Influenza and Ibuprofen

[Jolie, BSN]

I listened to a segment on a local talk radio show today about the seriousness of the flu outbreak. One of the experts was an Infectious Disease specialist from Loyola and the other was a local pediatrician.

On more than one occasion, the ID specialist insisted that the use of ibuprofen is unsafe in all flu patients due to the risk of Reye's Syndrome. I am aware of the connection between aspirin use in viral illness in children and Reye's Syndrome, but was surprised to hear her insist that NO NSAID is safe for use in ANY flu patient.

I realize that the chemical structure of ibuprofen is similar to aspirin, and that in theory, it could be linked to Reye's Syndrome, but I thought that research had pretty much de-bunked that link. I was also surprised to hear her say that Reye's Syndrome is a potential complication for patients of any age, not just kids.

Have I missed out on important information about Reye's Syndrome, or was she being overly cautious? She was not a pediatric specialist, and the pediatrician did not comment on this topic.

It would be a shame to needlessly "nix" the use of ibuprofen, which seems to be so much more effective in fever and pain management than Tylenol. Any input?

[LisaRN2B]

I don't have an answer to this, but I am very interested in the replies...

I, too, thought it was only aspirin that needed to be avoided. Let's see what others say...

[Shenandoah]

Maybe this site will shed some light on the subject...

http://www.reyessyndrome.org/aspirin.htm

[z's playa]

I take Naprosyn for back pain and migraines so I'm aware of its pitfalls and benefits. I'm personally surprised at how freely doctors prescribe this drug since it has some pretty serious side effects, the main one being gastrointestinal bleeding and such. Nsaids is in the same catagory as aspirin and ibuprofen so the fact that it can harm children AND adults is no big surprise to me.

Ran across this article....:)

http://www.harvard-magazine.com/issues/ja96/health.html

[LydiaGreen]

I am going to research this NOW... my final placement was in a small community clinic and every person who phoned about their kids having the flu were told by the nurse to give them Advil and lots of fluids, etc, etc. We really do push ibuprofen here but in a combination with acetaminophen. What I mean is... it's 1600, give your kid acetaminofen now so that you can give ibuprofen at 2000 - longer duration, kid gets more rest, parent gets more rest. We also push "double dosing". When a stubborn fever won't come down with the appropriate dose of acetaminophen, we give the appropriate dose of ibuprofen. They both have the same therapeutic effect but act on different areas to achieve it, so the theory behind "double dosing" is that it is a safe way to combat a stubborn fever.

Personally, I have found that acetaminophen "works" faster for my kids and that ibuprofen lasts longer once the fever is under control with the acetaminophen. I keep a stock of both at home (but do not treat a fever unless it is over 101, why interfere with one of the body's natural defense mechanisms if the temp is low grade?).

Anyway, I will be looking into the Reye's Syndrome link to ibuprofen. Very interesting and scary if it is true.

[LydiaGreen]

So far, nothing I can find indicates a link between ibuprofen and Reyes Syndrome - including the links above. If anything, source after source is saying that while ibuprofen has the same side effects of aspirin, there is one exception and that is Reyes Syndrome.

[Jolie, BSN]

Lydia,

Thanks for your input. I can't find anything on the internet linking ibuprofen with Reye's either. I'm planning to contact our pediatrician's NP today about another question, so I'll ask her, too. She has an extensive background in PICU, so I'm sure she's well versed in Reye's Syndrome.