An antipyretic (ˌæntipaɪˈrɛtɪk, from anti- 'against' and 'feverish') is a substance that reduces fever. Antipyretics cause the hypothalamus to override a prostaglandin-induced increase in temperature. The body then works to lower the temperature, which results in a reduction in fever.
Most antipyretic medications have other purposes. The most common antipyretics in the US are usually ibuprofen and aspirin, which are nonsteroidal anti-inflammatory drugs (NSAIDs) used primarily as anti-inflammatories and analgesics (pain relievers), but which also have antipyretic properties; and paracetamol (acetaminophen), an analgesic without anti-inflammatory properties.
There is some debate over the appropriate use of such medications, since fever is part of the body's immune response to infection. A study published by the Royal Society claims that fever suppression causes at least 1% more influenza deaths in the United States, or 700 extra deaths per year.
Bathing or sponging with lukewarm or cool water can effectively reduce body temperature in those with heat illness, but not usually in those with fever. The use of alcohol baths is not an appropriate cooling method, because there have been reported adverse events associated with systemic absorption of alcohol.
The list of medications with antipyretic effects includes many common drugs that also have analgesic and anti-inflammatory activity, several of which are commonly sold over-the-counter (OTC).
NSAIDs (non-steroidal anti-inflammatory drugs), a broad class of medications that in addition to their defining effect of reducing inflammation, also tend to be potent analgesics and antipyretics. The majority work by inhibiting the activity of the cyclooxygenase (COX) family of enzymes in the body.
Nonselective COX enzyme inhibitors like ibuprofen and naproxen.
Salicylates, including aspirin (acetylsalicylic acid), magnesium salicylate, and sodium salicylate. These are also primarily nonselective COX inhibitors, but also work through other mechanisms including activating AMP-activated protein kinase.
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Fever, also referred to as pyrexia, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using values between in humans. The increase in set point triggers increased muscle contractions and causes a feeling of cold or chills. This results in greater heat production and efforts to conserve heat. When the set point temperature returns to normal, a person feels hot, becomes flushed, and may begin to sweat.
Paracetamol (acetaminophen or para-hydroxyacetanilide) is a non-opioid analgesic and antipyretic agent used to treat fever and mild to moderate pain. It is a widely used over the counter medication and common brand names include Tylenol and Panadol. At a standard dose, paracetamol only slightly decreases body temperature; it is inferior to ibuprofen in that respect, and the benefits of its use for fever are unclear. Paracetamol may relieve pain in acute mild migraine but only slightly in episodic tension headache.
Salicylic acid is an organic compound with the formula HOC6H4COOH. A colorless, bitter-tasting solid, it is a precursor to and a metabolite of aspirin (acetylsalicylic acid). It is a plant hormone, and has been listed by the EPA Toxic Substances Control Act (TSCA) Chemical Substance Inventory as an experimental teratogen. The name is from Latin salix for willow tree, from which it was initially identified and derived. It is an ingredient in some anti-acne products. Salts and esters of salicylic acid are known as salicylates.
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