BNF for Children 2011-2012

504 10.1.1 Non-steroidal anti-inflammatory drugs BNFC 2011–201210 Musculoskeletal and joint diseasesFenbid c (Goldshield) ASpansule c (= capsule m/r), maroon/pink, enclosingoff-white pellets, ibuprofen 300 mg, net price 120-cappack = £9.64. Label: 25DosePain and inflammation. By mouthChild 12–18 years initially 2 capsules twice daily,increased in severe cases to 3 capsules twice daily; then1–2 capsules twice dailyINDOMETACIN(Indomethacin)Cautions see notes above; also epilepsy, psychiatricdisturbances; during prolonged therapy ophthalmicand blood examinations particularly advisable; avoidrectal administration in proctitis and haemorrhoidsSkilled tasks Dizziness may affect performance of skilledtasks (e.g. driving)Contra-indications see notes aboveHepatic impairment see notes aboveRenal impairment avoid in severe impairment; seealso notes abovePregnancy see notes aboveBreast-feeding amount probably too small to beharmful—manufacturer advises avoid; see also notesaboveSide-effects see notes above; rarely confusion, convulsions,psychiatric disturbances, syncope, blooddisorders (particularly thrombocytopenia), hyperglycaemia,peripheral neuropathy, and intestinalstrictures; suppositories may cause rectal irritationand occasional bleedingLicensed use not licensed for use in childrenIndication and doseRelief of pain and inflammation in rheumaticdiseases including juvenile idiopathic arthritis(but see p. 500). By mouthChild 1 month–18 years 0.5–1 mg/kg twicedaily; higher doses may be used under specialistsupervisionClosure of patent ductus arteriosus in prematurebabies section 2.14Indometacin (Non-proprietary) ACapsules, indometacin 25 mg, net price 28-cap pack= £2.33; 50 mg, 28-cap pack = £2.29. Label: 21,counselling, driving, see aboveBrands include Rimacid cSuppositories, indometacin 100 mg, net price 10 =£20.07. Counselling, driving, see aboveSuspension, indometacin 5 mg/mLAvailable from ‘special-order’ manufacturers or specialistimporting companies, see p. 809Modified releaseIndometacin m/r preparations ACapsules, m/r, indometacin 75 mg. Label: 21, 25,counselling, driving, see aboveBrands include Indolar SR c , Pardelprin cMEFENAMIC ACIDCautions see notes above; epilepsy; acute porphyria(section 9.8.2)Contra-indications see notes above; inflammatorybowel diseaseHepatic impairment see notes aboveRenal impairment avoid in severe impairment; seealso notes abovePregnancy see notes aboveBreast-feeding amount too small to be harmful butmanufacturer advises avoid; see also notes aboveSide-effects see notes above; also diarrhoea or rashes(withdraw treatment), stomatitis; less commonlyparaesthesia and fatigue; rarely hypotension, palpitation,glucose intolerance, thrombocytopenia, haemolyticanaemia (positive Coombs’ test), and aplasticanaemiaIndication and doseAcute pain including dysmenorrhoea, menorrhagia. By mouthChild 12–18 years 500 mg 3 times dailyMefenamic Acid (Non-proprietary) ACapsules, mefenamic acid 250 mg, net price 100 =£2.83. Label: 21Tablets, mefenamic acid 500 mg, net price 28-tabpack = £2.20. Label: 21Suspension, mefenamic acid 50 mg/5 mL, net price125 mL = £79.98. Label: 21Excipients include ethanolPonstan c (Chemidex) ACapsules, blue/ivory, mefenamic acid 250 mg, netprice 100-cap pack = £8.17. Label: 21Forte tablets, yellow, mefenamic acid 500 mg, netprice 100-tab pack = £15.72. Label: 21MELOXICAMCautions see notes aboveContra-indications see notes aboveHepatic impairment see notes aboveRenal impairment avoid if estimated glomerular filtrationrate less than 25 mL/minute/1.73 m 2 ; see alsonotes abovePregnancy see notes aboveBreast-feeding present in milk in animal studies—manufacturer advises avoid; see also notes aboveSide-effects see notes aboveLicensed use not licensed for use in children under16 yearsIndication and doseRelief of pain and inflammation in juvenileidiopathic arthritis and other musculoskeletaldisorders in children intolerant to other NSAIDs. By mouthChild 12–18 years and body-weight under50 kg 7.5 mg once dailyChild 12–18 years and body-weight over 50 kg15 mg once dailyAdministration Mobic c tablets may be dispersed inwater