Fever spikes in children are considered one of the most worrying challenges for parents in Egypt, especially during viral infection seasons. Amidst this anxiety, two options always take center stage: Cetal and Contafever N.
This guide provides a precise scientific comparison to help you make the most appropriate decision, clarifying the differences in active ingredients, dosages, and safety standards.
Ingredient Analysis: How Does Each Medication Work?
To understand the difference, we must look at the mechanism of action of the active ingredient within the child’s body:
1. Cetal (The Safe Option)
- Active Ingredient: Paracetamol.
- Mechanism of Action: Acts centrally on the brain to raise the pain threshold and inhibit heat-regulating centers.
- Advantages: It does not affect the stomach and does not interfere with platelet function, making it the safest option for the digestive system, even without food.
2. Contafever N (The Triple Warrior)
- Active Ingredient: Ibuprofen (Concentration: 200 mg/5 ml).
- Mechanism of Action: Belongs to Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). It reduces the production of substances that cause inflammation and pain.
- Advantages: Has a triple effect (antipyretic, analgesic, anti-inflammatory), making it stronger in cases of congestion and swelling.
Age and Weight: The Safety Equation
Determining the dose based on age and weight is the dividing line between treatment and harm.
When to use Cetal?
It is the first and only choice for children from birth up to 6 months. Paracetamol is considered the gold standard of safety for newborns and infants.
When to use Contafever N?
Due to its high concentration (200 mg), it is usually prescribed for children older than 2 years. It can be used from 6 months in special cases, but only with a very precise weight calculation under a doctor’s supervision.
Dosage Calculation Rule (By Weight, Not Age)
- Cetal: 15 mg per 1 kg of the child’s weight (every 4-6 hours).
- Contafever N: 5 to 10 mg per 1 kg (every 6-8 hours).
Note: The volume (milliliters) of the Contafever N dose is always smaller due to its high concentration.
Absorption Speed Comparison
- Onset of Action: Cetal leads slightly in absorption speed, as effects may begin within 20-30 minutes.
- Duration of Effect: Contafever N clearly wins here; its effect lasts from 6 to 8 hours thanks to its anti-inflammatory properties, giving the child a quiet night’s sleep without a rapid return of fever.
Ideal Use Cases (When do I choose which?)
- Choose Contafever N for: Purulent tonsillitis, otitis media (middle ear infection), and pain accompanied by swelling. Its ability to reduce inflammation speeds up the child’s relief.
- Choose Cetal for: Mild fever, light colds, and post-vaccination fever. (It is not preferred to use anti-inflammatories like Ibuprofen with vaccinations to ensure the best immune response).
Medical Warnings
1. Contafever N and Chest Allergies
Warning: Contafever N is prohibited for children suffering from bronchial asthma or chest allergies, as it may trigger shortness of breath. The safe alternative here is Cetal.
2. Stomach Impact
- Cetal: Completely safe on an empty stomach.
- Contafever N: Must be taken after eating to avoid stomach wall irritation or abdominal pain.
Comparison Table
| Aspect of Comparison | Cetal | Contafever N |
|---|---|---|
| Active Ingredient | Paracetamol | Ibuprofen |
| Concentration | 250 mg / 5 ml | 200 mg / 5 ml |
| Inflammatory Effect | Weak | Strong (Anti-swelling) |
| Asthma Safety | Safe ✅ | Needs Caution ⚠️ |
| Suitable Age | From Day 1 | Preferably from 2 years |
| Duration of Effect | 4 – 6 Hours | 6 – 8 Hours |
Alternating Protocol
In cases where the fever exceeds 39°C and does not respond to a single medication, an alternating system can be used:
- Mechanism: Switch between the two medications every 4 hours (e.g., Cetal at 12:00, Contafever at 4:00, Cetal at 8:00).
- Benefit: This reduces the load on the liver (Cetal’s exit pathway) and the kidneys (Contafever’s exit pathway) while attacking the fever with two different agents.
Tips for Mothers & Concept Corrections
- Shake Well: Contafever N is a Suspension. Not shaking the bottle means giving the child only water and sugar, leaving the active ingredient to settle at the bottom, which could cause toxicity in the final doses.
- Mixing Medications: Never mix the two drugs in one spoon. This causes intestinal upset and does not increase effectiveness.
- Household Spoons: Use the calibrated syringe only. Teaspoons are inaccurate and lead to wrong dosages.
- Shelf Life: The validity of the syrup after opening does not exceed 6 months, provided it is stored below 30°C and tightly closed.
Frequently Asked Questions
Q: Does Contafever N cause drowsiness?
A: It does not contain sedatives. The child’s sleep is caused by the relief of pain and the reduction of fever, which provides them with comfort.
Q: My child has G6PD Deficiency (Favism/Anemia of Fava Beans), is Contafever safe?
A: Yes, Ibuprofen is safe for G6PD patients and does not cause hemolysis (breakdown of red blood cells). However, Cetal remains the first choice for absolute safety, with Contafever used only when necessary.
Q: Can I mix the medicine with juice?
A: It is preferred to take it alone. In cases of extreme necessity, the dose can be mixed with one spoonful of juice to ensure the child consumes the full amount.
Q: When should I see a doctor?
A: If the fever persists for more than 3 days, a skin rash appears, a febrile seizure occurs, or the child completely refuses to drink fluids.
