OTC Cold Meds Not the Best Choice for KidsJan 6, 2009 | Parker Waichman LLP The use of over-the-counter (OTC) cold and cough medications has been a point of concern for some time now in the United States. Early last year, Health Canada—Canada’s federal health agency—recommended parents not give over OTC cold medications to children under the age of two, citing evidence of limited effectiveness in this population, reported Reuters. Reuters also reported last month that Health Canada raised the age to six over issues of misuse and overdosing problems.
Now, Reuters is reporting that the U.S. Food and Drug Administration (FDA) is warning these drugs can adversely affect young children, specifically under the age of six, with side effects such as hives, drowsiness, difficulty breathing, and, in the worst of situations, death.
Esther Yoon, M.D., general pediatrician in the Department of Pediatrics and Communicable Diseases at the University of Michigan Health System, told Reuters that "Some 7,000 children end up in the emergency room each year because of problems associated with these medicines." Reuters added that the Centers for Disease Control and Prevention (CDC) reported that the majority—about two-thirds—of the events took place when children drank medication when not supervised and that “most” events were the result of dosing errors.
Instead of treating young children with OTC cough and cold medications, Reuters said doctors suggest that for “harsh” coughs/throat pain that OTC acetaminophen and ibuprofen be used in age-appropriate doses. For symptoms, Yoon recommends, said Reuters, that nasal saline drops and either bulb suction or the child blowing his/her nose be used for blocked noses; a teaspoon of honey or corn syrup—if the child is over one-year-old—as well as warm fluids (water, apple juice, and chicken broth were suggested) for coughs; hot shower steam to relax airways and coughing spasms; and increased humidity for nasal congestion and coughing.
For prevention, frequent hand washing, hand sanitizer use, hydration, good nutrition, and sufficient sleep, as well as teaching children to cover their mouths and noses when coughing or sneezing, are recommended, said Reuters. Yoon also told Reuters, "Other good tips include disinfecting the home, kitchen countertops, door knobs and toys" and “Children should get plenty of vitamin C and E to help fight germs, and a multivitamin is also helpful." If a child is sick over the typical four-to-five-day length for cold symptoms, Yoon recommends taking the child to his/her pediatrician, unless difficulty breathing or wheezing is present or the child is under three months of age and with a fever, in which case he/she should be seen by a doctor immediately.
In October 2007, some drug makers removed infant versions of medications off the market, including Johnson & Johnson’s Tylenol Plus Cold, Novartis AG’s Triaminic Infant & Toddler Thin Strips Decongestant, and one product sold by Wyeth under its Robitussin brand; Pediacare, Dimetapp, and Little Colds brand products were also recalled. Earlier last year the FDA issued a warning advising that OTC cold and cough medicines should not be given to children under two following a 2007 study conducted by the CDC that found that between 2004 and 2005, 1,500 children under the age of two were injured by common OTC decongestants and antihistamines; a second study by FDA safety reviewers reached similar conclusions and that research revealed that from 1969 to 2006, at least 54 children died after taking OTC decongestants, and 69 died after taking OTC antihistamines.