Always read the label and consult with your ketogenic team if you are unsure of anything. 

Ibruprofen and Paracetamol Preparations

Ibruprofen or Paracetamol in a tablet or sugar free liquid form can be used to manage temperature, fever and pain. The sugar free liquids are likely to contain artificial sweeteners and sugar alcohols e.g. sorbitol, maltitol etc.  Individual tolerance may vary, but in general these should not have an adverse effect on ketogenic control.

As well as medications there are cool and soothe pads which can be used and purchased from pharmacies.  Although you can use a tepid flannel placed on the forehead as well or on the back of the neck to help bring temperatures down.

Cold/Flu Remedies/Cough Syrups

Again it is better to look for the tablet/capsule variety as they tend to have less carbohydrate in them but for liquid versions for children the same rules apply as with the ibruporfen and paracetamol.  Go for sugar free and as lower carbohydrates as you can find.

Always read the labels and give in accordance with the manufacturer’s instructions.

Otrivin Nasal Drops

These are saline drops that can be used on tiny babies to put up their nose and it is a decongestant so should help them breathe easier.  Please always refer to the manufacturer’s instructions and discuss with your doctor.

Other tips that may help include raising one end of the cot and/or an electronic vaporiser in the room.

Vapour Rubs and Essential Oils

There are different varieties and makes, some are suitable for babies and some for older children and adults.  These can be used as a decongestant and help with breathing.  Have a look at the ingredients on the vapour rubs as some will possibly contain oils which may not be recommended to use on someone with epilepsy and if you use essential oils the ones that should be avoided are:  Rosemary, fennel, sage, eucalyptus, hyssop, camphor and spike lavender.

Hayfever and allergic reactions

Cetirizine and Loratidine, the commonly used antihistamine tablets are acceptable.

If a liquid version is required, check that this is sugar free e.g. Piriton Sugar/Colour-Free liquid.

Please always discuss with your doctor or local pharmacist and keep careful records of seizures and symptoms when using any new medication.  Some children with seizures cannot tolerate these types of medication and increases in seizures have been reported from some families.

Teething Babies

There is Dentinox Teething Tooth Paste.  This has a mild flavour that seems quite low in carbohydrates if you need some kind of teething gel and/or use a cooling gel teething toys.

Lip Salves

Petroleum Jelly Vaseline lip salves that you can get in little round pots are good and it is better to go for the plain ones rather than the flavoured ones in case you have a little one that spends the entire time licking it off their lips.


Baking Soda Toothpaste is usually lower in carbohydrates so these types are usually recommended.  For little ones there is a Tom’s of Maine Silly Strawberry flavour that is also available.

Shampoo and Conditioner

Any variety can be used.

Suncream and Skin Moisturisers

Any variety can be used.

IF you should notice a drop in ketones after starting to use a skin cream or sun cream then please investigate every other possibility of lowered ketones/increased seizure activity such as:

  1. Hot weather can affect those with complex epilepsy and increase seizure activity due to intolerance to heat, being extra tired or needing extra fluids.
  2. Some conditions are extremely heat sensitive.
  3. Better weather can mean an increase in activities which would result in the requirement of additional calories.
  4. Check food labels to see if anything has been ‘new and improved’ or values have changed.
  5. Check there are no possible food cheats.

In our own clinical experience and from talking to many professionals and biochemists, it is unlikely that these creams will lower ketone levels.   So unless you are eating these products you should be safe to use any variety.

However, until there is a firm consensus on this subject – we recommend that you eliminate every other possible cause of increased seizures/lowered ketones before worrying about sun cream, skin cream or shampoo’s.