When to refer
When to refer
Pharmacy team members should refer to the pharmacist/GP:1,6
- Any child with any signs of other illnesses, any joint swelling or a persistent fever
- A baby with a temperature of 38°C or higher if under 3 months
- A baby with a temperature of 39°C or higher (aged 3-6 months)
- Any child who doesn't want to eat, or doesn't seem their usual self and the parent/carer is worried
- Any child with a high temperature that doesn't come down after they have been given paracetamol/ibuprofen
- Any child showing signs of dehydration (e.g. nappies that aren't very wet, sunken eyes or no tears when they are crying).
Listen out for any "red flag" signs such as a weak, high pitched/continuous cry, grunting when breathing or severe indrawing of the chest, signs of dehydration of the skin, a bulging fontanelle or seizures/fits.7 Any warning signs of meningitis or sepsis should also be referred urgently (see below).
REFERENCES
1. https://www.nhs.uk/conditions/fever-in-children (Accessed Aug 2018)
2. https://www.nhs.uk/conditions/dehydration/ (Accessed Aug 2018)
3. https://cks.nice.org.uk/chickenpox#!scenariorecommendation:1 (Accessed Aug 2018)
8. https://www.nhs.uk/conditions/Meningitis/#symptoms-of-meningitis (Accessed Aug 2018)
9. https://www.meningitis-trust.org.uk/symptoms (Accessed Aug 2018)
10. https://www.nhs.uk/conditions/meningitis/symptoms/ (Accessed Oct 2018)
11. https://www.nhs.uk/conditions/sepsis/ (Accessed Aug 2018)
12. https://www.meningitis.org/meningitis/check-symptoms/toddlers (Accessed Sep 2018)
Calpol Infant Suspension (incl. Sachets), Calpol Sugar-Free Infant Suspension (incl. Sachets) (Paracetamol)
Product Information:
Presentation: Suspension containing 120mg Paracetamol per 5ml Indication: Treatment of mild to moderate pain and as an antipyretic. Can be used in many conditions including headache, toothache, earache, teething, sore throat, colds and influenza, aches and pains and post immunisation fever.
Dosage and Administration: For the relief of fever after vaccinations at 2,3 and 4 months; 2.5ml up to 4 times a day starting at the time of vaccination. If your baby still needs this medicine two days after receiving the vaccine talk to you doctor or pharmacist. Dosage for the relief of pain and other causes of fever in babies aged 2-3 months (if your baby weighs over 4kg and was born after 37 weeks); 2.5ml. If necessary give a second dose after 4-6 hours. Dosage for Children over 3 months; Children 3 to 6 months: 2.5 ml. Children 6 to 24 months: 5 ml. Children 2 years to 4 years: 7.5 ml. Children 4 to 6 years: 10ml. Do not give more than 4 doses in 24 hours and leave at least 4 hours between doses.
Contraindications: Hypersensitivity to paracetamol or other ingredients. Precautions: Caution in severe hepatic or renal impairment. Interactions with domperidone, metoclopramide, colestyramine, anticoagulants, alcohol, drugs that induce hepatic microsomal enzymes. Patients with rare hereditary problems of fructose intolerance should not take this medicine. Due to the presence of sucrose and sorbitol in the Infant Suspension, patients with glucose-galactose malabsorption or sucrose-isomaltase insufficiency should not take this medicine. Maltitol may have a mild laxative effect (Sugar-Free only). Parahydroxybenzoates and carmoisine may cause allergic reactions. Patients should be informed about the signs of serious skin reactions, and use of the drug should be discontinued at the first appearance of skin rash or any other sign of hypersensitivity.
Fertility, pregnancy and lactation: Consult doctor before use.
Side effects: Very rarely hypersensitivity and anaphylactic reactions including skin rash. Very rare cases of skin reactions. Blood dyscrasias, chronic hepatic necrosis, papillary necrosis and low level transaminase elevations have been reported.
RRP (ex-VAT): 100ml bottle: £3.32; 200ml bottle: £5.48; 12 x 5ml sachets: £3.50; 20 x 5ml sachets (sugar free only): £5.63 Legal category: 200ml bottle: P; 100ml bottle: GSL; Sachets: GSL UK/CA/15-5848(3)
PL Holder: McNeil Products Ltd, Maidenhead, Berkshire, SL6 3UG
PL Numbers: Calpol Infant suspension: 100ml bottle: 15513/0122; 200ml bottle: 15513/0004; Sachets: 15513/0154. Calpol Sugar-free Infant Suspension: 100ml bottle: 15513/0123; 200ml bottle: 15513/0006; Sachets:15513/0155
Date of Preparation: January 2016
UK/CA/15-5848(3)
Calprofen 100mg/5ml Oral Suspension Ibuprofen, Calprofen 100mg/5ml Ibuprofen Suspension and Calprofen Ibuprofen Suspension
Product Information:
Presentation: Sachets and suspension containing 100mg Ibuprofen per 5ml. Calprofen 100mg/5ml Ibuprofen Suspension also contains maltitol syrup (E965), sodium methylhydroxybenzoate (E219), sodium propylhydroxybenzoate (E217), propylene glycol (E1520) and ethanol.
Uses: Treatment of mild to moderate pain, headache, fever, post-immunisation pyrexia, symptoms of colds and flu and minor aches and pains.
Dosage: For Pain and Fever: Infants 3-6 months, weighing over 5kg: One 2.5 ml dose may be taken 3 times in 24 hours; Infants 6-12 months: 2.5ml three times a day; Children 1-2 years: 2.5ml three to four times a day; Children 3-7 years: 5ml three to four times a day; Children 8-12 years: 10ml three to four times a day.
Post-immunisation fever: 2.5ml (50mg) followed by one further 2.5ml (50mg) dose six hours later if necessary. No more than 2 doses in 24 hours. Leave 6 - 8 hours between dose.
Contraindications: Hypersensitivity to ingredients, or to aspirin or other NSAIDs. Peptic ulceration/haemorrhage, perforation or GI bleeding. Concomitant use with NSAIDs. Severe hepatic, renal or heart failure. Women in the last trimester of pregnancy. Precautions: The elderly; women tying to conceive; dehydrated children; history of GI toxicity; concomitant medications increasing the risk of GI toxicity; hepatic or renal dysfunction; bronchial asthma or allergic disease; hypertension or heart failure; SLE and mixed connective tissue disease. Should be used with caution in patients receiving anticoagulants, antihypertensives and diuretics, corticosteroids, anti-platelet agents and SSRIs, cardiac glycosides, lithium, methotrexate, ciclosporin, mifepristone, tacrolimus, zidovudine, and quinolone antibiotics.
Pregnancy and lactation: Not recommended.
Side effects:
Uncommon: Hypersensitivity reactions with urticaria and pruritus, abdominal pain, nausea and dyspepsia, Headache,
various skin rashes.
Rare: diarrhoea, flatulence, constipation and vomiting.
Very rare: Severe hypersensitivity reactions. Symptoms could be: facial, tongue and laryngeal swelling, dyspnoea, tachycardia,
hypotension (anaphylaxis, angioedema, or severe shock). Exacerbation of asthma and bronchospasm, peptic ulcer, perforation
or gastrointestinal haemorrhage, melaena, haematemesis. Ulcerative stomatitis, gastritis, exacerbation of colitis and Crohn's
disease. Acute renal failure, papillary necrosis especially in long term use, associated with increased serum urea and oedema.
Liver disorders, haematopoietic disorders, severe forms of skin reactions such as bullous reactions, including Stevens-Johnson
Syndrome, erythema multiforme and toxic epidermal necrolysis.
Not known: Drug reaction with eosinophilia and systemic symptoms (DRESS syndrome).
Price (ex-VAT): Sachets: 12 x 5ml: £3.45, Bottle 200ml: £5.04; 100ml: £3.16.
Legal category: Sachets: GSL. 200ml bottle: P. 100ml bottle: GSL.
PL holder: McNeil Products Ltd, Maidenhead, Berkshire, SL6 3UG.
PL numbers: Sachets: 15513/0158, 200ml: bottle 15513/0120. 100ml bottle: 15513/0147.
Date of preparation: 13 April 2018.
UK/CP/18-11407