Flu and winter infections: paracetamol or ibuprofen? Only one choice should be preferred according to the Medicines Agency
Affected by the ailments of winter, here you are in front of your medicine cabinet: paracetamol or ibuprofen? Everyone often has their own preference. And yet. As a first intention, the National Medicines Safety Agency (ANSM) insists: we opt for paracetamol without touching on anti-inflammatories. But why?
Ibuprofen may mask serious symptoms
The reason is simple. “Ibuprofen and ketoprofen, which belong to the family of nonsteroidal anti-inflammatory drugs (NSAIDs), are not recommended as first-line treatment for winter infections such as the flu, because they can mask important signs such as fever or pain.
By alleviating these symptoms, they risk delaying the diagnosis of a bacterial superinfection and the implementation of appropriate antibiotic treatment, which exposes one to sometimes serious complications, particularly cutaneous, pulmonary or general…
“This is particularly the case when faced with bacteria such as streptococci or pneumococci, thus increasing the risk of serious complications such as sepsis, septic shock, meningitis or certain necrotizing skin infections..
Several serious cases should make us think
Turning to anti-inflammatories at the first symptoms is not without consequences. The ANSM adds that cases of serious bacterial infections in the context of taking a non-steroidal anti-inflammatory drug (NSAID) are regularly reported to it.
Thus, between January 1, 2019 and June 30, 2023, 162 serious cases were declared in France with ibuprofen, and 54 with ketoprofen. Twelve people died, including healthy children and young adults.
“In most cases, they had taken ibuprofen for flu symptoms or ENT infections (angina, otitis), or ketoprofen for pain (sprains, joints)”underlines the agency.
Rule n°1: paracetamol as a priority
How to react in case of flu, bronchitis, or even tonsillitis? For Dr. Kierzek, the rule is simple:
“Paracetamol is recommended as a first-line treatment for fever and pain, at a minimum dose and short duration, without masking infectious warning signs.”
NSAIDs should only be considered as second-line treatment after medical advice, especially if symptoms persist for more than 3 days (fever) or worsen (rash, shortness of breath).
“NSAIDs (ibuprofen, ketoprofen, etc.) also cause serious adverse effects (digestive, renal, cardiovascular damage, risks during pregnancy) and drug interactions, which justifies their use only on medical advice, at the minimum dose and for a very short duration.” specifies our expert.
Finally, in people on chronic NSAIDs or at risk (children, fragile), you should always consult your doctor in the event of a winter infection.
A seemingly innocuous choice can have serious consequences, hence the importance of respecting the recommendations and consulting in case of doubt or worsening of symptoms.