NSAIDS have antipyretic activity and can be used to treat fever.   Fever is caused by elevated levels of prostaglandin E2 , which alters the firing rate of neurons within the hypothalamus that control thermoregulation.   Antipyretics work by inhibiting the enzyme COX, which causes the general inhibition of prostanoid biosynthesis ( PGE2 ) within the hypothalamus .   PGE2 signals to the hypothalamus to increase the body's thermal set point.   Ibuprofen has been shown more effective as an antipyretic than paracetamol (acetaminophen).   Arachidonic acid is the precursor substrate for cyclooxygenase leading to the production of prostaglandins F, D & E.
FDA reviewed a meta-analysis of randomized clinical trials of cardiovascular and upper gastrointestinal events with non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs), conducted by the Coxib and traditional NSAID Trialists’ (CNT) Collaboration of the Clinical Trial Service and Epidemiological Studies Units at Oxford University. 2 We also reviewed observational studies and other scientific publications in the medical literature. 1 The findings of these studies were discussed at a joint meeting of the Arthritis Advisory Committee and Drug Safety and Risk Management Advisory Committee held on February 10-11, 2014 (for complete safety reviews, background information, and minutes of this meeting, click here ).