Ibuprofen (Paediatric)

How it works

Reversibly inhibits cyclo-oxygenase enzymes (COX-1 and COX-2), reducing prostaglandin synthesis and thereby producing analgesic, antipyretic and anti-inflammatory effects.

Prescribing in practice

• Avoid in dehydrated or hypovolaemic children (including significant vomiting, diarrhoea or chickenpox) because of the risk of acute kidney injury, and use caution with asthma where NSAIDs may trigger bronchospasm.
• Give with or after food and confirm weight-based paediatric dosing and minimum age against a children's formulary.
• Caution in children with gastrointestinal, renal or bleeding risk, and avoid combining with other NSAIDs.

Monitoring

For short-term antipyretic use formal monitoring is not usually required; review hydration, renal function and gastrointestinal tolerance with higher doses or prolonged use.

Counselling the patient

• Give with or after food and use the measuring device supplied.
• Keep the child well hydrated and stop and seek advice if they become very unwell, are vomiting or not drinking.
• Do not give alongside another ibuprofen or NSAID-containing product.

Evidence & guidelines

Ibuprofen is recommended for fever and pain in children by NICE feverish-illness guidance, used as a single antipyretic agent.