1. What are the licensed indications?
Nurofen for Children is on prescription and indicated for rapid and effective reduction of fever, including post immunisation pyrexia, and fast and effective relief of mild to moderate pain such as sore throat, teething pain, toothache, earache, headache, minor aches, sprains and post operative pain. Nurofen for Children is also indicated for the symptomatic treatment of juvenile rheumatoid arthritis.

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2. How does Nurofen for Children work?
The active ingredient in Nurofen for Children is ibuprofen, a non-steroidal anti-inflammatory drug with analgesic, antipyretic and anti-inflammatory properties. Ibuprofen works by inhibiting the synthesis of prostaglandins which are mediators in pain and fever.

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3. What is the therapeutic dose of Nurofen for Children?
For pain and fever the daily dosage of Nurofen for Children is 20-40 mg/kg body weight in divided doses, or for a single dose : 5-10 mg/kg.

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4. How rapidly does Nurofen for Children work?
Nurofen for Children taken orally is rapidly absorbed from the upper GI tract and maximum plasma concentrations are reached 1-2 hours following ingestion. Reduction of fever has been noted within 15 minutes¹ which lasts for up to 6-8 hours.

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5. What are the contraindications?
The contraindications to the use of Nurofen for Children are:

Hypersensitivity to any of the constituents, or aspirin or other NSAIDs

Patients with a history of, or existing, peptic ulcer

Patients with a history of asthma, rhinitis or urticaria associated with aspirin or other NSAIDs ( sometimes referred to as aspirin - sensitive asthma)

6. What happens in the case of an overdose?
Large doses of ibuprofen are generally well tolerated when no other drugs are involved. The symptoms of overdose can include, nausea, vomiting, abdominal pain, headache, hypotension, dizziness, drowsiness, nystagmus, blurred vision, tinnitus and rarely metabolic acidosis, renal failure and loss of consciousness. However ingested doses do not correlate well with clinical effect, therefore, patients need to be treated symptomatically. Use supportive care where appropriate. Activated charcoal can be used within one hour of ingestion or gastric lavage followed by activated charcoal if the dose is greater than 400mg/kg. The daily dosage of Nurofen for Children is 20-40 mg/kg body weight. Toxic dose is considered to be above 400mg/kg/day which means that ibuprofen has a very wide therapeutic window.

7. Does ibuprofen cause Reye's Syndrome?
There is no established association between ibuprofen and Reye's Syndrome. The use of ibuprofen in children with viral diseases has not been associated with the development of Reye's Syndrome. In a study conducted in over 84,000 children treated with either ibuprofen or paracetamol for fever, there were no reports of Reye's Syndrome².

Summary
Ibuprofen - the active ingredient in Nurofen for Children, has been taken by billions of people since it was first marketed in 1969. In the UK, ibuprofen has been available for children since 1994. Nurofen for Children has proven to be a well - tolerated, safe and effective analgesic and antipyretic medication.

References
¹ Pelen F et al. Treatment of Fever : monotherapy with ibuprofen. Ibuprofen pediatric suspension containing 100mg / 5ml, Multicentre acceptability study conducted in hospital (in French ) Ann. Pediat. (Paris), 1998; 45, 10: 719 - 728

² Lesko , SM, Mitchell, AA. An assessment of the safety of paediatric ibuprofen : A practitioner - based randomized clinical trial. Journal of the American Medical Association, 1995;273: 929 -933