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PrintA guide to over-the-counter medication for kids
A primer on what parents should know about giving their kids medication that can be purchased without prescription.
When my child has a runny nose, cough or a fever, I often wonder if I should try one of the over-the-counter (OTC) cough and cold medicines available at my pharmacy. Are these medications safe? And which one is right for my child?
Over-the-counter drugs are sold without a prescription in pharmacies and other stores.
There are dozens of these drugs on the market for common cold symptoms, such as a runny nose, congestion, sore throat, headache or cough.
However, because they are easy to acquire does not mean that they are effective or that they are safe. Except for pain and fever drugs, there is no proof that they work. In fact, some of the side effects can make your child feel even worse.
As well, OTC medications should not be given to babies and children under the age of 6. The only exceptions are drugs used to treat fever (such as ibuprofen and acetaminophen). Children under 6 should not be given a cough and cold product intended for an older child or an adult, even at a smaller dose. If your child is over 6 and you plan to use an OTC medication, be sure to follow dosing instructions very carefully.
If you go to a pharmacy, you’ll probably see the following medications on the shelves:
Cough syrups
Coughing is stressful when it keeps children awake at night, but coughing can also be productive. It can be a sign that the body is getting rid of mucus that irritates the airways. Syrups that stop, or claim to stop, this normal response can be harmful to children.
Many cough and cold products contain drugs to ease coughing, often either dextromethorphan (also called DM) and/or diphenhydramine. Codeine is another drug used to reduce coughing in children. Some OTC drugs contain codeine, but these usually require a prescription. Most studies on these drugs have been done with adults. The few that have been done with children have shown that these products have no benefit.
Decongestants
Oral decongestants (pills or syrups taken by mouth) are taken to reduce swelling and stuffiness in the nose due to colds. Decongestants can offer some relief but they won’t cure the problem. They can cause a rapid heartbeat, restlessness or insomnia in children.
Antihistamines
Antihistamines are usually used to dry up a runny nose or reduce sneezing caused by allergies. They can also ease itching from conditions like hives, chickenpox or insect bites. Antihistamines will not help someone with a cold.
Nasal drops or sprays
Nose drops or nose sprays containing saline (a weak salt water solution) can be used to soften the mucus in the nose and help your child to breathe easier. Do not use nasal drops or sprays that contain drugs.
Pain and fever relievers
The most common OTC pain relievers are acetylsalicylic acid (ASA), acetaminophen and ibuprofen. Products with acetylsalicylic acid (such as Aspirin) should not be given to children or teenagers for a fever from colds, chickenpox and influenza because it can cause Reyes syndrome, an illness that can cause brain and liver damage.
For fever and mild-to-moderate pain in children, you should use acetaminophen or ibuprofen. Acetaminophen is found in products such as Tylenol, Tempra, Panadol and others. Ibuprofen is found in products such as Advil or Motrin. These products come in drops for infants, liquid for toddlers and chewable tablets for older children. They should only be used for pain and for a fever greater than 38.5°C. Ibuprofen should only be given if your child is drinking reasonably well. Do not give ibuprofen to babies under 6 months without first consulting your doctor.
Remember that fever is a normal and helpful response to an infection. If your child has a fever but feels otherwise well, it is not always necessary to give him fever-lowering medication. When babies under 6 months have a fever, call your doctor for advice.
When using OTC drugs, be very careful never to use more than one product at the same time unless advised by your doctor. Products such as cough syrups may also contain a fever reliever, so by giving you child a dose of the syrup and a dose of Tylenol, for example, you have exceeded the correct amount of pain reliever needed for your youngster.
If your child has a cold, give him plenty of fluids and encourage him to rest. Colds are caused by viruses, which cannot be cured with drugs. They simply need to run their course, so there is little your doctor can offer.
Dr. Denis Leduc is a general pediatrician in the Montreal area. He is a Past President of the Canadian Pediatric Society.
For more information on your child’s growth and development, visit www.caringforkids.cps.ca or www.soinsdenosenfants.cps.ca.
