Ibuprofen for Children

1. Introduction

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used in children to reduce fever, relieve mild to moderate pain, and alleviate inflammation. It works by inhibiting cyclooxygenase (COX) enzymes, reducing prostaglandin production, which is responsible for pain, fever, and inflammation.

2. Indications

  • Approved Indications:
    • Fever (e.g., due to infections, immunisations).
    • Mild to moderate pain (e.g., headache, toothache, earache, sore throat).
    • Inflammation (e.g., juvenile idiopathic arthritis, sprains, strains).
  • Off-Label Uses:
    • Musculoskeletal injuries.
    • Postoperative pain (under medical supervision).

3. Dosage

  • By Weight:
    • Fever and Pain Relief: 5–10 mg/kg per dose every 6–8 hours as needed.
    • Maximum Single Dose: 10 mg/kg.
    • Maximum Daily Dose: 40 mg/kg/day.
  • By Age (when weight is unknown): Age Dose Maximum Daily Dose 3–6 months 50 mg every 8 hours 150 mg/day 6–12 months 50 mg every 6–8 hours 200 mg/day 1–3 years 100 mg every 6–8 hours 400 mg/day 4–6 years 150 mg every 6–8 hours 600 mg/day 7–9 years 200 mg every 6–8 hours 800 mg/day 10–12 years 300 mg every 6–8 hours 1200 mg/day

4. Administration

  • Oral Suspension or Syrup:
    • Shake well before use.
    • Measure the dose using a dosing syringe, spoon, or cup.
  • Chewable Tablets:
    • Chew thoroughly before swallowing. Suitable for children aged ≥6 years.
  • With or Without Food:
    • Can be taken with food or milk to reduce the risk of stomach upset.

5. Forms Available

  • Oral Suspension/Syrup: 100 mg/5 mL or 50 mg/1.25 mL.
  • Chewable Tablets: 50 mg, 100 mg.
  • Tablets (for older children): 200 mg.

6. Side Effects

6.1. Common Side Effects

  • Stomach upset or mild abdominal pain.
  • Nausea or vomiting.
  • Headache.

6.2. Less Common Side Effects

  • Diarrhoea or constipation.
  • Mild skin rash.

6.3. Rare but Serious Side Effects

  • Gastrointestinal bleeding.
  • Severe allergic reactions (e.g., rash, swelling, difficulty breathing).
  • Kidney dysfunction (e.g., decreased urine output).

7. Warnings

  • Gastrointestinal Risks: Prolonged use may increase the risk of ulcers or bleeding, especially in children with a history of stomach issues.
  • Dehydration: Increased risk of kidney injury if the child is dehydrated (e.g., due to vomiting or diarrhoea).
  • Allergic Reactions: Avoid in children with aspirin or NSAID allergies.

8. Precautions

  • Avoid Use in:
    • Children under 3 months old without medical supervision.
    • Children with severe dehydration, renal disease, or history of gastrointestinal bleeding.
  • Caution in:
    • Children with asthma, as ibuprofen may worsen symptoms in sensitive individuals.

9. Interactions

  • Drug-Drug Interactions:
    • Aspirin: Increased risk of side effects.
    • Anticoagulants (e.g., warfarin): Increased risk of bleeding.
    • Diuretics: May reduce kidney function.
  • Drug-Food Interactions:
    • None significant, but taking with food or milk can reduce stomach upset.

10. Monitoring Parameters

  • Improvement in fever or pain.
  • Signs of adverse effects such as stomach pain, vomiting, or reduced urine output.
  • Avoid exceeding the recommended dose to prevent toxicity.

11. Use in Children

  • Safe when used as directed. Dosage must be adjusted based on weight or age to avoid overdosing.

12. Use in Pregnancy

  • Not applicable for children. Ibuprofen is not recommended during the third trimester in pregnancy due to risks to the foetus.

13. Use in Elderly

  • Not applicable for children.

14. Use in Kidney Disease

  • Avoid in children with known renal impairment or dehydration, as ibuprofen may worsen kidney function.

15. Use in Liver Disease

  • Use cautiously in children with liver dysfunction. Dosage adjustments may be required.

16. Patient Counselling Points

  • Always use the correct measuring device for liquid formulations to ensure accurate dosing.
  • Avoid exceeding the maximum daily dose based on the child’s weight.
  • Give ibuprofen with food or milk if the child complains of stomach upset.
  • Do not combine ibuprofen with other NSAIDs or aspirin unless directed by a healthcare provider.
  • Seek immediate medical attention if the child develops difficulty breathing, swelling, or signs of an allergic reaction.

17. Table of Brand Names, Manufacturers, and Prices

Brand NameManufacturerPrice (USD)
Children’s AdvilPfizer$5–10 (120 mL, 100 mg/5 mL)
Motrin Children’sJohnson & Johnson$5–12 (120 mL, 100 mg/5 mL)
Generic Ibuprofen SyrupVarious manufacturers$3–8 (120 mL, 100 mg/5 mL)

18. FAQs (15 Questions)

  1. What is ibuprofen used for in children?
    It is used to treat fever, mild to moderate pain, and inflammation.
  2. How does ibuprofen work?
    It reduces the production of prostaglandins, which cause pain, inflammation, and fever.
  3. What is the correct dose of ibuprofen for my child?
    The dose depends on the child’s weight, typically 5–10 mg/kg every 6–8 hours.
  4. Can ibuprofen be used for teething pain?
    Yes, ibuprofen can be used to relieve teething pain in children older than 6 months.
  5. How often can I give ibuprofen to my child?
    Every 6–8 hours, not exceeding 4 doses in 24 hours.
  6. Can ibuprofen cause side effects in children?
    Yes, common side effects include stomach upset, nausea, and mild rash.
  7. Can I alternate ibuprofen with paracetamol for fever?
    Yes, alternating ibuprofen and paracetamol can be done under a doctor’s guidance to manage persistent fever.
  8. Can ibuprofen be given to infants under 6 months?
    Ibuprofen is not recommended for infants under 6 months unless prescribed by a doctor.
  9. Does ibuprofen reduce inflammation in children?
    Yes, it reduces inflammation and swelling associated with injuries or conditions like juvenile arthritis.
  10. Can ibuprofen cause allergies?
    Yes, though rare, ibuprofen can cause allergic reactions, particularly in children with NSAID or aspirin sensitivity.
  11. Can ibuprofen cause kidney problems in children?
    Yes, especially in dehydrated children or those with pre-existing kidney issues.
  12. How should ibuprofen be stored?
    Store at room temperature, away from moisture and direct sunlight.
  13. Can ibuprofen treat ear infections in children?
    It can relieve pain and reduce fever associated with ear infections but does not treat the infection itself.
  14. Can ibuprofen be given on an empty stomach?
    It is best to give ibuprofen with food or milk to prevent stomach upset.
  15. What should I do if I accidentally give too much ibuprofen?
    Seek medical attention immediately. Symptoms of overdose include vomiting, drowsiness, and breathing difficulties.