Recommendations for the Use of OTC Cough and Cold Medications in Children

Ann McMahon Wicker, PharmD, BCPS; Brice A. Labruzzo, PharmD


US Pharmacist. 2009;34(3):33-36. 

In This Article


Guaifenesin is the only nonprescription expectorant available for use in children. It is an oral mucolytic that helps loosen phlegm and bronchial secretions by increasing respiratory-tract secretions, which leads to a more productive cough and better airway clearance.[6] If the cough lasts for more than one week, recurs, or is accompanied by a fever, rash, or persistent headache, consultation with a primary health care provider is recommended. Adverse effects associated with guaifenesin include nausea, vomiting, dizziness, drowsiness, headache, and rash.

Guaifenesin should be taken with a full glass of water, and adequate hydration during use should be maintained. The extended-release tablets should not be chewed or crushed; therefore, if the patient cannot swallow the tablet, a different dosage form--such as syrup, solution, liquid, or minimelt (oral granule)--should be used. The most effective way to administer the oral granules is to place them on the tongue and swallow them without chewing; they may have an unpleasant taste if chewed. Appropriate dosing for children aged up to 6 years is as follows: age under 2 years, individualized dose (common dosing = 25-50 mg every four hours, with an MDD of 300 mg); age 2 to 6 years, 50 to 100 mg every four hours, with an MDD of 600 mg.[4,5,6]