Pharmacokinetics of common analgesics, anti-inflammatories and antipyretics in children

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) are a major component of paediatric therapeutics. This paper summarises the clinical pharmacology and pharmacokinetics of some commonly used NSAIDs as well as paracetamol (acetaminophen), which has very weak anti-inflammatory activity. Available information is reviewed in an attempt to evaluate the basis for paediatric dosing recommendations and to underline known or likely differences in drug disposition that result from diseases and changes in developmental physiology. Clinically important general considerations are stressed, including areas in which age-appropriate pharmacological information is needed but unavailable. The review is not exhaustive, as only the following selected drugs are surveyed: paracetamol, ibuprofen, indomethacin, diclofenac, naproxen and sulindac. Some compounds of interest, including salicylates (e.g. aspirin, salsalate), recently introduced drugs (e.g. ketoprofen, nimesulide) and those withdrawn (e.g. zomepirac, benoxaprofen), are not included. Non-NSAID analgesics (e.g. dextropropoxyphene, narcotics) are also not included.