Comparing Fever Suppositories: Voren vs. Paracetamol for Kids

Medication Consultation

Hello Dr.
Yeh,
I have two questions.
First, which of the two antipyretic suppositories is more harmful to the body: Voren non-inflammatory suppository 12.5mg or Paracetamol suppository 125mg? I understand that Western medication suppositories can be more harmful to children.
However, if the fever does not subside after taking oral medication for two hours or if the child vomits after taking fever-reducing medication, we cannot avoid using suppositories.
I hope to reduce the burden on my child's body!
The second question is regarding the dosage of fever-reducing suppositories at the pharmacy.
They always ask for the child's age and weight.
For example, my child is 10 years old and weighs 35 kg.
One pharmacy recommended using one Voren 12.5mg suppository, while another pharmacy insisted that 12.5mg is not enough and suggested using two suppositories at once.
I am confused by this.
I worry that one suppository may not be sufficient, but using two may exceed the recommended dosage.

Thank you for your assistance with these two questions, Dr.
Yeh.

Jia Ying, 30~39 year old female. Ask Date: 2023/12/16

Dr. Ye Qianyu reply Family Medicine

Hello! Suppositories are absorbed through the rectal mucosa after melting, which is faster than oral absorption.
Once the medication enters the body, it must undergo hepatic and renal metabolism.
As long as the composition of the medication is the same and the mechanism of action is identical, the only difference is the route of administration, which affects the onset time.
The term "harmful" is relative, so it is best to use medications under the guidance of a physician to ensure the correct items and dosages are used to avoid harm.
Fever is a protective mechanism of the body, and it should be managed appropriately.
Non-inflammatory suppositories can be administered at a dose of 0.5-1 mg/kg, so for children aged 9-11 years, 1-2 suppositories can be given.
Both physicians and pharmacists are correct; physicians typically adjust the appropriate medication dosage based on the patient's condition.
It is recommended to monitor the temperature regularly and administer medication according to medical advice.

Reply Date: 2023/12/16

More Info

When comparing fever suppositories for children, specifically Voren (Diclofenac) and Paracetamol (Acetaminophen), it's essential to understand their mechanisms, indications, and potential side effects.
1. Differences Between Voren and Paracetamol:
Voren suppositories contain Diclofenac, a non-steroidal anti-inflammatory drug (NSAID). It works by inhibiting the production of prostaglandins, which are chemicals in the body responsible for inflammation, pain, and fever. Diclofenac is often used for its anti-inflammatory properties and can be effective in reducing fever, but it is generally not the first choice for treating fever in children due to its potential side effects, particularly on the gastrointestinal tract and kidneys, especially with prolonged use.

On the other hand, Paracetamol (Acetaminophen) is widely used as a first-line treatment for fever and pain in children. It works primarily in the brain to reduce fever and alleviate pain. Paracetamol is considered safer for children when used at the recommended dosages. However, it is crucial to adhere to the maximum daily dosage to avoid liver damage, which can occur if the total intake exceeds 4,000 mg in adults and is proportionally lower for children.

2. Safety and Dosage Considerations:
When it comes to safety, Paracetamol is generally regarded as less harmful than Diclofenac for children, especially when used appropriately. The concern with NSAIDs like Voren is that they can lead to gastrointestinal issues, renal impairment, and other systemic effects, particularly in young children or those with pre-existing health conditions.

Regarding dosage, it is vital to follow the recommendations based on the child's age and weight. For a 10-year-old child weighing 35 kg, the typical dosage for Paracetamol would be around 10-15 mg/kg per dose, given every 4-6 hours as needed, without exceeding the maximum daily limit. For Voren, the dosage can vary, and it is essential to consult with a healthcare provider to determine the appropriate amount, as the dosing can differ based on the formulation and the specific condition being treated.

If one pharmacy suggests using one Voren suppository (12.5 mg) and another suggests two, it can be confusing. The correct approach is to consult with a healthcare professional who can provide guidance based on the child's specific health needs and the severity of the fever. It is also important to consider the overall treatment plan, including any oral medications the child may be taking, to avoid exceeding the recommended dosages.

3. Recommendations for Managing Fever in Children:
When managing fever in children, especially if they are unable to keep oral medications down due to vomiting, suppositories can be a useful alternative. However, it is crucial to monitor the child's response to the medication and ensure that the fever does not persist for more than a few days without medical evaluation. If the fever is high (above 39°C or 102°F) and does not respond to treatment, or if the child exhibits other concerning symptoms (such as difficulty breathing, persistent vomiting, or lethargy), seeking medical attention is essential.

In summary, while both Voren and Paracetamol can be used to manage fever in children, Paracetamol is generally the safer option. Always consult with a healthcare provider for personalized advice, especially regarding dosages and the appropriateness of using multiple medications concurrently.

Similar Q&A

Understanding Fever Medications: Voren vs. Paracetamol for Children

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 ad...

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 suppl...

Combining Fever Reducers and Suppositories in Pediatric Care

Hello Dr. Chang, My daughter is five years old and often suffers from severe colds that lead to high fevers, starting around the age of three. When her temperature exceeds 39 degrees Celsius, we anxiously give her antipyretics (powdered medication) along with rectal suppositorie...

Dr. Zhang Wenwang reply Pediatrics
If the active ingredients of the antipyretic medication differ from those in the suppository, there should not be significant issues. Please refer to the attached non-pharmacological methods for reducing fever in young children.

Fever Management in Patients with G6PD Deficiency: Safe Medication Options

Hello Dr. Ke: My child is a patient with favism. Is it safe to use Voltaren suppositories or Ibuprofen syrup for fever reduction? If not, what should we do?

Dr. Ke Zhengchang reply Internal Medicine
Hello, Ami: Common pain relievers and antipyretics such as Panadol (acetaminophen), Voltaren (diclofenac), or ibuprofen are safe for individuals with G6PD deficiency. However, antibiotics such as sulfonamides or Negacide should not be used.

Safe Medication Use for Children: Key Considerations and Guidelines

Hello, Pharmacist Liao: Thank you very much for your previous assistance; it was very helpful. I have another question. I would like to inquire about the (Liamobol Pediatric Suppository), which seems to be a newly launched medication. Question 1: My child had a high fever, and ...

Dr. Liao Lingmei reply Pharmacology
Hello: 1. "Limaobole Children's Suppository" is classified as an "over-the-counter medication," while "Non-inflammatory Suppository" is classified as a "prescription medication." According to regulations, prescription medications req...