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Which Painkillers Are Safe For Children?

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A toothache or muscle pain in children is very stressful for a parent. You may consider using medicines to suppress the children’s pain, however you must know their safety.

In this post, we explain the children safety of the painkillers and the situations when you may use them.

Are Painkillers Safe For Children?

Painkillers do not treat the cause of the pain, but they only alter the way your child’s body reacts to it. Some painkillers are safe for children, but prolonged use can cause serious medical problems (1) or intoxication when used in. higher doses. You need to administer the  prescribed dose for the shortest possible period.

Therefore, it is not ideal to give painkillers to kids without a prescription from their doctor.

When Can You Give Painkillers To Children?

If your child is suffering from mild pain from an injury caused while playing or muscle sprain, try non-pharmaceutical methods such as applying a soothing ointment, and distracting and comforting the child to divert them from the pain. It may be difficult to watch your child in pain, but using painkillers for mild pain may not be the right thing to do.

However, if your child is experiencing severe pain from fractures, has undergone surgery, or has severe body aches, then giving painkillers may be crucial to help the child sleep and heal better.

Which Painkillers Are Suitable For Children?

Painkillers are classified into two categories, namely non-opioid/over-the-counter analgesics and opioid/prescription analgesics.

Over-the-counter painkillers/ non-opioid analgesics

These drugs do not need a doctor’s prescription. But it is always advisable to consult a doctor before using them. The following are some over-the-counter painkillers which may be given to children, if necessary.

1. Paracetamol (acetaminophen)

Paracetamol should be given to babies under the age of one month only after doctor consultation Tylenol should be given to babies under the age of one month only after doctor consultation (2). Also, never give more than the prescribed dosage.

Paracetamol is most commonly used, generally safe and has few side-effects. However, overdosing can cause liver toxicity. Also, special care should be taken while administering this drug to children who are malnourished and on cytochrome P 450 enzyme-inducing drugs (3).

2. Ibuprofen

Ibuprofen (Motrin, Avdil) is a nonsteroidal anti-inflammatory drug (NSAID), and is considered as a safe painkiller for children. It usually helps to decrease swelling, relieve pain and reduce fever in children older than three months or those who weigh 5kg or more.

Ibuprofen is not suitable for children who have asthma, kidney, or liver disease (4). So, always consult your doctor before giving ibuprofen to your child.

Although this is an effective painkiller, it might have some side-effects such as

  • Stomach pain
  • Indigestion or heartburn
  • Nausea (5)
  • Although, rare, more serious side effects such as black or bloody stools, blood in urine or serious allergic reaction, might occur.Consult your physician or ER immediately if any of these happen.

3. Aspirin

Aspirin or salycilate is a nonsteroidal anti-inflammatory drug (NSAID) commonly used to reduce fever and relive mild to moderate pain in adults. However this medication is rarely prescribed in children under the age of 16 years.because of its potential risk for developing serious condition, known as Reye’s syndrome, where the liver and brain suffer damage  (6).

If your child’s doctor has prescribed aspirin, then these could be some of the side-effects.

  • Mild indigestion
  • Bleeding more than normal

Some serious side-effects are:

  • Red blisters, and peeling of skin
  • Yellow skin or whites of eyes turn yellow
  • Painful joints in hands and feet
  • Swollen hands
  • Abdominal pain/ nausea
  • Serious allergic reaction

Take your child to the doctor if you noticed any of these side-effects (6)

Prescription or opioid analgesics

These pain-relieving medications are only available through a doctor’s prescription. The doctor will prescribe them in situations where your child is experiencing severe and chronic pain.

1. Morphine

Morphine is an effective pain reliever and often used in children who have undergone surgery. It is considered safe for children and newborns. However, the US Food and Drug Administration (US FDA) specifies that the safety and effectiveness of morphine injection and oral solution in pediatric patients below the age of 18 years have not been established (7) (8). So, your child’s doctor might prescribe morphine when other treatment approaches fail to provide relief.

When used as a painkiller, the chances of getting addicted are low; however, your child’s body can show dependency, and display withdrawal symptoms. Doctors usually prescribe a regime where the drug dosage is reduced gradually.

Even though safe, morphine has a few side effects such as:

  • Fainting
  • Sleepiness
  • Problems in breathing (9)

Morphine is also contraindicated if your child is suffering from

  • Respiratory depression
  • Acute or severe bronchial asthma
  • gastrointestinal obstruction
  • hypersensitivity to morphine (7)

It must be noted that morphine should be used only under doctor’s prescription, never as a self-medication.

2. Codeine

The European Medicine Agency’s Pharmacovigilance Risk Assessment Committee (PRAC) warns that codeine should only be used for acute moderate pain in children, who are above the age of 12 years. The USFDA also warns that medications containing codeine should not be used for children below the age of 12. It also warns that codeine is not recommended to use for children between 12 and 18 years who are obese or have obstructive sleep apnea and severe lung disease (10).

Also, codeine is contraindicated in children who had surgery for the removal of tonsils or adenoids, as it can cause respiratory problems (11).

The side-effects of codeine include:

  • Drowsiness
  • Light-headedness
  • Dizziness
  • Sedation
  • Shortness of breath
  • Nausea
  • Vomiting
  • Sweating
  • Constipation (12)

It is best to consult your child’s doctor even before using over-the-counter painkillers. Parents need to observe some safety measures in case their child is administered painkillers.

Safety Tips For Giving Painkillers To Children

Keep the painkiller use effective and avoid overdosing by following these tips.

  1. Always check the labels of the product to know if you are using the right strength and dosage as per your child’s weight and age.
  1. Painkillers are sold under different brand names. Each product has different strengths and may have other added compounds. Read the label and clarify any doubts with your pharmacist.
  1. Do not administer the painkiller for more than 48 hours unless advised by a doctor.
  1. Never double or reduce the dosage without consulting your doctor.
  1. If you missed a dose, then continue with your original schedule. Do not double the dose or provide two doses at once since it can lead to poisoning.
  1. If the painkiller is a liquid medication, then always use the measuring device provided with the medicine.
  1. Check the labels of the medication as some painkillers can have aspirin, which is not safe for kids.
  1. Make sure the bottles of the medicine are closed tight and placed out of the reach of a child.

It is important to use the painkillers wisely . Always consult your doctor even if the painkillers seem to be harmless. Also, try to avoid them in the cases of mild and manageable pain.

Did you give any of the above painkillers to your children? Share your experience with us in the comment section below.

This post is for informational purposes only and is not a replacement for a doctor’s consultation. Do not use any medication without talking to your doctor.

References

1. Pain Management (Acute)- children; Better Health Channel; Victoria State Government
2. Children’s medicine; Health direct
3. M Riordan,G Rylance, K Berry; Poisoning in children 2: Painkillers; British Medical Journals
4. Pain relief for children- paracetamol and ibuprofen; The Royal Children’s Hospital Melbourne
5. Ibuprofen for pain and inflammation; Medicines for Children
6. Aspirin for pain relief; National Health System
7. Prescribing Information- Morphine Sulfate oral solution; US Food and Drug Administration
8. Prescribing Information- Morphine Injection; US Food and Drug Administration
9. Morphine for Pain Relief in Children; The Hospital for Sick Children
10. FDA Drug Safety Communication: FDA restricts use of prescription codeine pain and cough medicines and tramadol pain medicines in children; recommends against use in breastfeeding women; The US Food and Drugs Administration
11. Restrictions on use of codeine for pain relief in children – CMDh endorses PRAC recommendation; European Medicines Agency
12. Prescribing Information- Codeine Sulfate oral solution; US Food and Drug Administration

 

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