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any medicine that lowers body temperature to prevent or alleviate fever (同)febrifuge
preventing or alleviating fever

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熱さましの,解熱の / 解熱剤

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/05/29 01:17:17」(JST)

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Coated 200 mg ibuprofen tablets, a commonly used antipyretic

Antipyretics (/ænti.paɪˈrɛ.tɪks/), from the Greek anti, against, and pyreticus, pertaining to fever, are substances that reduce fever.^[1] Antipyretics cause the hypothalamus to override an interleukin-induced increase in temperature. The body then works to lower the temperature, resulting in a reduction in fever.

Most antipyretic medications have other purposes. The most common antipyretics in the United States are ibuprofen and aspirin, which are used primarily as pain relievers. Non-steroidal anti-inflammatory drugs (NSAIDs) are antipyretic, anti-inflammatory, and pain relievers.

There is some debate over the appropriate use of such medications, as fever is part of the body's immune response to infection.^[2]^[3] A study published by the Royal Society claims fever suppression causes at least 1% more influenza cases of death, resulting in at least 700 extra deaths per year in the United States alone.^[4]

Non-pharmacological treatment

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.^[5] The use of alcohol baths is not an appropriate cooling method, because there have been reported adverse events associated with systemic absorption of alcohol.^[6]

Medications

Many medications have antipyretic effects and thus are useful for fever but not heat illness, including:

NSAIDs such as ibuprofen, naproxen, ketoprofen, and nimesulide
Aspirin, and related salicylates such as choline salicylate, magnesium salicylate, and sodium salicylate
Paracetamol (USAN and JAN: Acetaminophen)
Metamizole, banned in over 30 countries for causing agranulocytosis
Nabumetone
Phenazone, also known as antipyrine, available in combination with benzocaine as an ear drop in the US.

Plants

Traditional use of higher plants with antipyretic properties is a common worldwide feature of many ethnobotanical cultural systems. In ethnobotany, plants with naturally occurring antipyretic properties are commonly referred to as febrifuges.^[7]^[8]

In children

The U.S. Food and Drug Administration (FDA) notes that improper dosing is one of the biggest problems in giving acetaminophen (paracetamol) to children.^[9] The effectiveness of acetaminophen alone as an antipyretic in children is uncertain, with some evidence showing it is no better than physical methods.^[10] Therapies involving alternating doses of acetaminophen and ibuprofen have shown greater antipyretic effect than either drug alone.^[11] One meta-analysis indicated that ibuprofen is more effective than acetaminophen in children at similar doses when both are given alone.^[12]

Due to concerns about Reye syndrome, the U.K. NHS,^[13] the U.S. Centers for Disease Control and Prevention (CDC), the U.S. Surgeon General, the American Academy of Pediatrics (AAP) and the U.S. Food and Drug Administration (FDA) recommend that aspirin and combination products containing aspirin not be given to children or teenagers during episodes of fever-causing illnesses.^[14] However, the decreased use of aspirin, with the converse increased use of acetaminophen/paracetamol, has been linked to the increase in asthma and other autoimmune disorders by several studies. Physicians recommending acetaminophen/paracetamol should use caution and be especially attentive to any genetic or environmental predisposition to asthma or other autoimmune disorders.^[15]

References

^ "Definition of antipyretic". Merriam-Webster Online Dictionary. Retrieved 2007-12-19.
^ "Mayo Clinic".
^ "Medline Plus".
^ Kupferschmidt, Kai (2014-01-21). "Fight the Flu, Hurt Society?". ScienceNow.
^ "UpToDate Inc".
^ Sullivan, J. E.; Committee On, H. C.; Sullivan, J. E.; Farrar, H. C. (2011). "Fever and Antipyretic Use in Children". Pediatrics 127 (3): 580–587. doi:10.1542/peds.2010-3852. PMID 21357332. edit
^ Schultes, R.E.; Raffauf, R.F. De Plantis Toxicariis e Mundo Novo Tropicale Commentationes. XXXIX. Febrifuges of northwest Amazonia. Harvard Papers in Botany Vol. 5, pp. 52-68. 1994.
^ Biren N. Shah and Avinash K. Seth Medicinal Plants as a Source of Anti-Pyretic Agents – A Review http://scholarsresearchlibrary.com/aasr-vol2-iss3/AASR-2010-2-3-188-195.pdf
^ Reducing Fever in Children: Safe Use of Acetaminophen
^ Meremikwu M, Oyo-Ita A (2002). Meremikwu, Martin M, ed. "Paracetamol for treating fever in children". Cochrane Database Syst Rev (2): CD003676. doi:10.1002/14651858.CD003676. PMID 12076499. Trial evidence that paracetamol has a superior antipyretic effect than placebo is inconclusive.
^ E. Michael Sarrell, MD; Eliahu Wielunsky, MD; Herman Avner Cohen, MD (2006). "Antipyretic treatment in young children with fever: acetaminophen, ibuprofen, or both alternating in a randomized, double-blind study". Archives of Pediatrics & Adolescent Medicine 160 (2): 197–202. doi:10.1001/archpedi.160.2.197. PMID 16461878. Retrieved 2010-09-25.
^ Kauffman, Ralph; Sawyer, L.A.; Scheinbaum, M.L. (1992). "Antipyretic Efficacy of Ibuprofen vs Acetaminophen". Am J Dis Child. 146 (5): 622–625.
^ Reye's syndrome - Prevention
^ CDC Study Shows Sharp Decline in Reye's Syndrome among U.S. Children
^ Varner, A. E.; Busse, W. W.; Lemanske, R. F. (1998). "Hypothesis: Decreased Use of Pediatric Aspirin Has Contributed to the Increasing Prevalence of Childhood Asthma". Annals of Allergy, Asthma & Immunology 81 (4): 347–351. doi:10.1016/S1081-1206(10)63127-4. PMID 9809499. edit

UpToDate Contents

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1. 成人における発熱の病態生理および治療 pathophysiology and treatment of fever in adults
2. 幼児および小児における発熱：病態生理およびマネージメント fever in infants and children pathophysiology and management
3. Approach to the patient with night sweats
4. 集中治療室（ICU）における発熱 fever in the intensive care unit
5. 熱性けいれんの治療および予防 treatment and prognosis of febrile seizures

English Journal

The impact of providing rapid diagnostic malaria tests on fever management in the private retail sector in Ghana: a cluster randomized trial.

Ansah EK1, Narh-Bana S2, Affran-Bonful H3, Bart-Plange C4, Cundill B5, Gyapong M2, Whitty CJ5.
BMJ (Clinical research ed.).BMJ.2015 Mar 4;350:h1019. doi: 10.1136/bmj.h1019.
OBJECTIVE: To examine the impact of providing rapid diagnostic tests for malaria on fever management in private drug retail shops where most poor rural people with fever present, with the aim of reducing current massive overdiagnosis and overtreatment of malaria.DESIGN: Cluster randomized trial of 2
PMID 25739769

Fever and the use of paracetamol during IL-2-based immunotherapy in metastatic melanoma.

Køstner AH1, Ellegaard MB, Christensen IJ, Bastholt L, Schmidt H.
Cancer immunology, immunotherapy : CII.Cancer Immunol Immunother.2015 Mar;64(3):349-55. doi: 10.1007/s00262-014-1637-5. Epub 2014 Dec 2.
Fever is frequently observed in conjunction with interleukin-2 (IL-2)-based immunotherapy. Traditionally, fever has been regarded as an undesirable side effect and treated with fever-lowering drugs. However, new insights in tumor immunology suggest that elevated temperature may facilitate a more eff
PMID 25445814

Japanese Journal

解熱鎮痛薬 (特集エキスパートが教える研修医のための薬の使いかた)

関口進一郎
小児科診療 74(5), 765-770, 2011-05
NAID 40018804189

解熱薬--使わなくてもよいですか? (特集 ERで使う薬剤--ちょっとした疑問とピットフォール) -- (この薬は必要ですか?)

前田重信
救急医学 32(7), 747-750, 2008-07
NAID 40016155985

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