Cough, Cold Drugs Not for Kids Under 4

from WebMD — a health information Web site for patients

Miranda Hitti

October 07, 2008

October 7, 2008 — Don't use over-the-counter pediatric cough and cold drugs in kids younger than 4.

Leading makers of over-the-counter pediatric cough and cold drugs are putting that message on the products' labels, according to the Consumer Healthcare Products Association (CHPA), a trade group for makers of over-the counter drugs.

The label change comes after consulting with the FDA, which has been reviewing the safety of over-the-counter pediatric cough and cold drugs. But the FDA didn't order the label change; drugmakers did that voluntarily.

"We support this voluntary action that's been taken by the industry," Janet Woodcock, MD, director of the FDA's Center for Drug Evaluation and Research, said today at a news conference. “Parents should follow, very carefully, the directions on the package” and not give children multiple products at the same time, says Woodcock.

Nonprescription pediatric cough and cold medicines are covered by rules that date back 30 to 40 years, and modern studies of the drugs – including clinical trials in children -- are needed, notes Woodock, adding that that process may take several years.

The issue isn't an ingredient in the drugs, but dosing errors, notes the CHPA. Pediatric cough and cold drugs are "safe and effective when used as directed," says the CHPA, adding that dosing errors and accidental ingestions are "the leading causes of rare adverse events in young children."

About 7,000 children under 11 go to emergency rooms each year after taking cough and cold medicines, according to the CDC. Roughly two-thirds of those occurred after children drank medication while unsupervised, according to the CDC.

The goal of the label change is to encourage "the appropriate use of these medicines," says the CHPA.

The new labels will start showing up on store shelves this year. The CHPA says there are no plans to take products with the old labels off the shelves since the FDA hasn't indicated a need to do so.

In January, the FDA urged parents and caregivers not to give over-the-counter cough and cold drugs to kids younger than 2. Drugmakers voluntarily took over-the-counter infant cough and cold drugs off the market in October 2007.

Don't Use Products to Make Kids Sleepy

Don't use over-the-counter pediatric cough and cold drugs containing antihistamines to sedate or make a child sleepy. Pediatric cough and cold drugmakers are voluntarily adding language to that effect to the label of products containing certain antihistamines.

The CHPA is also stressing these key points to parents, caregivers, and health care providers:

  • Follow the dosing recommendations exactly and use the measuring device that comes with the medicine.

  • Do not give a medicine only intended for adults to a child.

  • Do not use two medicines at the same time that contain the same ingredients.

  • Prevent unsupervised ingestions by keeping all medicines out of the reach and sight of children.

  • Do not use antihistamine products to make a child sleepy.

  • Consult a physician or health care professional with questions.

What Can You Give Kids?

If over-the-counter cough and cold drugs are off limits for kids younger than 4, what can you give those children?

Nothing cures a cold, but pediatricians say these strategies may help:

  • Keep kids hydrated.

  • Reduce the child's fever using appropriate medication (check with a doctor).

  • Consider using honey for coughs or sore throat for kids older than 1.

  • To ease congestion, consider using saline nasal drops or a humidifier, and keep the child's head elevated when resting (tuck a rolled-up towel under the crib mattress for small kids, and between the mattress and box spring for older children).

Of course, parents should seek medical care as needed and not hesitate to ask questions.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.