Issue 504 – Understanding Antipyretics: Learn the Best Time to Use Fever-Reducing Medications

Most people have experience taking antipyretics (fever-reducing medications), but do you know what ingredients they contain and what side effects they might cause? Dr. Wen-Hui Fang from the Taiwan Academy of Family Medicine explains the three most common types of fever-reducing medications used in Taiwan:

1. Acetaminophen (also known as Paracetamol)

This is the active ingredient in the widely used brand Panadol. Acetaminophen is free from aspirin, does not irritate the stomach, and does not affect kidney function. It usually lowers a fever within an hour after administration.

⚠️ However, excessive use of acetaminophen or taking it when liver function is impaired can lead to liver damage. This is because the liver cannot properly metabolize the drug, and its metabolites become toxic. Therefore, it is important to follow dosage instructions provided by a physician or pharmacist.

2. NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)

NSAIDs are widely used for fever relief and are effective, but they come in various forms and can have different side effects. They are mainly divided into two types:

• Cox-1 Inhibitors: These can cause gastrointestinal discomfort and are not recommended for people with impaired kidney function. Consult a doctor or pharmacist before use.
• Rectal suppositories for children fall into this category. Since they are not taken orally, they do not cause GI symptoms.
• Cox-2 Inhibitors only: These are less likely to irritate the stomach, but long-term use may affect kidney function.

3. Corticosteroids

Steroids are generally not first-line treatments for fever and are mainly prescribed for patients with autoimmune diseases who experience fever as a symptom of their underlying condition.

Don’t Take Fever-Reducing Medications Without Knowing the Cause

Dr. Fang emphasizes that mild to moderate fever can help enhance the immune system, so don’t rush to reduce a fever without first identifying the underlying cause.

• If a physician diagnoses a bacterial infection, antibiotics may be used.
• For viral infections, antiviral medications are only effective against specific viruses (e.g., oseltamivir for influenza).
• In most cases, supportive care is recommended, including antipyretics to reduce discomfort, along with adequate fluid and electrolyte intake.

⚠️ Avoid excessive or unnecessary use of antipyretics simply to normalize body temperature.

TFDA Reminder: Check for Potential Drug Interactions

The Taiwan Food and Drug Administration (TFDA) reminds the public:

• People taking antiplatelet drugs, anticoagulants, hypertension medications, or corticosteroids (especially for autoimmune diseases) should consult a physician or pharmacist before using antipyretics.
• This is to prevent harmful drug interactions that could endanger your health.