The list of medications with antipyretic effects includes many common drugs that also have analgesic and anti-inflammatory activity, several of which are commonly sold
over-the-counter (OTC). •
NSAIDs (non-steroidal anti-inflammatory drugs), a broad class of medications that in addition to their defining effect of reducing inflammation, also tend to be potent analgesics and antipyretics. The majority work by inhibiting the activity of the
cyclooxygenase (COX) family of enzymes in the body. • Nonselective COX enzyme inhibitors like
ibuprofen and
naproxen. •
Salicylates, including
aspirin (acetylsalicylic acid),
magnesium salicylate, and
sodium salicylate. These are also primarily nonselective COX inhibitors, but also work through other mechanisms including activating
AMP-activated protein kinase. • COX inhibitors that are relatively selective for the
COX-1 enzyme, such as
ketoprofen and
flurbiprofen. as well as slight evidence from one human trial, that
α2-adrenergic agonists, and particularly
clonidine (a common drug used to treat
high blood pressure,
ADHD,
spasticity and several other conditions), may have antipyretic effects, which if verified could potentially be useful in patients with
septic shock or
acute respiratory distress syndrome.
Use in children The U.S.
Food and Drug Administration (FDA) notes that improper dosing is one of the biggest problems in giving
acetaminophen (paracetamol) to children. The effectiveness of acetaminophen alone as an antipyretic in children is uncertain, with some evidence showing it is no better than physical methods. Therapies involving alternating doses of acetaminophen and
ibuprofen have shown greater antipyretic effect than either drug alone. One meta-analysis indicated that ibuprofen is more effective than acetaminophen in children at similar doses when both are given alone. Due to concerns about
Reye syndrome, it is recommended that aspirin and
combination products that contain aspirin not be given to children or teenagers during episodes of fever-causing illnesses. ==Traditional medicine==