Efficacy and Safety of Ibuprofen and Acetaminophen in Children and Adults: A Meta-Analysis and Qualitative Review
Abstract
Abstract
Objective:
To evaluate the analgesic and antipyretic efficacy and safety of ibuprofen compared to acetaminophen in children and adults.
Data Sources:
Literature searches were performed using PubMed/MEDLINE (through August 2009) and EMBASE (through January 2008) and were restricted to the English language. In PubMed/MEDLINE, search terms used were ibuprofen, acetaminophen, paracetamol, clinical trials, and randomized controlled trials. EMBASE search terms included ibuprofen and acetaminophen, restricted to human and clinical trials.
Study Selection And Data Extraction:
All English-language articles identified from the data sources were reviewed. Multiple review articles were studied for any pertinent references and this yielded additional articles. Only articles that directly compared ibuprofen and acetaminophen were eligible for this review.
Data Synthesis:
Eighty-five studies that directly compared ibuprofen to acetaminophen were identified; 54 contained analgesic efficacy data, 35 contained antipyretic/temperature reduction data, and 66 contained safety data (some articles contained more than 1 type of data). Qualitative review of the literature revealed that, for the most part, ibuprofen was more efficacious than acetaminophen for the treatment of pain and fever in both pediatric and adult populations, and that these 2 drugs were equally safe. Meta-analyses on the subset of randomized clinical trial articles that reported sufficient quantitative information to calculate either an odds ratio (adverse event [AE]) or standardized mean difference (pain and fever) confirmed the qualitative results for adult (standardized mean difference [SMD] 0.69; 95% CI 0.57 to 0.81) and pediatric (SMD 0.28; 95% CI 0.10 to 0.46) pain at 2 hours postdose and pediatric fever (SMD 0.26; 95% CI 0.10 to 0.41) at 4 hours postdose. Conclusions regarding adult fever/temperature reduction could not be made due to a lack of evaluable data. The combined odds ratio for the proportion of adult subjects experiencing at least 1 AE slightly favored ibuprofen; however, the difference was not statistically significant (1.12; 95% CI 1.00 to 1.25). No significant difference between drugs in AE incidence was found for pediatric patients (0.82; 95% CI 0.60 to 1.12).
Conclusions:
Ibuprofen is as or more efficacious than acetaminophen for the treatment of pain and fever in adult and pediatric populations and is equally safe.
Resumen
Objetivo:
Evaluar la eficacia y seguridad analgésica y antipirética de ibuprofén y acetaminofén en niños y adultos
Fuentes De Información:
Se realizó una búsqueda de la literatura en los sistemas PubMed/MEDLINE y EMBASE utilizando los términos ibuprofén y acetaminofén. Para esta revisión fueron elegibles sólo los artículos que compararon directamente ibuprofén con acetaminofén.
Síntesis:
Se identificaron 85 estudios, los cuales compararon directamente ibuprofén con acetaminofén; 54 contenían datos de eficacia analgésica, 35 contenían datos en la reducción de temperatura/antipirético, y 66 contenían datos de seguridad (nota: algunos artículos contenían datos de analgesia y/o antipirético y/o seguridad). La revisión cualitativa reveló que ibuprofén fue más eficaz que acetaminofén, en la mayoría de la literatura evaluada en esta revisión, para el tratamiento de dolor y fiebre en ambas poblaciones de pacientes, pediátricos y adultos y que los mismos fueron igualmente seguros. Los meta-análisis de los subgrupos de estudios clínicos aleatorios que reportaron suficiente información cuantitativa para calcular tanto la razón de probabilidad (odds ratio) (eventos adversos) como la diferencia en el promedio estandarizada (dolor y fiebre), confirmó los resultados cualitativos de dolor para adulto (diferencia en promedio estandarizada de 0.69; 95% CI 057 y 0.81) y pediátrico (diferencia en promedio estandarizada de 0.28; 95% CI 0.10 y 0.46) a las 2 horas luego de la dosis y fiebre pediátrica (diferencia en promedio estandarizada de 0.26; 95% CI 0.10 y 0.41) a las 4 horas luego de la dosis. Conclusiones relacionadas a la reducción en temperatura/fiebre en adultos no se pudieron realizar debido a la falta de datos evaluables. La razón de probabilidad combinada para la proporción de sujetos adultos que experimentaron al menos un evento adverso, favoreció levemente a ibuprofén; sin embargo, la diferencia no fue estadísticamente significativa (1.12; 95% CI 1.00 y 1.25). No se encontró diferencia en la incidencia de eventos adversos en pacientes pediátricos (0.82; 95% CI 0.60 y 1.12).
Conclusiones:
Ibuprofén es tan o más eficaz que acetaminofén para el tratamiento del dolor y fiebre en poblaciones adultas y pediátricas e igualmente seguro.
Résumé
Sources De L'Information:
PubMed/MedLINE, et EMBASE, et les articles tirés des bibliographies.
Sélection Des Études Et Extraction Des Données:
Les recherches sur les bases de données PubMed/MedLINE, et EMBASE ont été réalisées avec les mots-clés ibuprofen et acetaminophen. Seuls les articles qui comparaient directement l'ibuprofène et l'acétaminophène étaient éligibles pour cette révision.
Synthèse De L'Information:
Quatre-vingt cinq études comparant directement l'ibuprofène et l'acétaminophène ont été identifiées; 54 contenaient des données sur l'efficacité analgésique, 35 contenaient des données sur l'efficacité antipyrétique, et 66 contenaient des données sur la sécurité (note: certains articles contenaient des données sur l'efficacité analgésique et/ou antipyrétique et/ou la sécurité.) La révision qualitative a révélé que l'ibuprofène est plus efficace que l'acétaminophène dans la plupart des études évaluées dans le traitement de la douleur et de la fièvre, et ce, tant au sein de la population pédiatrique qu'adulte. Cette révision démontre aussi que les 2 médicaments sont également sécuritaires. La méta-analyse réalisée avec le sous-groupe d'études cliniques qui rapportaient suffisamment d'informations quantitatives pour calculer un rapport de cote (réactions indésirables) ou une différence moyenne standardisée (douleur et fièvre), vient confirmer les résultats de l'analyse quantitative chez les adultes (différence moyenne standardisée 0.69; IC 95% 0.57 à 0 81), et chez les enfants (différence moyenne standardisée 0.28, IC 95% 0.10 à 0.46) pour la douleur 2 heures post dose et pour la fièvre en pédiatrie (différence moyenne standardisée 0.26; IC 95% 0.10 à 0.41) 4 heures post dose. Il a été impossible de tirer des conclusions concernant la réduction de la fièvre/température chez les adultes en raison de l'absence de données. Les rapports de cote combinés pour la proportion de sujets adultes qui ont présenté au moins un épisode de réaction indésirable favorise légèrement l'ibuprofène; cependant, cette différence n'était pas statistiquement significative (1.12; IC 95% 1 00 à 1.5). Aucune différence n'a été notée dans la population pédiatrique concernant l'incidence d'effets indésirables (0.82; IC 95% 0.60 à 1.12)
Conclusions:
L'ibuprofène est au moins aussi efficace que l'acétaminophène pour le traitement de la douleur ou de la fièvre chez les adultes ou les enfants et semble tout aussi sécuritaire.
Get full access to this article
View all access and purchase options for this article.
References
1. Moore N. Forty years of ibuprofen use. Int J Clin Pract Suppl 2003: 28–31.
2. FDA TAHWG. 2009 Joint Meeting of the Drug Safety and Risk Management Advisory Committee with the Anesthetic and Life Support Drugs Advisory Committee and the Nonprescription Drugs Advisory Committee. http://www.fda.gov/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/DrugSafetyandRiskManagementAdvisoryCommittee/ucm161515.htm. 2009 (accessed 2009 Aug 12).
3. Perrott DA, Piira T, Goodenough B, Champion GD. Efficacy and safety of acetaminophen vs ibuprofen for treating children's pain or fever: a meta-analysis. Arch Pediatr Adolesc Med 2004; 158:521–6.
4. Goldman RD, Ko K, Linett LJ, Scolnik D. Antipyretic efficacy and safety of ibuprofen and acetaminophen in children. Ann Pharmacother 2004; 38:146–50.
5. Wang MC, Bushman BJ. Integrating results through meta-analytic review using SAS software, SAS Institute, Cary, NC, 1999.
6. Cochrane handbook for systematic reviews of interventions, 5.0.1 ed, 2008.
7. Aksoylar S, Aksit S, Caglayan S, Yaprak I, Bakiler R, Cetin F. Evaluation of sponging and antipyretic medication to reduce body temperature in febrile children. Acta Paediatr Jpn 1997; 39:215–7.
8. Amdekar YK, Desai RZ. Antipyretic activity of ibuprofen and paracetamol in children with pyrexia. Br J Clin Pract 1985; 39:140–3.
9. Ashraf E, Ford L, Geetha R, Cooper S. Safety profile of ibuprofen suspension in young children. Inflammopharmacology 1999; 7:219–25.
10. Autret E, Breart G, Jonville AP, Courcier S, Lassale C, Goehrs JM. Comparative efficacy and tolerance of ibuprofen syrup and acetaminophen syrup in children with pyrexia associated with infectious diseases and treated with antibiotics. Eur J Clin Pharmacol 1994; 46:197–201.
11. Autret E, Reboul-Marty J, Henry-Launois B, et al. Evaluation of ibuprofen versus aspirin and paracetamol on efficacy and comfort in children with fever. Eur J Clin Pharmacol 1997; 51:367–71.
12. Autret-Leca E, Gibb IA, Goulder MA. Ibuprofen versus paracetamol in pediatric fever: objective and subjective findings from a randomized, blinded study. Curr Med Res Opin 2007; 23:2205–11.
13. Bennie RE, Boehringer LA, McMahon S, Allen H, Dierdorf SF. Postoperative analgesia with preoperative oral ibuprofen or acetaminophen in children undergoing myringotomy. Paediatr Anaesth 1997; 7:399–403.
14. Bertin L, Pons G, d'Athis P, et al. A randomized, double-blind, multicentre controlled trial of ibuprofen versus acetaminophen and placebo for symptoms of acute otitis media in children. Fundam Clin Pharmacol 1996; 10:387–92.
15. Bertin L, Pons G, d'Athis P, et al. Randomized, double-blind, multicenter, controlled trial of ibuprofen versus acetaminophen (paracetamol) and placebo for treatment of symptoms of tonsillitis and pharyngitis in children. J Pediatr 1991; 119:811–4.
16. Bhounsule SA, Nevreker PR, Agshikar NV, Pal MN, Dhume VG. A comparison of four analgesics in post-episiotomy pain. Indian J Physiol Pharmacol 1990; 34:34–8.
17. Bird SE, Williams K, Kula K. Preoperative acetaminophen vs ibuprofen for control of pain after orthodontic separator placement. Am J Orthod Dentofacial Orthop 2007; 132:504–10.
18. Bjornsson GA, Haanaes HR, Skoglund LA. A randomized, double-blind crossover trial of paracetamol 1000 mg four times daily vs ibuprofen 600 mg: effect on swelling and other postoperative events after third molar surgery. Br J Clin Pharmacol 2003; 55:405–12.
19. Boureau F, Schneid H, Zeghari N, Wall R, Bourgeois P. The IPSO study: ibuprofen, paracetamol study in osteoarthritis. A randomised comparative clinical study comparing the efficacy and safety of ibuprofen and paracetamol analgesic treatment of osteoarthritis of the knee or hip. Ann Rheum Dis 2004; 63:1028–34.
20. Boureau F. Pelen F, Verriere F, Paliwoda A, Manfredi R, Farhan M, Wall R. Evaluation of ibuprofen vs paracetamol analgesic activity using a sore throat pain model. Clin Drug Invest 1999; 17:1–8.
21. Bradley JD, Brandt KD, Katz BP, Kalasinski LA, Ryan SI. Comparison of an antiinflammatory dose of ibuprofen, an analgesic dose of ibuprofen, and acetaminophen in the treatment of patients with osteoarthritis of the knee. N Engl J Med 1991; 325:87–91.
22. Bradley RL, Ellis PE, Thomas P, Bellis H, Ireland AJ, Sandy JR. A randomized clinical trial comparing the efficacy of ibuprofen and paracetamol in the control of orthodontic pain. Am J Orthod Dentofacial Orthop 2007; 132:511–7.
23. Chopra D, Rehan HS, Mehra P, Kakkar AK. A randomized, double-blind, placebo-controlled study comparing the efficacy and safety of paracetamol, serratiopeptidase, ibuprofen and betamethasone using the dental impaction pain model. Int J Oral Maxillofac Surg 2009; 38:350–5.
24. Clark E, Plint AC, Correll R, Gaboury I, Passi B. A randomized, controlled trial of acetaminophen, ibuprofen, and codeine for acute pain relief in children with musculoskeletal trauma. Pediatrics 2007; 119:460–7.
25. Cooper SA, Schachtel BP, Goldman E, Gelb S, Cohn P. Ibuprofen and acetaminophen in the relief of acute pain: a randomized, double-blind, placebo-controlled study. J Clin Pharmacol 1989; 29:1026–30.
26. Dahl V, Dybvik T, Steen T, Aune AK, Rosenlund EK, Raeder JC. Ibuprofen vs acetaminophen vs ibuprofen and acetaminophen after arthroscopically assisted anterior cruciate ligament reconstruction. Eur J Anaesthesiol 2004; 21:471–5.
27. Dahl V, Erno PE, Raeder JC. No analgesic effect of ibuprofen or paracetamol vs placebo for hysterectomies. Eur J Pain 1997; 1:31–5.
28. Dalton JD Jr, Schweinle JE. Randomized controlled noninferiority trial to compare extended release acetaminophen and ibuprofen for the treatment of ankle sprains. Ann Emerg Med 2006; 48:615–23.
29. Daniels S, Reader S, Berry P, Goulder M. Onset of analgesia with sodium ibuprofen, ibuprofen acid incorporating poloxamer and acetaminophen—a single-dose, double-blind, placebo-controlled study in patients with post-operative dental pain. Eur J Clin Pharmacol 2009; 65:343–53.
30. Dawood MY, Khan-Dawood FS. Clinical efficacy and differential inhibition of menstrual fluid prostaglandin F2alpha in a randomized, double-blind, crossover treatment with placebo, acetaminophen, and ibuprofen in primary dysmenorrhea. Am J Obstet Gynecol 2007; 196:35 e1-5.
31. Derkay CS, Wadsworth JT, Darrow DH, Strasnick B, Thompson GK, O'Master J. Tube placement: a prospective, randomized double-blind study. Laryngoscope 1998; 108:97–101.
32. Dionne RA, Campbell RA, Cooper SA, Hall DL, Buckingham B. Suppression of postoperative pain by preoperative administration of ibuprofen in comparison to placebo, acetaminophen, and acetaminophen plus codeine. J Clin Pharmacol 1983; 23:37–43.
33. Dippel DW, van Breda EJ, van der Worp HB, et al. Effect of paracetamol (acetaminophen) and ibuprofen on body temperature in acute ischemic stroke PISA, a phase II double-blind, randomized, placebo-controlled trial [ISRCTN98608690]. BMC Cardiovasc Disord 2003; 3:2.
34. Figueras Nadal C, Garcia de Miguel MJ, Gomez Campdera A, Pou Fernandez J, Alvarez Calatayud G, Sanchez Bayle M. Effectiveness and tolerability of ibuprofen-arginine versus paracetamol in children with fever of likely infectious origin. Acta Paediatr 2002; 91:383–90.
35. Forbes JA, Kehm CJ, Grodin CD, Beaver WT. Evaluation of ketorolac, ibuprofen, acetaminophen, and an acetaminophen-codeine combination in postoperative oral surgery pain. Pharmacotherapy 1990; 10:94S–105S.
36. Forster C, Magerl W, Beck A, et al. Differential effects of dipyrone, ibuprofen, and paracetamol on experimentally induced pain in man. Agents Actions 1992; 35:112–21.
37. Furey SA, Vargas R, McMahon FG. Renovascular effects of nonprescription ibuprofen in elderly hypertensive patients with mild renal impairment. Pharmacotherapy 1993; 13:143–8.
38. Gazal G, Mackie IC. A comparison of paracetamol, ibuprofen or their combination for pain relief following extractions in children under general anaesthesia: a randomized controlled trial. Int J Paediatr Dent 2007; 17:169–77.
39. Hamalainen ML, Hoppu K, Valkeila E, Santavuori P. Ibuprofen or acetaminophen for the acute treatment of migraine in children: a double-blind, randomized, placebo-controlled, crossover study. Neurology 1997; 48:103–7.
40. Harris NS, Wenzel RP, Thomas SH. High altitude headache: efficacy of acetaminophen vs ibuprofen in a randomized, controlled trial. J Emerg Med 2003; 24:383–7.
41. Hay AD, Costelloe C, Redmond NM, et al. Paracetamol plus ibuprofen for the treatment of fever in children (PITCH): randomised controlled trial. BMJ 2008; 337:a1302.
42. Hersh EV, Levin LM, Cooper SA, et al. Ibuprofen liquigel for oral surgery pain. Clin Ther 2000; 22:1306–18.
43. Jackson LA, Dunstan M, Starkovich P, et al. Prophylaxis with acetaminophen or ibuprofen for prevention of local reactions to the fifth diphtheria-tetanus toxoids-acellular pertussis vaccination: a randomized, controlled trial. Pediatrics 2006; 117:620–5.
44. Joshi YM, Sovani VB, Joshi VV, et al. Comparative evaluation of the antipyretic efficacy of ibuprofen and paracetamol. Indian Pediatr 1990; 27:803–6.
45. Kamondetdecha R, Tannirandorn Y. Ibuprofen versus acetaminophen for the relief of perineal pain after childbirth: a randomized controlled trial. J Med Assoc Thai 2008; 91:282–6.
46. Kashefi P, Mirdamadi M. Preemptive analgesia with ibuprofen and acetaminophen in pediatric lower abdominal surgery. J Res Med Sci 2005; 10:222–6.
47. Kauffman RE, Sawyer LA, Scheinbaum ML. Antipyretic efficacy of ibuprofen vs acetaminophen. Am J Dis Child 1992; 146:622–5.
48. Kelley MT, Walson PD, Edge JH, Cox S, Mortensen ME. Pharmacokinetics and pharmacodynamics of ibuprofen isomers and acetaminophen in febrile children. Clin Pharmacol Ther 1992; 52:181–9.
49. Khubchandani RP, Ghatikar KN, Keny S, Usgaonkar NG. Choice of antipyretic in children. J Assoc Physicians India 1995; 43:614–6.
50. Krishna S, Pukrittayakamee S, Supanaranond W, et al. Fever in uncomplicated Plasmodium falciparum malaria: randomized double-“blind” comparison of ibuprofen and paracetamol treatment. Trans R Soc Trop Med Hyg 1995; 89:507–9.
51. Lala I, Leech P, Montgomery L, Bhagat K. Use of a simple pain model to evaluate analgesic activity of ibuprofen versus paracetamol. East Afr Med J 2000; 77:504–7.
52. Lesko SM, Mitchell AA. An assessment of the safety of pediatric ibuprofen. A practitioner-based randomized clinical trial. JAMA 1995; 273:929–33.
53. Leuschen MP, Filipi M, Healey K. A randomized open label study of pain medications (naproxen, acetaminophen and ibuprofen) for controlling side effects during initiation of IFN beta-1a therapy and during its ongoing use for relapsing-remitting multiple sclerosis. Mult Scler 2004; 10:636–42.
54. Livshits A, Machtinger R, David LB, Spira M, Moshe-Zahav A, Seidman DS. Ibuprofen and paracetamol for pain relief during medical abortion: a double-blind randomized controlled study. Fertil Steril 2009; 91:1877–80.
55. McGaw T, Raborn W, Grace M. Analgesics in pediatric dental surgery: relative efficacy of aluminum ibuprofen suspension and acetaminophen elixir. ASDC J Dent Child 1987; 54:106–9.
56. McIntyre J, Hull D. Comparing efficacy and tolerability of ibuprofen and paracetamol in fever. Arch Dis Child 1996; 74:164–7.
57. Mehlisch DR, Jasper RD, Brown P, Korn SH, McCarroll K, Murakami AA. Comparative study of ibuprofen lysine and acetaminophen in patients with postoperative dental pain. Clin Ther 1995; 17:852–60.
58. Mehlisch DR, Sollecito WA, Helfrick JF, et al. Multicenter clinical trial of ibuprofen and acetaminophen in the treatment of postoperative dental pain. J Am Dent Assoc 1990; 121:257–63.
59. Milsom I, Andersch B. Effect of ibuprofen, naproxen sodium and paracetamol on intrauterine pressure and menstrual pain in dysmenorrhoea. Br J Obstet Gynaecol 1984; 91:1129–35.
60. Molla AL, Donald JF. A comparative study of ibuprofen and paracetamol in primary dysmenorrhea. J Int Med Res 1974; 2:395–9.
61. Moore N, Van Ganse E, Le Parc J-M, Wall R, et al. The PAIN study: paracetamol, aspirin and ibuprofen new tolerability study. A large-scale, randomised clinical trial comparing the tolerability of aspirin, ibuprofen and paracetamol for short-term analgesia. Clin Drug Invest 1999; 18:89–98.
62. Moore PA, Acs G, Hargreaves JA. Postextraction pain relief in children: a clinical trial of liquid analgesics. Int J Clin Pharmacol Ther Toxicol 1985; 23:573–7.
63. Nwanyanwu OC, Ziba C, Kazembe PN. Paracetamol and ibuprofen for treatment of fever in Malawian children aged less than five years. Trans R Soc Trop Med Hyg 1999; 93:84.
64. Olson NZ, Otero AM, Marrero I, et al. Onset of analgesia for liquigel ibuprofen 400 mg, acetaminophen 1000 mg, ketoprofen 25 mg, and placebo in the treatment of postoperative dental pain. J Clin Pharmacol 2001; 41:1238–47.
65. Owen HPJ, Ilsley AH, Tordoff K, Toouli J. Pain control in the week following laparoscopic surgery: a comparison of sustained release ibuprofen and paracetamol. Min Invasive Ther Allied Technol 1997; 6:235–40.
66. Packman B, Packman E, Doyle G, et al. Solubilized ibuprofen: evaluation of onset, relief, and safety of a novel formulation in the treatment of episodic tension-type headache. Headache 2000; 40:561–7.
67. Pearce I, Frank GJ, Pearce JM. Ibuprofen compared with paracetamol in migraine. Practitioner 1983; 227:465–7.
68. Phadke MA, Paranjape PV, Joshi AS. Ibuprofen in children with infective disorders—antipyretic efficacy. Br J Clin Pract 1985; 39:437–40.
69. Primosch RE, Nichols DL, Courts FJ. Comparison of preoperative ibuprofen, acetaminophen, and placebo administration on the parental report of postextraction pain in children. Pediatr Dent 1995; 17:187–91.
70. Reess J, Haas J, Gabriel K, Fuhlrott A, Fiola M. Both paracetamol and ibuprofen are equally effective in managing flu-like symptoms in relapsing-remitting multiple sclerosis patients during interferon beta-1a (AVONEX) therapy. Mult Scler 2002; 8:15–8.
71. Rio J, Nos C, Bonaventura I, et al. Corticosteroids, ibuprofen, and acetaminophen for IFNbeta-1a flu symptoms in MS: a randomized trial. Neurology 2004; 63:525–8.
72. Salmassian R, Oesterle LJ, Shellhart WC, Newman SM. Comparison of the efficacy of ibuprofen and acetaminophen in controlling pain after orthodontic tooth movement. Am J Orthod Dentofacial Orthop 2009; 135:516–21.
73. Schachtel BP, Fillingim JM, Thoden WR, Lane AC, Baybutt RI. Sore throat pain in the evaluation of mild analgesics. Clin Pharmacol Ther 1988; 44:704–11.
74. Schachtel BP, Furey SA, Thoden WR. Nonprescription ibuprofen and acetaminophen in the treatment of tension-type headache. J Clin Pharmacol 1996; 36:1120–5.
75. Schachtel BP, Thoden WR. A placebo-controlled model for assaying systemic analgesics in children. Clin Pharmacol Ther 1993; 53:593–601.
76. Schachtel BP, Thoden WR, Baybutt RI. Ibuprofen and acetaminophen in the relief of postpartum episiotomy pain. J Clin Pharmacol 1989; 29:550–3.
77. Sheth UK, Gupta K, Paul T, Pispati PK. Measurement of antipyretic activity of ibuprofen and paracetamol in children. J Clin Pharmacol 1980; 20:672–5.
78. Sidler J, Frey B, Baerlocher K. A double-blind comparison of ibuprofen and paracetamol in juvenile pyrexia. Br J Clin Pract Suppl 1990; 70:22–5.
79. Simila S, Kouvalainen K, Keinanen S. Oral antipyretic therapy. Scand J Rheumatol 1976; 5:81–3.
80. Ulukol B, Koksal Y, Cin S. Assessment of the efficacy and safety of paracetamol, ibuprofen and nimesulide in children with upper respiratory tract infections. Eur J Clin Pharmacol 1999; 55:615–8.
81. Van Esch A, Van Steensel-Moll HA, Steyerberg EW, Offringa M, Habbema JD, Derksen-Lubsen G. Antipyretic efficacy of ibuprofen and acetaminophen in children with febrile seizures. Arch Pediatr Adolesc Med 1995; 149:632–7.
82. Vauzelle-Kervroedan F, d'Athis P, Pariente-Khayat A, Debregeas S, Olive G, Pons G. Equivalent antipyretic activity of ibuprofen and paracetamol in febrile children. J Pediatr 1997; 131:683–7.
83. Ventafridda V, De Conno F, Panerai AE, Maresca V, Monza GC, Ripamonti C. Non-steroidal anti-inflammatory drugs as the first step in cancer pain therapy: double-blind, within-patient study comparing nine drugs. J Int Med Res 1990; 18:21–9.
84. Viitanen H, Tuominen N, Vaaraniemi H, Nikanne E, Annila P. Analgesic efficacy of rectal acetaminophen and ibuprofen alone or in combination for paediatric day-case adenoidectomy. Br J Anaesth 2003; 91:363–7.
85. Vinh H, Parry CM, Hanh VT, et al. Double blind comparison of ibuprofen and paracetamol for adjunctive treatment of uncomplicated typhoid fever. Pediatr Infect Dis J 2004; 23:226–30.
86. Walson PD, Galletta G, Braden NJ, Alexander L. Ibuprofen, acetaminophen, and placebo treatment of febrile children. Clin Pharmacol Ther 1989; 46:9–17.
87. Walson PD, Galletta G, Chomilo F, Braden NJ, Sawyer LA, Scheinbaum ML. Comparison of multidose ibuprofen and acetaminophen therapy in febrile children. Am J Dis Child 1992; 146:626–32.
88. Wilson G, Guerra AJ, Santos NT. Comparative study of the antipyretic effect of ibuprofen (oral suspension) and paracetamol (suppositories) in paediatrics. J Int Med Res 1984; 12:250–4.
89. Wilson JT, Brown RD, Kearns GL, et al. Single-dose, placebo-controlled comparative study of ibuprofen and acetaminophen antipyresis in children. J Pediatr 1991; 119:803–11.
90. Wong A, Sibbald A, Ferrero F, et al. Antipyretic effects of dipyrone versus ibuprofen versus acetaminophen in children: results of a multinational, randomized, modified double-blind study. Clin Pediatr (Phila) 2001; 40:313–24.
91. Radack KL, Deck CC, Bloomfield SS. Ibuprofen interferes with the efficacy of antihypertensive drugs. A randomized, double-blind, placebo-controlled trial of ibuprofen compared with acetaminophen. Ann Intern Med 1987; 107:628–35.
92. Farquhar WB, Morgan AL, Zambraski EJ, Kenney WL. Effects of acetaminophen and ibuprofen on renal function in the stressed kidney. J Appl Physiol 1999; 86:598–604.
93. Heard K. Nonprescription analgesics: misunderstood and abused. Emergency Medicine 2009: 25–9.
Cite
Cite
Cite
OR
Download to reference manager
If you have citation software installed, you can download citation data to the citation manager of your choice
Information, rights and permissions
Information
Published In
Article first published online: February 11, 2010
Issue published: March 2010
Keywords
PubMed: 20150507
Authors
Metrics and citations
Metrics
Publication usage*
Total views and downloads: 2323
*Publication usage tracking started in December 2016
Altmetric
See the impact this article is making through the number of times it’s been read, and the Altmetric Score.
Learn more about the Altmetric Scores
Publications citing this one
Receive email alerts when this publication is cited
Web of Science: 157 view articles Opens in new tab
Crossref: 194
- Effects of preemptive analgesia and preoperative anxiety on emergence delirium after pediatric adenotonsillectomy
- Appropriateness and Abuse of Antipyretics, Anti-Inflammatory Drugs and Antibiotics in Children and Adults
- Acetaminophen (Paracetamol) or Opioid Analgesia Added to Ibuprofen for Children’s Musculoskeletal Injury
- Development and Optimization of a Fixed Dose Combination Tablet Containing Ibuprofen and Loratadine Using Design Expert and Box-Behnken Design
- The use and misuse of non-steroidal anti-inflammatory drugs (Ibuprofen) and paracetamol among mothers who presented with their children in health facilities in Enugu, South‒East Nigeria
- An Italian survey on the management of children with fever and pain in clinical practice
- Structural, Electronic, and Optical Properties of Monoclinic Pharmaceutical Crystals: A DFT Study of Salicylic Acid, Acetylsalicylic Acid, Acetaminophen, and Ibuprofen
- A distance-based paper sensor for simple and rapid detection of paracetamol in pharmaceutical samples
- Efficacy and Safety of Paracetamol and NSAIDs for Fever and Pain Management in Children with Chronic Diseases: A Narrative Review
- The use of oral ibuprofen plus acetaminophen versus ibuprofen alone for acute pain reduction in children
- View More
Figures and tables
Figures & Media
Tables
View Options
Access options
If you have access to journal content via a personal subscription, university, library, employer or society, select from the options below:
I am signed in as:
View my profileSign out
I can access personal subscriptions, purchases, paired institutional access and free tools such as favourite journals, email alerts and saved searches.
loading institutional access options
Alternatively, view purchase options below:
Purchase 24 hour online access to view and download content.
Access journal content via a DeepDyve subscription or find out more about this option.
