5 Managing fever

5 Managing fever

We will review and update these recommendations on a regular basis.

5.1 Be aware that, on average, fever is most common 5 days after exposure to the infection.

5.2 Advise patients to drink fluids regularly to avoid dehydration (no more than 2 litres per day).

5.3 Do not use antipyretics with the sole aim of reducing body temperature.

5.4 Advise patients to take paracetamol or ibuprofen if they have fever and other symptoms that antipyretics would help treat (see table 2 for treatments for managing fever). Tell them to continue only while the symptoms of fever and the other symptoms are present. If using a non-steroidal anti-inflammatory drug they should take the lowest effective dose for the shortest period needed to control symptoms. For more information on the short-term use of ibuprofen and other non-steroidal anti-inflammatory drugs, see the NICE evidence summary on acute use of non-steroidal anti-inflammatory drugs (NSAIDs) for people with or at risk of COVID-19, an NHS England policy on acute use of NSAIDs in people with or at risk of COVID-19, and the Commission on Human Medicines' advice on ibuprofen and COVID-19. [amended 22 April 2020]

Table 2 Antipyretics for managing fever in adults and children

Treatment

Dosage

Adults (18 years and over): paracetamol

0.5 g to 1 g every 4 to 6 hours, maximum 4 g per day

Adults (18 years and over): ibuprofen

400 mg three times a day when required

See BNF for dosing and for alternative non-steroidal anti-inflammatory medicines

Children and young people over 1 month and under 18 years: paracetamol or ibuprofen

See the dosing information on the pack or the BNF for children

Notes: See BNF and MHRA advice for appropriate use and dosing in specific populations.

All doses are for oral administration. Rectal paracetamol, if available, can be used as an alternative. See the BNF and BNF for children for rectal dosing information.

Continue only while the symptoms of fever and the other symptoms are present.

[amended 22 April 2020]