BNF for Children 2011-2012

BNFC 2011–2012 10.1.1 Non-steroidal anti-inflammatory drugs 503Renal impairment avoid if estimated glomerular filtrationrate less than 30 mL/minute/1.73 m 2 ; see alsonotes abovePregnancy manufacturer advises avoid (teratogenic inanimal studies); see also notes aboveBreast-feeding manufacturer advises avoid—presentin milk in animal studies; see also notes aboveSide-effects see notes above; also palpitation, fatigue,influenza-like symptoms, ecchymosis; less commonlydry mouth, taste disturbance, mouth ulcer, appetiteand weight change, atrial fibrillation, transientischaemic attack, chest pain, flushing, cough, dyspnoea,epistaxis, anxiety, mental acuity impaired,paraesthesia, electrolyte disturbance, myalgia andarthralgia; very rarely confusion and hallucinationsIndication and doseOsteoarthritis. By mouthChild 16–18 years 30 mg once daily, increased ifnecessary to 60 mg once dailyRheumatoid arthritis and ankylosing spondylitis. By mouthChild 16–18 years 90 mg once dailyAcute gout. By mouthChild 16–18 years 120 mg once daily for max. 8daysArcoxia c (MSD) TATablets, f/c, etoricoxib 30 mg (blue-green), net price28-tab pack = £13.99; 60 mg (dark green), 28-tab pack= £20.11; 90 mg (white), 28-tab pack = £22.96; 120 mg(pale green), 7-tab pack = £6.03, 28-tab pack = £24.11IBUPROFENCautions see notes aboveContra-indications see notes aboveHepatic impairment see notes aboveRenal impairment avoid in severe impairment; seealso notes abovePregnancy see notes aboveBreast-feeding amount too small to be harmful, butsome manufacturers advise avoid; see also notesaboveSide-effects see notes aboveLicensed use not licensed for use in children under 3months or body-weight under 5 kgIndication and doseMild to moderate pain, pain and inflammationof soft-tissue injuries, pyrexia with discomfort. By mouthChild 1–3 months 5 mg/kg 3–4 times dailyChild 3–6 months 50 mg 3 times daily; max.30 mg/kg daily in 3–4 divided dosesChild 6 months–1 year 50 mg 3–4 times daily;max. 30 mg/kg daily in 3–4 divided dosesChild 1–4 years 100 mg 3 times daily; max.30 mg/kg daily in 3–4 divided dosesChild 4–7 years 150 mg 3 times daily; max.30 mg/kg daily in 3–4 divided dosesChild 7–10 years 200 mg 3 times daily; max.30 mg/kg (max. 2.4 g) daily in 3–4 divided dosesChild 10–12 years 300 mg 3 times daily; max.30 mg/kg (max. 2.4 g) daily in 3–4 divided dosesChild 12–18 years initially 300–400 mg 3–4 timesdaily; increased if necessary to max. 600 mg 4times daily; maintenance dose of 200–400 mg 3times daily may be adequatePain and inflammation in rheumatic diseaseincluding juvenile idiopathic arthritis. By mouthChild 3 months–18 years 30–40 mg/kg (max.2.4 g) daily in 3–4 divided doses; in systemicjuvenile idiopathic arthritis up to 60 mg/kg (max.2.4 g) daily [unlicensed] in 4–6 divided dosesPost-immunisation pyrexia in infants (see alsop. 600). By mouthChild 2–3 months 50 mg as a single doserepeated once after 6 hours if necessaryClosure of patent ductus arteriosus in neonatessee section 2.141Ibuprofen (Non-proprietary) ATablets, coated, ibuprofen 200 mg, net price 84-tabpack = £1.62; 400 mg, 84-tab pack = £1.72; 600 mg,84-tab pack = £4.06. Label: 21Brands include Arthrofen c , Ebufac c , Rimafen cDental prescribing on NHS Ibuprofen Tablets may be prescribedOral suspension, ibuprofen 100 mg/5 mL, net price100 mL = £1.48, 150 mL = £2.71, 500 mL = £8.88.Label: 21Note Sugar-free versions are available and can be ordered byspecifying ‘sugar-free’ on the prescriptionBrands include Calprofen c , Feverfen c , Nurofen c for Children,Orbifen c for ChildrenDental prescribing on NHS Ibuprofen Oral SuspensionSugar-free may be prescribed1. Can be sold to the public under certain circumstances; forexemptions see Medicines, Ethics and Practice, London,Pharmaceutical Press (always consult latest edition)Brufen c (Abbott) ATablets, f/c, ibuprofen 200 mg, net price 100-tab pack= £3.92; 400 mg, 100-tab pack = £8.16; 600 mg, 100-tab pack = £12.24. Label: 21Syrup, orange, ibuprofen 100 mg/5 mL, net price500 mL (orange-flavoured) = £8.88. Label: 21Granules, effervescent, ibuprofen 600 mg/sachet, netprice 20–sachet pack = £6.53. Label: 13, 21Contains sodium approx. 9 mmol/sachetModified releaseBrufen Retard c (Abbott) ATablets, m/r, ibuprofen 800 mg, net price 56-tab pack= £6.48. Label: 25, 27DosePain and inflammation. By mouthChild 12–18 years 2 tablets daily as a single dose,preferably in the early evening, increased in severe casesto 3 tablets daily in 2 divided doses10 Musculoskeletal and joint diseases