Author: Chen Chuxiong, Sun Yat-sen Memorial Hospital, Sun Yat-sen University
Recently, the epidemic has spread rapidly, and the antipyretic drugs acetaminophen and ibuprofen are hard to find. Whether on the Internet or in daily life, everyone has said: There is no way to buy the medicine!
So, in addition to acetaminophen and ibuprofen, what other antipyretic and analgesic drugs can be used? In fact, in addition to acetaminophen and ibuprofen, there is another drug that has a good antipyretic effect, which is diclofenac sodium .
Next, pharmacist Yixian will introduce this medicine to you:
Both diclofenac sodium and ibuprofen are non-selective. Steroidal anti-inflammatory drugs can also play an antipyretic and analgesic effect, and their antipyretic and analgesic effects are also very strong. In the drug catalog for patients with new coronavirus infection (first edition) released by in Beijing, diclofenac sodium enteric-coated tablets (capsules), sustained-release tablets (capsules), and suppositories are all recommended for the symptomatic treatment of fever.
Among them, the indications in the drug instructions of diclofenac sodium enteric-coated tablets (capsules) and suppositories indicate that they can be used for antipyretic treatment in patients with fever. However, diclofenac sodium sustained-release tablets (capsules) are not indicated for use in patients with fever. The reason is that sustained-release preparations are more suitable for analgesic treatment of pain patients. Sustained-release preparations use sustained-release technology to release the drug smoothly and slowly, thereby ensuring a more stable blood drug concentration and achieving a sustained analgesic effect. When used to reduce fever, its onset of action is slow, and its maximum antipyretic effect is slightly worse than that of ordinary dosage forms.
However, diclofenac sodium sustained-release tablets (capsules) can also have an antipyretic effect, but its onset time is slower . For those with high fever who need to quickly reduce fever, of course does not recommend the preferred sustained-release dosage form . Although the onset of action is slower than other dosage forms, the sustained-release dosage form also has its own characteristics, such as long maintenance time. Generally, it only needs to be taken 1-2 times a day, while ordinary dosage forms may need to be taken 2-3 times a day.
Diclofenac sodium and ibuprofen are both non-selective non-steroidal anti-inflammatory drugs. Why is ibuprofen an over-the-counter drug , while diclofenac sodium is a prescription drug? This is because diclofenac sodium may cause bone marrow suppression and has slightly more adverse reactions than ibuprofen, so is an over-the-counter drug only for external use. Therefore, taking diclofenac sodium requires the guidance of a doctor or pharmacist.
Precautions for taking diclofenac sodium
1. It should not be used during pregnancy and lactation.
2. Older adults are at greater risk of renal , cardiovascular or gastrointestinal adverse events and monitoring is recommended.
3. It is prohibited to be used in patients with asthma , urticaria or allergic reactions induced by taking aspirin or other non-steroidal anti-inflammatory drugs.
4. Contraindicated in preparation for coronary artery bypass grafting.
5. It is prohibited to use it in combination with other antipyretic and analgesic drugs.
6. It is contraindicated in patients with active peptic tract ulcers/bleeding, or patients who have had recurrent ulcers/bleeding in the past.
7. It is prohibited for patients with severe heart failure.
8. It is prohibited for patients with liver and kidney failure.
9. It should be taken with or after meals to reduce gastrointestinal discomfort and side effects.
10. Drinking alcohol while taking the medicine can increase gastrointestinal adverse reactions and may cause ulcer.
11. When used together with antihypertensive drugs and hypoglycemic drugs, it may affect the efficacy of the latter.
There are many drugs that have antipyretic, analgesic, and anti-inflammatory effects like ibuprofen and diclofenac sodium, such as aspirin, loxoprofen sodium , nimesulide , naproxen , meloxicam, celecoxib, orecoxib , etc. They are all called non-steroidal anti-inflammatory drugs. The mechanism of action of non-steroidal anti-inflammatory drugs has antipyretic, analgesic and anti-inflammatory effects. Of course, some medicines used to reduce fever are used off-label. It is not recommended to be used as the first choice. It can only be substituted as appropriate if ibuprofen or diclofenac sodium is not available at home.
Pay attention to these symptomatic treatment drugs. If they are used to reduce fever, they should generally be used for no more than 3 days, and if used for analgesia, they should be used for no more than 5 days. Use of drugs beyond the treatment course will increase the risk of gastrointestinal damage and abnormal liver and kidney function.
