Fever/Headache Meds

APAP: OTC tab/caps

Reg. strength= 325mg

Extra strength= 500mg

ER= 650mg

APAP: OTC Chewable/Powder

160mg

APAP: OTC Liquid

160mg/5mL, 500mg/15mL, 960mg/30mL

APAP Dose: Ages 12+ and adults

325-1000mg every 4-6 hours

650-1300mg ER every 8 hours

APAP Max Dose Adults

4000mg/day

APAP Dose: Children newborn-11 y.o.

10-15mg/kg every 4-6 hours

APAP Max Dose 11mths-11y.o.

5 doses/day

Drug Class and MOA for APAP

Antipyretic: central inhibition of prostaglandin synthesis (PGE2 for fever)

Analgesic: unclear MOA for pain

Symptoms Treated with APAP

Fever discomfort (1st line therapy), onset 30min-1hr w/ reductions in fever by 1-2 degrees, Max temp. reduction in at 2hr, mild to mod. headache, onset 30 min.

Side effects of APAP

None

Pros for APAP

Safe for most people, safe for pregnancy and breastfeeding, well-tolerated, can be used with blood thinners, can be used in children

Cons for APAP

overdose can lead to liver failure, rare skin rxns, only treats pain and fever

ibuprofen OTC Tab/caps

200mg

ibuprofen OTC Chewables

100mg tablets

ibuprofen OTC liquid

50mg/1.25mL (child), 100mg/5mL (adult)

ibuprofen Rx Tabs

400, 600, 800mg

ibuprofen Max dosing for adults (non-Rx)

200-400mg every 4-6hr, Max: 1200mg/day

ibuprofen dosing and max for Children

5-10mg/kg every 6-8hrs, Max: 4 doses per day

Ibuprofen Rx tab dosage and Max

400, 600, 800mg. Max: 3200mg/day

targets for low/high dosages of ibuprofen

low: reduces pain/fever, high: reduces inflammation, high fever

Drug class and MOA for ibuprofen

NSAID, analgesic, antipyretic, and anti-inflammatory activity: inhibits COX-1 and COX-2 centrally and peripherally to reduce prostaglandin synthesis (PGE2 for fever)

Symptoms treated with ibuprofen

Mild to Mod. headache pain, Fever discomfort (1st line therapy, maybe more effective than APAP) onset 30min-1hr w/ reductions in fever by 1-2 degrees. max temp reduction at 2 hr. Longer duration of fever reduction than APAP

Side effects of ibuprofen (7)

NSAID side effects: stomach upset/heartburn, Stomach/ulcer bleeding, Bleeding, decreased kidney function, increased BP, Worsening of heart failure, increased risk of MI and stroke

Pros of ibuprofen

treats inflammation, pain, and fever

compatible with breastfeeding, not preferred though

avoid in pregnancy weeks 20+, careful use in weeks before

Cons of ibuprofen

Contraindicated in infants less than 6mths (GI/kidney issues)

Contraindicated in patients with an ASA allergy

increased risk of all side effects in older adults

side effects > APAP but < ASA

risk may increase with duration of use

drug interactions

Boxed warning for Rx ibuprofen

Cardiovascular events, GI toxicity, use around time of CABG surgery

Metabolized through liver and highly renally eliminated, avoid in pateints with CrCl greater than or equal to 30mL/min

Naproxen OTC tab/cap and dosing

220mg, initial 220-440mg followed by 220mg every 8-12hr. Max= 660mg/day

Rx availability for Naproxen

Oral tab= 250, 275, 375, 500, 750mg;

Oral tab, DR-24hr= 375, 500, 750mg;

Oral tab, ER-24hr= 375, 500, 750mg;

Oral cap.= 220mg;

Oral sus.= 125mg/5mL

Naproxen drug class and MOA

NSAID, analgesic, antipyretic, and anti-inflammatory activity: inhibits COX-1 and COX-2 centrally and peripherally to reduce prostaglandin synthesis (PGE2 for fever)

Symptoms relieved by Naproxen

Fever discomfort (best if person is needing relief for 8-12 hours), mild to mod. headache pain

Side effects for Naproxen

NSAID side effects: stomach upset/heartburn, stomach ulcer/bleeding, bleeding, decreased kidney function, increased BP, worsening heart failure, increased risk of MI and stroke

Pros for Naproxen

same pros as ibuprofen, but: potentially decreased risk for CV than ibuprofen, and OTC is only labeled for age 12+

Cons for Naproxen

Not for breastfeeding, limited data maybe compatible

Exedrine Migraine ingredients

ASA + APAP + caffeine

Exedrine Migraine MOA

APAP MOA, ASA MOA, NSAID MOA, caffeine= vasoconstriction

APAP w/ Naproxen dose

APAP 325mg/naproxen 110mg per tab, two tabs every 12 hours, Max= 4 tabs/day

Advil Dual Action ingredients

ibuprofen, APAP

Advil Dual Action doses

APAP 250mg/ibuprofen 125mg per tab, 2 tabs every 8 hours, Max: 6 tabs

NSAID or APAP + decongestant (Advil cold and sinus) treats

Mild to mod. headache pain, sinus headache