Print Print
CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.

Chickenpox - Management
What are the general issues when prescribing paracetamol or ibuprofen?

  • Paracetamol and ibuprofen are well tolerated when used for short periods [BNF 54, 2007]:
    • Both paracetamol and ibuprofen are licensed for the relief of pain and fever from 3 months of age:
    • Seek specialist advice before prescribing to neonates younger than 4 weeks of age given the high risk of complications in this age group.
      • Both paracetamol and ibuprofen are not licensed for use under 4 weeks of age.
    • As with other nonsteroidal anti-inflammatory drugs (NSAIDs), ibuprofen may worsen or precipitate gastrointestinal haemorrhage, asthma, hypertension, renal impairment, or cardiac failure. Avoid ibuprofen if there is a history of peptic ulcers. Paracetamol is often a safer option in older people.
  • Paracetamol and ibuprofen rarely cause adverse effects when used in the short term [BNF 54, 2007]:
    • Paracetamol has no notable adverse effects when used at the correct dosage.
    • Ibuprofen may occasionally cause exacerbation of asthma and gastrointestinal adverse effects, such as discomfort, nausea, and diarrhoea.
    • There are concerns that use of NSAIDs in children with varicella is associated with an increased risk of necrotizing soft-tissue infections and infections with invasive group A beta-haemolytic streptococci [Heininger and Seward, 2006]:
      • Evidence from two small case-control studies are conflicting [Lesko and Mitchell, 1995; Zerr et al, 1999].
      • Although the association cannot be ruled out with certainty, evidence is insufficient to advise that ibuprofen (or other NSAIDs) be avoided in children with chickenpox.

© NHS Institute for Innovation and Improvement