Covid-19: France advises against ibuprofen to treat symptoms

CHCINACTION

France’s Health Minister Olivier Véran delivered a message via his Twitter account over the weekend, advising against taking anti-inflammatory medicines (ibuprofen, cortisone, etc) to treat Covid-19 symptoms, as they could be an aggravating factor for the infection. His advice for those with a fever was to take paracetamol instead. Patients already on anti-inflammatory drugs for other illnesses, or anyone with any questions, are advised to seek advice from their doctor.

Public health interventions like this, with directives specifically citing which OTC medicines to take or not take, are rare and so the story was picked up by major news outlets in the UK (Guardian), USA (New York Times) and elsewhere. According to a report in The Local, Véran’s tweet prompted several members of the public to ask for the source of his reasoning on not taking ibuprofen to treat Covid-19 symptoms. The main concern appears to be that anti-inflammatories have an “immunosuppressive effect“, plus the background in France is that medicines agency ANSM has already removed medicines containing paracetamol, ibuprofen and / or aspirin from the self-selection list in January 2020 to reinforce the advisory role of the pharmacist and guarantee safe use.

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Meanwhile, the effect of the Covid-19 pandemic on sales and availability of painkillers in other markets is already becoming evident, with UK retailer Boots imposing a limit of two items per customer on cough & cold and pain medicines and US marketer J&J reporting a spike in demand for its Tylenol range and other self-care products. In the wake of the Covid-19 outbreak, and India’s decision last week to restrict the export of some ingredients (including paracetamol), there have been fears of shortages and disruptions to supply chains, but J&J said it did not anticipate a shortage of Tylenol and that it was taking all possible measures to maximise availability of its consumer healthcare range.

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UK press misreports paracetamol’s autism / ADHD links

Paracetamol is the most widely used analgesic in the world and was once deemed the only painkiller that is safe for mothers-to-be.

However, women who take paracetamol during pregnancy “risk having a child with autism or ADHD”, the Mail Online reported last week. Other UK newspapers, The Times and The Daily Telegraph, are also ‘guilty’ of publishing headlines that could potentially cause unnecessary worry for pregnant women.

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The Spanish study that reported on the matter actually provided no direct link or solid evidence to ADHD or autism. Over 2,000 pregnant women using paracetamol, before and during pregnancy, were assessed between 2004 and 2008. Various developmental and behavioural tests on the children at the ages of one and five were then conducted.

Links were found between paracetamol use and hyperactivity / impulse symptoms at age five, and autism symptoms in boys. There was however no direct link to ADHD or autism symptoms, nor a link to intellect or development in the children being affected.

The study will most likely contribute to the long list of pregnancy “dos” and “don’ts” owing to its media focus. Most importantly, the NHS has confirmed that there was no link with the full diagnostic criteria for attention deficit hyperactivity disorder (ADHD) or autism; highlighting that the study cannot prove that using paracetamol in pregnancy caused these symptoms.