Study Says Ibuprofen Is Best Painkiller for Children

The first head-to-head study of three common painkillers has found that ibuprofen works best, at least for children with broken bones, bruises and sprains.

Ibuprofen, which is available both generically and under the brand names Advil and Motrin, beat generic acetaminophen and codeine in an emergency-room study of 300 children treated at a Canadian hospital.

The youngsters, ages 6 to 17, were randomly assigned to receive standard doses of one of the three medicines. They then periodically rated their pain. Half an hour after taking the medicine, ratings were similar in the three groups. But starting an hour after the dose, children who got ibuprofen reported substantially greater relief.

The children rated their pain on a 100-point scale before and after taking the medicine. At 60 minutes afterward, scores for children who got ibuprofen had dropped 24 points, compared with 12 points for the acetaminophen group and 11 points for the codeine group. The differences remained at 120 minutes.

Also at 60 minutes, about half the children given ibuprofen reported what doctors considered "adequate" pain relief, or scores below 30. That compared with 40 percent of the children given codeine and 36 percent of the acetaminophen group.

There were no major side effects, the researchers said. Aspirin, ibuprofen and other nonsteroidal anti-inflammatory drugs carry a risk of gastrointestinal bleeding and kidney injury even at the correct dose. The drugs are linked to thousands of deaths a year, but the Food and Drug Administration says the risk is rare compared with the number of patients who take the drugs.

The study was done at Children's Hospital of Eastern Ontario in Ottawa. Results appear in the March edition of Pediatrics, released today.

Doctors in hospitals often prefer ibuprofen for children with broken bones because they seem to do better on it. The study validates that practice, said Steven E. Krug, head of emergency medicine at Chicago's Children's Memorial Hospital.