Antipyretics are medications that are prescribed to treat fever, which can be caused by various infections and illnesses. 

  1. Treat a high temperature.
  2. Some are available to buy over the counter.
  3. Stronger medications will require a prescription.

If you are concerned about a fever, you can speak to one of our registered clinicians via our online video consultation service. You can book an appointment with them between 9.30am-4.30pm, Monday to Friday.

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What are antipyretics?

Antipyretics are medications that can bring down a high temperature when you are infected by a virus or bacteria, or when you have heat exhaustion or certain inflammatory conditions, such as rheumatoid arthritis. COVID 19 is a type of coronavirus which can cause a fever. Further examples of coronaviruses include the common cold and flu. Common bacterial infections include those of the ear and food poisoning. The body’s temperature rises as a reaction to these infections.

What is the flu?

The flu is short for influenza and is a viral infection that can range from mild to severe. As the infection is caused by a virus, antibiotics have no effect on it. Symptoms of influenza include a temperature of above 38°C (which comes on suddenly, unlike the common cold), aches and pains, headaches, a sore throat, a dry cough, loss of appetite, stomach upsets, nausea, vomiting, insomnia and fatigue. In children, an earache may also be present.

How is the flu treated?

In most cases, the flu can be treated at home with rest and over the counter medications. You should aim to stay warm, get plenty of sleep and not exert yourself physically during recovery. Drinking plenty of water is also essential as becoming dehydrated significantly reduces your body’s ability to fight the infection. Over the counter medications can treat many of the symptoms of flu, and these include antipyretics, such as paracetamol. Ibuprofen can also be highly effective at reducing aches and pains.

In the rare event that flu causes more serious symptoms, you may require hospital treatment. You should call 999 if you experience difficulty breathing, have sudden chest pain or are coughing up blood, which can be a sign of pneumonia (an infection of the lungs). Because the flu is highly infectious, you should wash your hands regularly with soap and water if you have it or are around someone who does. Using a tissue to catch any germs that may be spread through coughing or sneezing is also key. 

You are at your most infectious during the first five days of an infection. The length of time it takes for you to recover depends on the severity of the infection, but you should start to see an improvement in symptoms after about a week.

What is rheumatoid arthritis? 

Rheumatoid arthritis is a painful condition for which there is no cure. It causes inflammation in the joints of the body, typically the hands, wrists and feet, although it may not always be confined to the joints. The pain is often described as a throb or ache and is often accompanied by stiffness. You may also notice it is worse after periods of inactivity, such as when you wake in the mornings. The affected areas will often feel hot to the touch and appear swollen, with nodules appearing under the skin in a small number of cases. Other symptoms associated with the condition include a fever, fatigue, sweating and a loss of appetite.

What causes rheumatoid arthritis?

Rheumatoid arthritis is caused by an immune response; the immune system attacks healthy cells in the body, but it isn’t clear what triggers this. In particular, the immune system targets the lining of the joints, as if it were an invading substance. The resulting chemical response leads to damage to the bones, cartilage, tendons and ligaments. Left untreated, this can lead to the destruction of the joints. 

While what causes the immune system to react in this way remains uncertain, there are some risk factors that are understood. These include genetics (you are more likely to suffer from the condition if a family member has it), hormones (women are more prone to the condition than men, which is thought to be related to oestrogen levels) and smoking (although the link has yet to be firmly established).

How is rheumatoid arthritis treated?

There are many effective treatments available for rheumatoid arthritis, but none can be considered a cure. Disease modifying anti-rheumatic drugs (DMARDs) are usually offered in combination at the start of treatment. They slow down the progression of the condition and treat symptoms, such as pain and stiffness. DMARDs work by blocking the chemicals that cause the inflammation, and so protect the joints from damage. A newer group of medications are biological treatments. These are usually taken in combination with at least one DMARD or when the latter has been proven to be ineffective. They are given via an injection and work in much the same way as DMARDs. JAK inhibitors have recently become available on the NHS and are provided when the other medications have proven ineffective or are causing issues with side effects. They may also be taken alongside DMARDs.

Other treatments can be bought over the counter, such as antipyretics. They include paracetamol or, when the pain and fever symptoms are particularly severe, codeine (although higher doses of codeine are available on prescription only). Non-steroidal anti-inflammatory drugs (NSAIDs) are also available to buy over the counter, although stronger versions, such as celecoxib, require a prescription too. 

Ibuprofen is the most commonly used NSAID, and can reduce inflammation and pain, as well as fever. Steroids may also be prescribed in some circumstances, but can only be taken for a short time due to the likelihood of serious side effects. These treatments are used alongside physiotherapy, which helps improve fitness and to keep your body flexible.

What is food poisoning?

Food poisoning is relatively common in the UK and is rarely serious, but in some cases, it can be severe enough to warrant hospital treatment. It occurs when food is contaminated with bacteria, such as E-coli or salmonella, which can thrive on certain foods in some circumstances. This includes food that has not been properly stored or that has been left out, is undercooked or inadequately reheated, has come into contact with someone who hasn’t washed their hands or has been consumed after the use by date (which should not be confused with the best before or sell by date).

What symptoms does food poisoning cause?

Symptoms of food poisoning include nausea, vomiting, diarrhoea, aches and pains, fever, chills, fatigue and stomach cramps. Typically, they begin to present a day or two after you have consumed contaminated food, but they can appear anywhere between a few hours or a few weeks later.

How is food poisoning treated? 

Treatment generally consists of rest until the symptoms have passed. It’s important that you drink plenty of water at this time, particularly if you have diarrhoea or are vomiting. If you feel sick, it may help to take small and regular sips, rather than swallowing large quantities at a time. 

Over the counter treatments such as paracetamol can manage many of the symptoms of food poisoning, including a fever or diarrhoea. They should not however be given to people under the age of 12. Food poisoning should begin to clear up after a week. 

If you would like to speak to a doctor about antipyretics or any related conditions, you can make an appointment with one of our GMC-registered clinicians via our online video consultation service. They are available from 9.30am-4.30pm, five days a week, and can also provide referral to specialists for treatment and fit notes, where appropriate. 

Page last reviewed:  30/06/2020
Side effects and warnings

What side effects can antipyretics cause? 

As is the case with any medication, there are some risks of side effects when taking antipyretics. While these are often mild or rare, depending on the medication itself, it’s important to be aware of them before starting treatment. You can discuss any potential side effects with your prescribing clinician, and read the patient information leaflet that comes with your medication prior to use.  

As there are many types of antipyretics, the information below may not apply to your specific treatment; it relates to the over the counter treatment, paracetamol. 

You should stop taking paracetamol and seek immediate medical assistance if you experience any of the following: swelling of the hands, feet, ankles, face, lips or throat, difficulty swallowing or breathing, itchy or lumpy rash or nettle rash. 

If an infection persists for more than a few days or if bruising becomes severe, you should inform your clinician as soon as possible. While these side effects have been reported, they are extremely rare. 

Is it safe to use antipyretics alongside other treatments?

All medications carry risks when taken alongside other treatments, so it’s important to tell your doctor about any treatments you are currently taking or have recently taken. This includes over the counter medications, herbal supplements and prescription medications. 

In the case of paracetamol, you should not take any other medication that contains paracetamol, such as some cough syrups and cold remedies. 

Your doctor or pharmacist may consider paracetamol unsuitable if you are taking any of the following: blood thinners (such as warfarin), metoclopramide or domperidone and cholestyramine.

Warnings and precautions when using antipyretics 

You should inform your clinician of any conditions you have or are prone to before starting treatment with antipyretics.  

Paracetamol may not be suitable for you if you have drug or alcohol issues, serious kidney problems or a severe liver disorder. 

Is it safe to use antipyretics during pregnancy?

It depends on the treatment. For example, paracetamol can be used whilst you are pregnant, but dosages should be kept to a minimum where possible. Ibuprofen should not be used beyond week 30 of your pregnancy in any circumstances, and it’s best practice to avoid it altogether prior to this. It’s generally recommended that you avoid use of any medication in the first three months of pregnancy if possible. 

In terms of prescription antipyretics, these are generally not recommended for use whilst you are pregnant.  You should also discuss antipyretics with your clinician before starting to breastfeed your baby.

If you have any concerns about antipyretics and pregnancy, you should discuss these with your doctor before starting a course of treatment. 

What types of antipyretics are available? 

The most commonly used antipyretics are paracetamol and ibuprofen, which are available to purchase over the counter. They are usually available in tablets and capsule form. Certain NSAIDs can also be purchased over the counter, although they are in most cases prescription only treatments, such as diclofenac. Aspirin belongs to a group of medications known as salicylates, and have an antipyretic effect.

Page last reviewed:  30/06/2020
Questions and Answers

Can I take antipyretics with alcohol? 

It depends on the treatment, and the amount of alcohol that’s consumed. In most cases, it’s not recommended that you consume alcohol with any of these treatments. If you have any concerns about alcohol and its interaction with antipyretics, you should speak to your clinician. 

Can antipyretics affect my ability to drive?

Most antipyretics shouldn’t cause any issues with driving, although some treatments can lead to dizziness and blurred vision. You should discuss this with your doctor before starting treatment, who may advise you to see how the medication affects you first before operating any heavy machinery.

Can I buy antipyretics over the counter?

Some antipyretics are available to buy over the counter, such as paracetamol, aspirin and ibuprofen. You will however require a prescription for stronger treatments. 

How can I buy antipyretics online?

Our GPhC-registered clinicians can discuss antipyretics and any related conditions with you via our online video consultation service. They are available for appointments between 9.30am-4.30pm, Monday to Friday. Our clinicians can also issue fit notes and referral to specialists for treatment, where suitable.   

Page last reviewed:  30/06/2020

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