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Antipyretic effects of nimesulide, paracetamol and ibuprofen-paracetamol
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.
Abstract:
The antipyretic effect of nimesulide has not been adequately compared with paracetamol and ibuprofen-paracetamol combination in children. Hence, a randomized, double blind, and parallel groups' design and multicenter study was conducted on children with respiratory tract infections. Eighty-nine patients with temperatures above 38.5 degrees C were randomly administered nimesulide (1.5 mg/kg/dose), paracetamol (10.0 mg/kg/dose), or ibuprofen-patients combination (10.0 mg/kg/dose), thrice daily for five days. The axillary temperature was recorded at the baseline and at different time intervals post administration of drugs. The hematological and biochemical investigations were performed at the basal level and at the end of the treatment period. The adverse drug reactions were monitored during the trial. All the drugs produced a significant fall in temperature as compared to their respective basal values (p < 0.001). However, on looking at the change in temperatures at different time intervals from the respective basal levels, no significant difference was found among all the drugs. Surprisingly, nimesulide had a tendency to raise serum glutamate pyruvate transaminase and serum glutamate oxaloacetate transaminase levels as compared to its baseline values. There was no marked adverse effect of the drugs on other hematological and biochemical parameters investigated. No other serious adverse reaction occurred in the study. Ibuprofen-paracetamol combination, nimesulide, and paracetamol had almost similar antipyretic effects in children.
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