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Oral Antipyretics

Introduction

Fever is manifested as an abnormally elevated body temperature. In general, an oral temperature of 37.5 °C or higher, or a rectal/tympanic (ear) temperature of 38.0 °C or higher will be considered as significant and one should consult a doctor for suspected fever. Antipyretics are medications that reduce fever.

Oral antipyretics can be generally classified into two categories: paracetamol and non-steroidal anti-inflammatory drugs (e.g. ibuprofen and aspirin).

Paracetamol, sold as a branded product or under the generic name paracetamol, is the most widely used over-the-counter antipyretic medication. Please note that paracetamol is also known as acetaminophen, they are referring to the same drug.

Common side effects*

Serious adverse effects of paracetamol are rare if you take it correctly, although hypersensitivity including skin rash may occur. Very rare cases of serious skin reactions have also been reported.

Common adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs) are gastrointestinal disturbances such as nausea, vomiting, diarrhea, constipation and decreased appetite. Irritation of the gastric mucosa with erosion, ulceration and melaena may occur. Aspirin also increases bleeding time and decreases platelet adhesiveness.

If you are worried about a side effect or notice anything unusual, please seek advice from healthcare professionals.

General advice on taking oral antipyretics*

  • Some of the oral antipyretics (e.g. paracetamol) are generally over-the-counter medicines, which could be purchased without a doctor’s prescription. Nevertheless, you should seek advice from healthcare professionals before taking any medicines. To assist members of the public to differentiate different over-the-counter registered products containing paracetamol, a list of these products has been posted in the website of the Drug Office, Department of Health:
    https://www.drugoffice.gov.hk/eps/do/en/doc/List_of_registered_pharmaceutical_products_containing_paracetamol.pdf
  • Do not take more than the recommended dosage. You should read the instructions as stated in the product package or insert, and seek advice from healthcare professionals, before using antipyretics.
  • Consult your doctor if symptoms persist or worsen.
  • Consult your doctor before using any medication if you are pregnant or breastfeeding.
  • Stop using the product immediately and consult your doctor if allergic reaction occurs.

Additional information/precautions when taking paracetamol*

  • You should monitor your health condition, and seek advice from healthcare professionals if fever persists for more than 3 days after taking paracetamol.
  • Do not take paracetamol with any other products containing paracetamol (e.g. other cold and flu medicines that may contain paracetamol) unless advised by healthcare professionals.
  • Do not take more than the recommended dosage. Inappropriate use of paracetamol has the potential to cause liver toxicity or severe liver damage.
  • If you have kidney disease, liver disease or are taking oral anticoagulants (e.g. Warfarin), you are advised to consult healthcare professionals before using medicines containing paracetamol.
  • Overdose of paracetamol may cause serious liver injury, therefore, a normal adult should not consume more than 4,000mg of paracetamol within 24 hours (for a tablet containing 500mg paracetamol, the maximum daily intake for a normal adult is 8 tablets). Children or persons with certain disease conditions should take a lower dose either in accordance with product package or insert and/or advice from healthcare professionals. Persons who are underweight or malnourished should consult a doctor before using medicines containing paracetamol.
  • Please refer to the following link for more details on the use of medicines containing paracetamol:
    https://www.drugoffice.gov.hk/eps/do/en/consumer/news_informations/knowledge_on_medicines/paracetamol.html

Additional information/precautions when taking NSAIDs*

  • All NSAIDs are contraindicated in severe heart failure patients.
  • Do not use NSAIDs if you have a history of gastrointestinal bleeding or perforation related to previous NSAIDs therapy, active or history of recurrent peptic ulcer or haemorrhage
  • Do not use NSAIDs if you have a history of hypersensitivity to aspirin or any other NSAIDs, which includes those in whom attacks of asthma, angioedema, urticaria, or rhinitis have been precipitated by aspirin or any other NSAIDs.
  • Do not use aspirin in children under 16 years old except on medical advice.
  • Do not use aspirin if you have stomach ulcers, persistent indigestion or liver disease as aspirin irritates stomach and can cause bleeding.
  • Please refer to the following link for more information about oral NSAIDs:
    https://www.drugoffice.gov.hk/eps/do/en/consumer/news_informations/dm_03.html#e

Storage

Oral antipyretics should be stored in a cool dry place and avoid direct sunlight. Unless specified on the labels, medicines should not be stored in refrigerators. Furthermore, medicines should be kept properly in places unreachable by children to prevent accidental ingestion.

* Information contained herein may not cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects.



Drug Office
Department of Health
Dec 2023
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