risk of causing Reye syndrome. This danger is most common when children have a viral infection or chickenpox.

Conditions of Concern if Treated with Pain and Fever Medications

Parents should inform a doctor of any medical condition their child may have, as some preclude the use of certain pain and fever medications. These conditions include:

  • Allergies, asthma and history of nasal polyps
  • Anemia (red blood cell deficiency)
  • Colitis (intestinal inflammation)
  • Diabetes or other endocrine disorders
  • Emphysema or other chronic lung disease
  • Head injury or brain disease
  • Heart disease
  • Hemophilia or other bleeding problems
  • History of seizures
  • Kidney disease
  • Liver disease
  • Mental illness
  • Overactive or underactive thyroid
  • Stomach ulcer or other stomach problems
  • Vitamin K deficiency

Potential Side Effects of Pain and Fever Medications

The most common side effect children experience when taking pain and fever medications is upset stomach. To avoid this side effect, children should take these medicines with meals, or a glass of water or milk. Possible side effects associated with the use of analgesics and antipyretics in children, especially when taken in large doses, include:

  • Constipation
  • Dizziness or lightheadedness
  • Drowsiness
  • Dry mouth
  • Nausea and vomiting

Paracetamol and ibuprofen are considered safe for use in children when taken correctly. However, long-term use of paracetamol or overdose of this drug can cause serious liver damage while ibuprofen is known to cause indigestion, gastrointestinal bleeding and reduced blood flow to the kidneys in some children. Another analgesic, naproxen, which is occasionally given to children, may present certain specific risks, such as an increased risk of developing a skin rash when used in children under two years of age.

Possible Interactions of Pain and Fever Medications

Parents should not give more than one pain reliever or one fever reducer to their child at one time unless recommended by the doctor. Parents should also inform the doctor when the child has ever had a reaction to any other medication or allergy to other substances such as food. Medications that can interfere with analgesics or antipyretics include:

  • Antacids
  • Anticoagulants
  • Antidepressants
  • Anti-inflammatories
  • Antiseizure medications
  • Central nervous system depressants
  • Diarrhea medications
  • Oral antidiabetics
  • Urinary alkalizers

Other substances and medications that may adversely interact with pain and fever medications include phenothiazine, rifampin, certain vitamin supplements, watercress as well as some others. Therefore, always ask the doctor before giving analgesics or antipyretics to your child.