Is Ibuprofen safe to give if you have Coronavirus Disease?

Dr W Muller 

                  Written                               Updated                     Next Review 
              18/03/2020                        24/05/2020                      Mar 2021

There are a lot of news coming out on the internet and social media that Ibuprofen [Nurofen] and related drugs such as Diclofenac [Voltarol] or Naproxen should be avoided in cases of infection with COVID-19. These are drugs belong to a group of Non-Steroidal Anti-inflammatory Drugs [NSAIDs].

Currently the initial concerns of increased risk of more severe symptoms of COVID-19 when Non-Steroidal Anti-inflammatory Drugs [NSAIDs] {like Ibuprofen} are taken have subsequently NOT BEEEN confirmed (3). 

There was initially concern that these were fake news but highly respected medical journals initially issued warnings:

Articles in highly rate medical journals such as BMJ {British Medical Journal} had also suggested there could be a link but in March 2020 these were only suspicions, case reports and expert opinions(1). There was no conclusive evidence and many had doubted that there is a link(2).

What is a sensible approach for now?

For viral infections in general (see for Coronavirus Disease further down):

Should I bring the temperature down? This is a good question and many think fever is dangerous and it comes with a risk of febrile convulsions. More and more doctors now believe that nature developed a fever as a body response for a purpose (7). If we reduce the fever our body may find it even harder to do its ‘job’ effectively.

So, what should we do?

In my experience, it is absolutely justifiable not to give Paracetamol or Ibuprofen if the fever is below 39°C as long as the child is not uncomfortable or in pain. We also know that we cannot prevent febrile convulsions with anti-pyretics (fever reducing medications) at the best of times. It is not well understood why, but the risk of a febrile convulsion stays the same with or without regular Paracetamol or Ibuprofen.

However if your child is younger than 3 months you should see a doctor on the same day. Equally, if your child is unusually irritable, lethargic, uncomfortable or usually when your child has a fever over 39°C, you should see a doctor too.

You should avoid overwrapping a febrile child. You may use a tepid sponge bath or a wet flannel on the forehead or the calves. It is important not to use cold water but lukewarm water to moisten the flannels. But remember, a fever does not need to be lowered if it is mild.

see for more Frequently Asked Questions: Acute viral infection: What can I do?

For viral infection with COVID-19 or if you do not know for sure:

With regards to the possibility of an infection with COVID-19 it WAS INITIALLY sensible to avoid Ibuprofen. However, as many parents know well, Paracetamol alone often does not bring a fever of 40C down to normal and Ibuprofen works often well in conjunction with Paracetamol:

Here is my personal view:

Give Paracetamol if your child has fever over 39C or is in discomfort.
You do not have to give anything if your child is comfortable and the fever is 'only' up to 39C.
If your child has high fever >39C and you are giving Paracetamol do not expect the temperature to be in the normal range [36.5-37.5] but may still be 38-39C. As long as you child is not in discomfort or pain leave it at that and repeat Paracetamol for now.
Your doctor may be able to advise if it is safe to give a little bit more Paracetamol than indicated on the bottle for a shot while.
If you have given Paracetamol in the correct dose and you child has still a temperature over 39C or is in pain I would advise to give Ibuprofen even if you are not sure whether your child has coronavirus. This is based on what I can read in the scientific journal for now.
You should be aware if your child is very young (less than 4 months), sleepy and drowsy all day, you are worried or the fever is gong on for more than 4-5 days you must speak to a doctor or bring the child to be seen.

What if my child is on a regular NSAIDs (Ibuprofen, Diclofenac, Naproxen or other] :

My advice is do not stop taking them but do speak to your doctor!

(1) Covid-19: ibuprofen should not be used for managing symptoms, say doctors and scientists;  BMJ 2020;368:m1086 17 March 2020

(2) Advice about Anti-Inflammatory medication and COVID-19; Health and Safety Executive 16 March 2020
(3) COVID-19 pandemic and therapy with ibuprofen; Naunyn-Schmiedeberg's Archives of Pharmacology 15 April 2020