Clever Currents: Children’s Cold and Cough Medicines – Can They Really Be So Dangerous?

Last month, the FDA issued this advisory warning to parents: NEVER give cough and cold medicines to children younger than 2 years old unless your doctor has instructed you to do so. The agency is very concerned about the hundreds of adverse reactions and several deaths resulting from popular children’s medicines containing dextromethorphan (often DM in a drug’s brand name) and pseudoephedrine (a decongestant). Adverse effects include hallucinations and abnormal movements (dextromethorphan) and increased blood pressure and irregular heartbeats (pseudoephedrine).

Accidental overdoses happen for at least three reasons:

Parents buy different branded products that have the same active ingredient, and they give the child a double dose

“Infant” formulations are about triple-strength to “children’s” strength (with a special dose-measurer because babies can only swallow so much fluid) and sleep-deprived parents can easily give the infant too much medicine

A child with several well-meaning relatives and caregivers can be given medicine by each without the other’s knowledge. Pharmaceutical companies are now substituting the decongestant phenylephrine in place of pseudoephedrine in their over-the-counter versions due to FDA legislation

The Blue Lake take on it:

This is a tough one. Children in the U.S. average 6-10 colds per year, many more than adults. When your child is sick, you would do almost anything to “make it go away.” It’s not worth the risk to give OTC cold/cough medicines to the under-2-years set without first talking to your pediatrician. But it is important to know that these active ingredients were approved for use in children years ago, before testing on children was required. Most children’s cough and cold formulations still have not been thoroughly tested in children, and recent studies show that they work no better than placebos. Read The American Medical Association’s article to find out more. We agree with the position of Dr. Wayne Snodgrass, the chair of The American Academy of Pediatrics who says, “Personally in a common cold in a young child, I wouldn’t recommend these agents.” Dr. Snodgrass is one of the authors of a petition to the FDA to ban marketing of these drugs for children less than 6 years of age. If you do decide to use these drugs, pay close attention to labels and educate yourself on dosages. The East Coast grocery chain Wegman’s has an online explanation of children’s medicines including dosage guidelines.