Why you should NEVER give kids ibuprofen for chickenpox – and other essential tips for taking paracetamol, ibuprofen and aspirin
THEY are in everyone's medicine cabinet, a go-to first line treatment for most minor illnesses.
But do you really know how you should be taking paracetamol, ibuprofen or aspirin?
Are you putting your family at risk by giving them medicine that could actually make their condition worse?
This week experts revealed taking ibuprofen raises your heart attack risk by half after just one day.
And past studies have warned of health risks linked to taking painkillers.
They range from stomach ulcers and liver problems to increased risk of heart failure and cardiac arrest.
1. Do not give ibuprofen to kids with chickenpox
Parents should think twice about giving their kids ibuprofen if they have chickenpox, Dr Jarvis warned.
While ibuprofen doesn't make the illness itself worse, it has been linked to an increased risk of potentially life-threatening flesh-eating infections in children.
The bacteria can trigger necrotising fasciitis, a very serious infection that affects the tissue under the skin.
It effectively "eats away" at the tissue, and can lead to limb amputations and death.
Dr Jarvis said the bacteria that triggers the vicious infection can "feed off" inflammatory drugs and make it worse.
Dr Jarvis said: "Ibuprofen can cause a bacterial infection [in children with chickenpox] that eat away at soft tissue, which is called necrotising fasciitis.
"As far as we are aware the evidence is that there isn't any other condition where it can cause this."
Dr Jarvis also recommends that adults with chickenpox should not take ibuprofen.
But in this case it is because experts "do not know" if the same risk applies to grown-ups.
2. Be careful taking ibuprofen if you have asthma
Ibuprofen and other anti-inflammatories can make asthma symptoms worse.
People with the condition can still take the drugs but they must be aware the painkiller can trigger an attack, Dr Jarvis said.
Dr Jarvis explained: "In some people any anti-inflammatory or aspirin can increase the risk of an asthma attack.
"If you have taken anti-inflammatories before you have asthma then you're probably OK, but if you haven't be wary."
3. Don't give aspirin to children under 16
Seeing your child ill and in pain is hard for any parent.
And while you will be desperate to ease their suffering and will do what it takes to make them more comfortable, pause for thought.
Before you reach into the medicine cabinet to find them a painkiller make sure you know what you can and can't give them, said Dr Jarvis.
If you don't it could prove deadly.
WHAT IS ASPIRIN?
Aspirin is a common medicine that has a number of uses, from relieving pain to reducing the risk of serious problems such as heart attacks and strokes.
It comes in many forms including pills, dissolvable tablets and gels.
Its uses:
High-doses can relieve pain such as headaches, toothache, period pain, general aches and pains and fever.
Low-doses may be recommended by a doctor for a long period of time if you have had a heart attack, stroke, heart surgery or have a clotting disease.
That's because it makes the blood less sticky and can stop clots from forming.
Who can take it?
Most people can take aspirin safely, but if you are concerned or have any underlying conditions you should speak to a GP or pharmacist.
She said: "Never give your child aspirin.
"It runs a risk of [triggering] a condition called Reye's syndrome.
"It is rare but it can cause severe liver and brain damage.
"It causes mitochondrial damage within the cells - so the powerhouses that provide energy inside your cells get damaged.
"That causes a build-up of toxic chemicals in the blood that damages the body and can make the brain swell and cause symptoms similar to meningitis and encephalitis - swelling of the brain."
If Reye's syndrome is not treated promptly it can lead to permanent brain damage or death.
4. Do not go over the prescribed amount
It's important to remember that not all painkillers have the same recommended dosage.
And if you go over that dosage you could cause serious harm to your health
Dr Jarvis said: "With ibuprofen usually we recommend no more than 400mg three times a day and if you are taking it for more than a week or so speak to a GP because there may be an alternative.
"The higher the dosage the higher the risk as far as heart attack is concerned.
The risk of taking ibuprofen and heart attack
This week ibuprofen has been linked with an increased risk of heart attack.
Taking the drug for just one day increases the risk of the deadly condition by half.
Past studies have found the common painkillers increase risk of cardiac arrest by up to a third.
Scientists fear the drugs may cause blood vessels to narrow, increase fluid retention and alter blood pressure.
Canadian experts found taking any regular dose of ibuprofen for between one to seven days raised chances by 48 per cent.
Dr Jarvis said the risk of someone suffering a heart attack after taking ibuprofen was one in 100.
She said: "But the message is ‘don’t panic’ because it still means that 99 per cent of people won’t.
"However the higher the dose you take the higher your risk.
"If you are young and healthy, taking the occasional dose of ibuprofen is highly unlikely to cause you harm but we certainly wouldn’t recommend you take it regularly or pop pills just for the sake of it.
"You just need to be aware that there are risks with taking it."
"The risks of stomach ulcers go up over time.
"In terms of paracetamol, we all know that a paracetamol overdose can be dangerous, but actually just taking even a bit over the recommended dose over a short period can lead to liver failure."
5. Can you combine ibuprofen and paracetamol?
You can combine paracetamol and ibuprofen, but it is always best to try one on its own first, said Dr Jarvis.
"For instance, if you have a child whose fever hasn't come down with one you could use the other," she told The Sun Online.
"But we don't recommend you take both at the same time, try one and then if that doesn't work try the other."
5. Don't fall into the 'four-hour' trap - always read the label
It is easy to fall into the trap of thinking painkillers can be taken every four hours but some drugs, like ibuprofen, actually last longer than that.
Dr Jarvis said: "It is extraordinary how many people don't read the label.
"You could be taking too much of one drug.
"You should also check how often you should take it and get the dosage right."
WHAT IS IBUPROFEN?
Ibuprofen is a painkiller available over the counter without a prescription.
It's one of a group of painkillers called non-steroidal anti-inflammatory drugs (NSAIDs) and can be used to ease mild pain, control a high temperature, ease inflammation and ease swelling.
It comes in many forms including tablets, capsules, liquid, gels and even sprays.
Who can take it?
Not everyone can take ibuprofen.
Some people can but others should use it with caution.
You shouldn't take the medicine if you:
- have had an allergic reaction to it before
- have had or currently have stomach ulcers
- have severe heart failure
- have severe liver disease
- are taking low-dose aspirin for heart disease
Use it with caution if you have:
- asthma
- kidney or liver problems
- lupus
- high blood pressure
- Crohn's disease
- previous bleeding in the stomach
- heart problems
- have had a stroke
Source: NHS Choices
So what are the right dosages?
Dr Jarvis recommends: "With ibuprofen the dosage is three times a day ideally spaced at eight hourly intervals because it lasts longer.
"With paracetamol it is every four to six hours but if you are taking it every four hours you still mustn't take it more than four times a day."
And while it might be tempting to take one more tablet that recommended to ease your pain, Dr Jarvis said you should absolutely not do that.
6.Don't mix ibuprofen with steroid tablets, anti-depressants, blood thinners or aspirin
People already taking certain medication should be wary of combining it with ibuprofen.
Those on steroids, anti-depressants and blood thinners are already at a higher risk of bleeding in the stomach and an inflamed stomach lining.
Ibuprofen has been linked to an increased risk of stomach irritation and can therefore make bleeding worse.
Dr Jarvis said: "All of these make you more prone to bleeding in the stomach so if you add something to it it can make it worse.
"We are very wary of the risks of ibuprofen and any anti-inflammatory in terms of causing irritation in the stomach."
WHAT IS PARACETAMOL?
Paracetamol is a commonly used medicine that can help treat pain and reduce a fever.
It is often used to relieve mild pain such as headaches, toothache or sprains and can reduce the high temperature associated with colds and flu.
Paracetamol is often recommended as one of the first treatments for pain, as it's safe for most people to take and side effects are rare.
Who can take it?
Most people can take it including pregnant women, breastfeeding women and children over two months.
But if you are not sure if you can take paracetamol it is always best to read the label or speak to a GP or pharmacist.
Always seek advice if you:
- have liver or kidney problems
- suffer from alcohol misuse
- are very underweight
- are taking other medications
Paracetamol comes in many different forms including tablets, capsules, liquid and injections.
Source: NHS Choices
The drugs can be combined under the recommendation of your GP, but not for long periods of time.
Dr Jarvis recommends always speaking to your GP or pharmacist before combining the medications to minimise your risk of bleeding.
7. Don't take ibuprofen if you have stomach ulcers
Along with the increased risk of bleeding, there is an increased risk of stomach ulcers when you take ibuprofen, Dr Jarvis said.
And the longer you are taking anti-inflammatories the greater your risk of developing the painful condition.
Dr Jarvis said: "If you are taking any anti-inflammatory for more than a week then it is worth thinking about taking an acid suppressing medication.
"You can speak to your pharmacist about that or you can speak to your GP.
"Anti-inflammatory irritate the lining of the stomach and with inflammation can cause bleeding and stomach ulcers."
8. Seek advice if you're older and have kidney problems
As we get older it becomes harder for our bodies to break down painkillers, which are seen as toxins in the body.
The kidneys filter the painkillers out of our blood but in older people this becomes an increasingly difficult process.
"In older people it can cause acute kidney damage and can actually make your kidneys fail," Dr Jarvis warned.
"It is toxic to the kidneys.
"Your kidneys and your liver can deal with a certain amount of it but once you get beyond a certain amount they don't cope as well and that gets worse with age."
9. Seek advice if you are pregnant
As with many things, if you are pregnant, you should always seek advice from your GP or pharmacist before taking painkillers.
Dr Jarvis said: "We don't recommend ibuprofen if you can avoid it, especially during the first 30 weeks.
"Some women are recommended to take low-dose aspirin regularly during pregnancy if they have certain conditions that can increase their risk of miscarriage.
"If it has been recommended then absolutely take it, but otherwise just be aware that with aspirin and ibuprofen you need to be careful."
The main condition that is cause for concern is antiphospholipid syndrome - a disorder of the immune system that causes an increased risk of blood clots.
Aspirin has blood thinning properties and can therefore protect pregnant women against clots that can be potentially deadly to their baby.
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