Antipyretic

An antipyretic (/ˌæntipaɪˈrɛtɪk/, from anti- 'against' and pyretic 'feverish') is a substance that reduces fever.[1] Antipyretics cause the hypothalamus to override a prostaglandin-induced increase in temperature. The body then works to lower the temperature, which results in a reduction in fever.

Tablets of ibuprofen, a common antipyretic

Most antipyretic medications have other purposes. The most common antipyretics in the United States are ibuprofen and aspirin, which are nonsteroidal anti-inflammatory drugs (NSAIDs) used primarily as analgesics (pain relievers), but which also have antipyretic properties; and paracetamol (acetaminophen), an analgesic with weak anti-inflammatory properties.[2]

There is some debate over the appropriate use of such medications, since fever is part of the body's immune response to infection.[3][4] A study published by the Royal Society claims that fever suppression causes at least 1% more influenza deaths in the United States, or 700 extra deaths per year.[5]

Non-pharmacological treatment

Bathing or sponging with lukewarm or cool water can effectively reduce body temperature in those with heat illness, but not usually in those with fever.[6] The use of alcohol baths is not an appropriate cooling method, because there have been reported adverse events associated with systemic absorption of alcohol.[7]

Medications

Many medications have antipyretic effects and thus are useful for fever, but not in treating illness, including:

Children

The U.S. Food and Drug Administration (FDA) notes that improper dosing is one of the biggest problems in giving acetaminophen (paracetamol) to children.[8] The effectiveness of acetaminophen alone as an antipyretic in children is uncertain, with some evidence showing it is no better than physical methods.[9] Therapies involving alternating doses of acetaminophen and ibuprofen have shown greater antipyretic effect than either drug alone.[10] One meta-analysis indicated that ibuprofen is more effective than acetaminophen in children at similar doses when both are given alone.[11]

Due to concerns about Reye syndrome, it is recommended that aspirin and combination products that contain aspirin not be given to children or teenagers during episodes of fever-causing illnesses.[12][13]

Plants

Traditional use of higher plants with antipyretic properties is a common worldwide feature of many ethnobotanical cultures. In ethnobotany, a plant with naturally occurring antipyretic properties is commonly referred to as a febrifuge.[14]

References
  1. "Definition of antipyretic". Merriam-Webster Online Dictionary. Retrieved 2007-12-19.
  2. "Acetaminophen," National Center for Biotechnology Information, U.S. National Library of Medicine. Modified 2016-08-07, Accessed 2016-08-16.
  3. "Mayo Clinic".
  4. "Medline Plus".
  5. Kupferschmidt, Kai (2014-01-21). "Fight the Flu, Hurt Society?". ScienceNow.
  6. "UpToDate Inc".
  7. Sullivan, J. E.; Committee On, H. C.; Sullivan, J. E.; Farrar, H. C. (2011). "Fever and Antipyretic Use in Children". Pediatrics. 127 (3): 580–587. doi:10.1542/peds.2010-3852. PMID 21357332.
  8. Reducing Fever in Children: Safe Use of Acetaminophen
  9. Meremikwu M, Oyo-Ita A (2002). Meremikwu MM (ed.). "Paracetamol for treating fever in children". The Cochrane Database of Systematic Reviews (2): CD003676. doi:10.1002/14651858.CD003676. PMC 6532671. PMID 12076499. Trial evidence that paracetamol has a superior antipyretic effect than placebo is inconclusive.
  10. E. Michael Sarrell, MD; Eliahu Wielunsky, MD; Herman Avner Cohen, MD (2006). "Antipyretic treatment in young children with fever: acetaminophen, ibuprofen, or both alternating in a randomized, double-blind study". Archives of Pediatrics & Adolescent Medicine. 160 (2): 197–202. doi:10.1001/archpedi.160.2.197. PMID 16461878.
  11. Kauffman, Ralph; Sawyer, L.A.; Scheinbaum, M.L. (1992). "Antipyretic Efficacy of Ibuprofen vs Acetaminophen". American Journal of Diseases of Children. 146 (5): 622–625. doi:10.1001/archpedi.1992.02160170102024. PMID 1621668.
  12. CDC Study Shows Sharp Decline in Reye's Syndrome among U.S. Children Archived November 15, 2014, at the Wayback Machine
  13. Reye's syndrome - Prevention
  14. Schultes, Richard Evans; Raffauf, Robert F. (1994). "De Plantis Toxicariis e Mundo Novo Tropicale Commentationes XXXIX Febrifuges of northwest Amazonia". Harvard Papers in Botany. 1 (5): 52–68. ISSN 1043-4534. JSTOR 41761491.
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