Fever Medications: Voren vs. Paracetamol for Children

Q: Fever Medications: Voren vs. Paracetamol for Children

Hello, Miss Chih-Hsuan：<br>1. <br>The active ingredient in VOREN 12.5 mg suppositories is Diclofenac, which inhibits the production of prostaglandins. <br>Prostaglandins are major factors that cause inflammation, pain, and fever. <br>In addition to daytime treatment with tablets,

Fever medication issues?

Dear Dr.
Hou,
My daughter, who is in the 5th grade, caught a cold and had a fever, so I took her to the clinic where the doctor prescribed a three-day supply of cold medicine and one Voren suppository (12.5 mg).
In the afternoon, her fever spiked to 39.5 degrees Celsius, so I administered the suppository to reduce her fever.
After two hours, her fever subsided, but I was concerned she might have another high fever at night, so I asked a family member to buy additional fever-reducing suppositories at the pharmacy.

I noticed that the suppositories purchased at the pharmacy were paracetamol suppositories (125 mg), which are different from what the clinic prescribed.
The instructions indicate that it is only suitable for children up to 6 years old.
If my daughter has a fever again, can I safely administer a paracetamol suppository (125 mg) for its antipyretic effect? What are the differences between Voren suppository (12.5 mg) and paracetamol suppository (125 mg)?
Thank you for your assistance, and I apologize for the disturbance.

Zhixuan, 40~49 year old female. Ask Date: 2023/03/27

Dr. Hou Fangmin reply Pharmacology

Hello, Miss Chih-Hsuan:
1.
The active ingredient in VOREN 12.5 mg suppositories is Diclofenac, which inhibits the production of prostaglandins.
Prostaglandins are major factors that cause inflammation, pain, and fever.
In addition to daytime treatment with tablets, you may supplement with one suppository before bedtime.
2.
The active ingredient in Paracetamol suppositories (125 mg) is Acetaminophen, commonly known as Tylenol.
It works by raising the pain threshold to provide analgesic effects and acts on the hypothalamic temperature regulation center to produce antipyretic effects.
Do not repeatedly administer it to children for fever reduction; remember that the "total dosage" includes all forms (tablets, liquid, and suppositories).
Using lukewarm water to sponge the limbs can also help dissipate heat.
For children aged 6 to under 12 years, the appropriate dosage is half of the adult dose.
Taking more than 4,000 mg of Acetaminophen per day can lead to liver damage.
3.
Voren is a non-steroidal anti-inflammatory drug (NSAID), while Paracetamol is simply Acetaminophen.
Since you also have oral medications, I am unsure which type of analgesic and anti-inflammatory medication you are using.
Generally, if you are taking oral medications and experience a fever in between doses, you may use a suppository.
Ensure that oral medications are spaced at least four hours apart.
Additionally, using lukewarm water to sponge the body and limbs is recommended.
Try to avoid combining different anti-inflammatory and analgesic medications (as they have different mechanisms of action).
You can use the originally prescribed Voren suppositories (12.5 mg) for fever reduction when using oral medications.
Is this explanation clear to you? Wishing you and the hardworking mothers good health and safety.

Reply Date: 2023/03/27

More Info

When it comes to managing fever in children, particularly with the medications Voren (Diclofenac) and Paracetamol (Acetaminophen), it's essential to understand their differences, indications, and safety profiles.
Voren suppositories contain Diclofenac, a non-steroidal anti-inflammatory drug (NSAID) that works by inhibiting the production of prostaglandins, which are compounds in the body that promote inflammation, pain, and fever. This makes Voren effective for reducing fever and alleviating pain. It is often used in cases where oral administration is not feasible, such as in children who may be vomiting or unable to take oral medications. The typical dosage for children is based on their weight and age, and it is crucial to follow the healthcare provider's instructions regarding the frequency and amount.

On the other hand, Paracetamol (known as Acetaminophen in the U.S.) is a widely used antipyretic (fever reducer) and analgesic (pain reliever). It works primarily in the brain to raise the pain threshold and lower body temperature. Paracetamol is generally considered safe for children, but it is essential to adhere to the recommended dosages to avoid potential liver damage, especially if the total daily intake exceeds 4,000 mg. The suppository form of Paracetamol is often used when oral administration is not possible.

In your case, your daughter has been prescribed Voren for her fever, and you have also obtained Paracetamol suppositories from the pharmacy. The concern arises from the fact that the Paracetamol suppository is labeled for children over six years old. While it is generally safe to use Paracetamol in children, you should be cautious about the dosage, especially since your daughter is in the fifth grade and may weigh less than the average child of that age.
If your daughter is experiencing a high fever (39.5°C or 103.1°F), using the Voren suppository first is appropriate, as it has already been prescribed by her doctor. If her fever returns and you consider using the Paracetamol suppository, ensure that you do not exceed the total daily dosage of Paracetamol when combining it with any other forms (like oral or liquid).
It is also important to note that while both medications can be used to manage fever, they should not be used simultaneously without medical advice. If you choose to administer the Paracetamol suppository after Voren, ensure that there is a sufficient time gap between the two doses, typically at least four hours, to avoid any potential overdose.

In conclusion, both Voren and Paracetamol can be effective in managing fever in children, but they work through different mechanisms and have different safety profiles. Always consult with a healthcare provider before administering any medication, especially in children, to ensure that it is safe and appropriate for their specific situation. If your daughter continues to have high fevers or shows any concerning symptoms, it is crucial to seek medical attention promptly.

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