Antipyretic effects of nimesulide, paracetamol and ibuprofen-paracetamol

A Lal1, S Gomber, B Talukdar

  • 1Department of Pharmacology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi. avtarlal@hotmail.com

Insights

Nimesulide, paracetamol, and ibuprofen-paracetamol combinations show similar fever reduction in children with respiratory infections. Nimesulide showed a slight increase in liver enzymes but no other serious adverse effects were noted.

Area of Science:

  • Pediatrics
  • Pharmacology
  • Infectious Diseases

Background:

  • Fever management in pediatric respiratory tract infections is crucial.
  • Comparative efficacy of antipyretics like nimesulide, paracetamol, and ibuprofen-paracetamol combinations requires further investigation in children.

Purpose of the Study:

  • To compare the antipyretic efficacy and safety of nimesulide, paracetamol, and an ibuprofen-paracetamol combination in children.

Main Methods:

  • A randomized, double-blind, parallel-group, multicenter study involving 89 children with fever (>38.5°C).
  • Participants received nimesulide (1.5 mg/kg/dose), paracetamol (10.0 mg/kg/dose), or ibuprofen-paracetamol combination (10.0 mg/kg/dose) thrice daily for five days.
  • Axillary temperature, hematological, biochemical parameters, and adverse drug reactions were monitored.

Main Results:

  • All tested drugs significantly reduced fever compared to baseline (p < 0.001).
  • No significant differences in temperature reduction were observed among the three treatment groups over time.
  • Nimesulide exhibited a tendency to increase liver enzymes (SGPT, SGOT) without affecting other hematological/biochemical parameters.
  • No serious adverse reactions were reported for any drug.

Conclusions:

  • Nimesulide, paracetamol, and the ibuprofen-paracetamol combination demonstrate comparable antipyretic effects in children.
  • While nimesulide may cause minor liver enzyme elevations, it appears safe for short-term fever management in this pediatric population.

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