{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:21:28Z","timestamp":1787840488524,"version":"build-2784847793"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Pain and fever are common paediatric complaints that demand meticulous symptom alleviation to ensure the child\u2019s holistic well-being. Paracetamol, ibuprofen, and their synergistic coadministration occupy a crucial position, rendering the management of these symptoms efficacious. This study aims to evaluate the safety and adverse effects of paracetamol, ibuprofen, and their combination comprehensively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A prospective observational study was conducted at the Department of Paediatrics, Bombay Hospital Institute of Medical Sciences, Mumbai, India. 108 paediatric patients aged 6 months to 18 years experiencing fever, pain, or both. Patients were assigned to receive one of the three medications and were randomized into one of the three groups: paracetamol, ibuprofen, or a combination. Baseline and 48-hour assessments included vital signs, adverse effects, and biochemical markers including SGOT, SGPT, serum creatinine, platelet count, and occult blood in stool samples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Paracetamol, ibuprofen, and their combination were found to be equally effective in relieving symptoms associated with fever and pain. The most common adverse effect observed was vomiting, with minimal occurrences of rash, cough, and diarrhoea. Biochemical markers, including SGOT, SGPT, serum creatinine, platelet count, and occult blood in stool samples, remained within normal ranges after 48 h of drug administration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study affirms the safety of paracetamol, ibuprofen, and their combination for paediatric pain and fever management. Minimal adverse effects and the absence of significant biochemical derangements support their favourable risk\u2013benefit profiles, emphasizing their importance in paediatric clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jfmpc.jfmpc_348_24","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T07:01:32Z","timestamp":1740034892000},"page":"680-686","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Assessing the safety and adverse effects of paracetamol, ibuprofen, and their combination in paediatric pain and fever management: A prospective observational study"],"prefix":"10.4103","volume":"14","author":[{"given":"Vivek","family":"Charde","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Bombay Hospital Institute of Medical Sciences, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukesh","family":"Sanklecha","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Bombay Hospital Institute of Medical Sciences, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyank","family":"Rajan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Bombay Hospital Institute of Medical Sciences, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babar","family":"Naeem","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Jinnah Hospital, Lahore, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayur","family":"Wanjari","sequence":"additional","affiliation":[{"name":"Department of Research and Development, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav","family":"Mittal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanjmi Djabo Eric","family":"Adrien","sequence":"additional","affiliation":[{"name":"Department of Medicine, Universit\u00e9 Technologique Bel Campus, Kinshasa, Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,2,21]]},"reference":[{"key":"R1-20260109","first-page":"43","article-title":"Understanding pain and pain management","volume":"34","author":"Smith","year":"2019","journal-title":"Nurs Stand"},{"key":"R2-20260109","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1080\/15563650.2021.1989785","article-title":"2011. Annual report of the American Association of Poison Control Centers'National Poison Data System (NPDS):38th annual report","volume":"59","author":"Gummin","year":"2021","journal-title":"Clin Toxicol (Phila)"},{"key":"R3-20260109","first-page":"e00925","article-title":"Nonsteroidal anti-inflammatory drugs in acute viral respiratory tract infections:An updated systematic review","volume":"10","author":"Azh","year":"2022","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"R4-20260109","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1007\/s10787-013-0172-x","article-title":"The modern pharmacology of paracetamol:Therapeutic actions, mechanism of action, metabolism, toxicity and recent pharmacological findings","volume":"21","author":"Graham","year":"2013","journal-title":"Inflammopharmacology"},{"key":"R5-20260109","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1161\/ATVBAHA.110.207449","article-title":"Prostaglandins and inflammation","volume":"31","author":"Ricciotti","year":"2011","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"R6-20260109","first-page":"807","article-title":"Accidental acetaminophen overdose:Reducing the risk","volume":"188","author":"Wong","year":"2016","journal-title":"CMAJ"},{"key":"R7-20260109","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.ihj.2020.05.012","article-title":"The efficacy and safety oforal paracetamol versus oral ibuprofen for patent ductus arteriosusclosure in preterm neonates\u2014A systematic review and meta-analysis","volume":"72","author":"Pranata","year":"2020","journal-title":"Indian Heart J"},{"key":"R8-20260109","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s00784-019-02910-3","article-title":"Efficacy and safety of selective COX-2 inhibitors for pain management after third molar removal:A meta-analysis of randomized clinical trials","volume":"24","author":"Gonz\u00e1lez-Barnadas","year":"2020","journal-title":"Clin Oral Investig"},{"key":"R9-20260109","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/j.jmwh.2004.08.013","article-title":"Primary dysmenorrhea:Assessment and management update","volume":"49","author":"Durain","year":"2004","journal-title":"J Midwifery Womens Health"},{"key":"R10-20260109","first-page":"52","article-title":"Pharmacotherapy for patent ductus arteriosus closure","volume":"14","author":"Ferguson","year":"2019","journal-title":"Congenit Heart Dis"},{"key":"R11-20260109","doi-asserted-by":"crossref","first-page":"415","DOI":"10.3109\/09537104.2011.632032","article-title":"50th anniversary of the discovery of ibuprofen:An interview with Dr Stewart Adams","volume":"23","author":"Halford","year":"2012","journal-title":"Platelets"},{"key":"R12-20260109","doi-asserted-by":"crossref","first-page":"3","DOI":"10.3892\/mco.2014.446","article-title":"Potency of non-steroidal anti-inflammatory drugs in chemotherapy","volume":"3","author":"Hi\u013eovsk\u00e1","year":"2015","journal-title":"Mol Clin Oncol"},{"key":"R13-20260109","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1007\/s13312-016-0924-y","article-title":"Ibuprofen induced DRESS syndrome in a child","volume":"53","author":"Koca","year":"2016","journal-title":"Indian Pediatr"},{"key":"R14-20260109","doi-asserted-by":"crossref","first-page":"395","DOI":"10.2169\/internalmedicine.54.3204","article-title":"Drug-induced liver injury with serious multiform exudative erythema following the use of an over-the-counter medication containing ibuprofen","volume":"54","author":"Watanabe","year":"2015","journal-title":"Intern Med"},{"key":"R15-20260109","first-page":"e46907","article-title":"Comparing the efficacy of paracetamol, ibuprofen, and a combination of the two drugs in relieving pain and fever in the pediatric age group:A prospective observational study","volume":"15","author":"Charde","year":"2023","journal-title":"Cureus"},{"key":"R16-20260109","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1136\/adc.74.2.164","article-title":"Comparing efficacy and tolerability of ibuprofen and paracetamol in fever","volume":"74","author":"McIntyre","year":"1996","journal-title":"Arch Dis Child"},{"key":"R17-20260109","doi-asserted-by":"crossref","first-page":"a1302","DOI":"10.1136\/bmj.a1302","article-title":"Paracetamol plus ibuprofen for the treatment of fever in children (PITCH):Randomised controlled trial","volume":"337","author":"Hay","year":"2008","journal-title":"BMJ"},{"key":"R18-20260109","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1212\/WNL.48.1.103","article-title":"Ibuprofen or acetaminophen for the acute treatment of migraine in children:A double-blind, randomized, placebo-controlled, crossover study","volume":"48","author":"H\u00e4m\u00e4l\u00e4inen","year":"1997","journal-title":"Neurology"},{"key":"R19-20260109","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1016\/S0194-5998(98)70107-X","article-title":"Ibuprofen for tonsillectomy pain in children:Efficacy and complications","volume":"119","author":"Harley","year":"1998","journal-title":"Otolaryngol Head Neck Surg"},{"key":"R20-20260109","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.ajodo.2006.12.009","article-title":"A randomized clinical trial comparing the efficacy of ibuprofen and paracetamol in the control of orthodontic pain","volume":"132","author":"Bradley","year":"2007","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"R21-20260109","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1111\/j.1572-0241.1998.00327.x","article-title":"An endoscopic comparison of gastroduodenal injury with over-the-counter doses of ketoprofen and acetaminophen","volume":"93","author":"Lanza","year":"1998","journal-title":"Am J Gastroenterol"},{"key":"R22-20260109","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/0002-9343(83)90233-4","article-title":"Gastrointestinal effects of antipyretic analgesics","volume":"75","author":"Ivey","year":"1983","journal-title":"Am J Med"},{"key":"R23-20260109","doi-asserted-by":"crossref","first-page":"2831","DOI":"10.1002\/art.10609","article-title":"Et tu, acetaminophen?","volume":"46","author":"Abramson","year":"2002","journal-title":"Arthritis Rheum"},{"key":"R24-20260109","doi-asserted-by":"crossref","first-page":"10","DOI":"10.3390\/ph3010010","article-title":"Hypersensitivity reactions to nonsteroidal anti-inflammatory drugs:An update","volume":"3","author":"Sanchez-Borges","year":"2010","journal-title":"Pharmaceuticals"},{"key":"R25-20260109","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s40413-015-0080-1","article-title":"2015 update of the evidence base:World Allergy Organization anaphylaxis guidelines","volume":"8","author":"Simons","year":"2015","journal-title":"World Allergy Organ J"},{"key":"R27-20260109","doi-asserted-by":"crossref","first-page":"56","DOI":"10.3109\/00365528909091176","article-title":"The changing gastrointestinal side effect profile of non-steroidal anti-inflammatory drugs","volume":"24","author":"Bjarnason","year":"1989","journal-title":"Scand J Gastroenterol"},{"key":"R28-20260109","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1007\/BF02049158","article-title":"Toxicity of nonsteroidal anti-inflammatory drugs in the large intestine","volume":"38","author":"Davies","year":"1995","journal-title":"Dis Colon Rectum"},{"key":"R29-20260109","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/0002-9343(93)90392-3","article-title":"Efficacy and safety of nabumetone versus diclofenac, naproxen, ibuprofen, and piroxicam in the elderly","volume":"95","author":"Morgan","year":"1993","journal-title":"Am J Med"},{"key":"R30-20260109","doi-asserted-by":"crossref","first-page":"109","DOI":"10.3109\/15360288.2014.908993","article-title":"Patient perception and knowledge of acetaminophen in a large family medicine service","volume":"28","author":"Herndon","year":"2014","journal-title":"J Pain Palliat Care Pharmacother"},{"key":"R31-20260109","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.cld.2013.07.005","article-title":"Acetaminophen-related hepatotoxicity","volume":"17","author":"Bunchorntavakul","year":"2013","journal-title":"Clin Liver Dis"}],"container-title":["Journal of Family Medicine and Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_348_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:23:50Z","timestamp":1787837030000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_348_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":30,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jfmpc.jfmpc_348_24","relation":{},"ISSN":["2249-4863","2278-7135"],"issn-type":[{"value":"2249-4863","type":"print"},{"value":"2278-7135","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2]]},"assertion":[{"value":"2024-03-03","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-09","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}