Cold Medicine For Children: Safety, Side Effects & Precautions

Cold medicines for children should be used judiciously to prevent adverse effects.

Medically reviewed by Dr. Dur Afshar Agha, MS Dr. Dur Afshar Agha Dr. Dur Afshar AghaMS facebook_iconinsta_icon Specialty: Masters of Tropical PediatricsExperience: 26 years
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Common cold refers to viral infections in the upper respiratory tract, and rhinoviruses are the most common cause. When considering cold medicines for kids, it is advisable to check with the health care provider. The medicines offer symptomatic relief in cold but are mostly incapable of altering the duration or course of the disease. They act by managing the symptoms such as runny or stuffy nose, congestion, sneezing, sore throat, cough, and a fever. Antibiotics cannot cure a cold as they are meant to treat bacterial infections and not those caused by viruses (1).

The following post talks about the types of cold medicines for children, side effects, concerns, precautions, and alternatives to treat the common cold.

Are Cold Medicines Safe For Children?

Common cold is self-limiting, and you should use medicines only if needed. Government and medical bodies of various countries have laid down instructions for the safe use of cold medications in children.

  • The US Food and Drug Administration (FDA) disapproves the use of over-the-counter (OTC) or prescription medicines for the common cold in children below two years of age. FDA restricts the use of products containing codeine or pholcodine below 18 years of age (2).
  • The American Academy of Pediatrics (AAP) does not recommend OTC cold medications for children younger than four years and advises approval from a registered medical practitioner for children between four to six years.
  • The Consumer Healthcare Products Association (CHPA) mandates labeling instructions saying not to use cold medications in children below four years (3) (4).
  • The government of the UK approves the use of OTC cold medicines only in children above six years of age (5).

What Cold Medications Are Available For Children?

Common cold is often associated with multiple symptoms such as cough and fever. Most of the medications for the common cold contain more than one ingredient to address the symptoms. The following table may help you to identify commonly used drugs for common colds in children (6) (7) (8) (9).

Class of medicationActive IngredientsFunctionBrand names
DecongestantOral Phenylephrine, Pseudoephedrine Nasal drops or nasal sprays – Oxymetazoline, XylometazolineUnclog stuffy noseAdvil, Neosynephrine, Sudafed, Otrivine
AntipyreticsAcetaminophenReduces fever and mild body achesFeverall, Tylenol
AnalgesicsNSAIDs, IbuprofenReduces body painsAdvil, Motrin
AntihistaminesChlorpheniramine, brompheniramine, Diphenhydramine, CetirizinRelief from runny nose or allergiesBenadryl, Dimetapp Zyrtec

What Are The Side Effects Of Cold Medications?

The side effects of OTC cold medications may vary with the active ingredients present in them. They may be summarized as (10):

  • Drowsiness
  • Increased or altered heart rate
  • Shallow breathing
  • Hallucination
  • Seizures
  • Allergic reactions such as rashes
  • Nausea
  • Constipation

Drowsiness or sleepiness is the most common side effect of OTC cold medications. However, you should consult a pediatrician if it is very severe or side effects appear.

What Are The Concerns With Cold Medicines In Children?

The majority of cold medications contain a mixture of two or more active ingredients, which increases the chance of overdosing in children if more than one preparation is used. Some other concerns include (11):

  • Safe doses of many of the ingredients have not yet been studied properly in children.
  • Cold medications do not improve symptoms of cold to a large extent in children
  • Rare fatalities have been reported in young children.

What Precautions Should Be Taken?

The precautions to be taken while giving cold medicines to children include the following (12) (13).

  • Make sure the cold remedy you choose is for children. Do not give any formulation meant for adults to your child.
  • Avoid using more than one OTC cold medication for your child.
  • Aspirin in any form should not be given to children. It increases the risk of a rare disease, Reye’s syndrome, which causes inflammation in the liver and brain.
  • Check packet inserts of medications to note dosage, list of ingredients, and special instructions to avoid any mistake.
  • Do not use ordinary kitchen spoons to measure liquid medications. Make sure you use the measuring device, such as a calibrated dropper or cup, provided with the pack to administer the correct dose and minimize the chances of overdosing.
  • Consult a doctor if the symptoms of the common cold do not subside after two weeks and become severe.
  • Keep all medications out of children’s reach.

What Are The Alternatives To Relieve Cold Symptoms In Children?

The body can cure itself of the common cold in a week or two. In the meantime, you can reduce the discomfort of your child through some simple measures (11).

  • Ensure that the child has adequate rest.
  • Use saline (saltwater) drops or sprays to unclog stuffy nose and ease breathing.
  • Use a cool-mist humidifier in your child’s room. It helps in reducing swelling in the nasal passages and keeping the mucus thin. Make sure to clean out and dry the humidifier to avoid any bacterial or fungal growth.
  • Keep your child away from any secondhand smoke.

Cold medications may relieve some symptoms of the common cold but cannot cure it. You should not use multiple OTC cold remedies to treat your child as they may contain the same ingredients resulting in double dosing. Use the provided dosing tool to ensure the correct measurement of medicines. It is always advisable to consult a pediatrician to seek a prescription for the most suitable cold medication for your child.

Key Pointers

  • Common cold in children is self-resolving and seldom needs medical intervention.
  • The American Academy of Pediatrics (AAP) advises avoiding OTC cold medications for children below four. Likewise, you must give cold medications to older children only with a doctor’s consent.
  • Nasal drops, analgesics, and antihistamines are the common cold medications for children, which should be given only on the doctor’s advice.
  • Avoid giving more than one OTC medicine and aspirin as they pose the risk of side effects.

References

  1. Antibiotic Use Questions and Answers.
    https://www.cdc.gov/antibiotic-use/q-a.html
  2. When to Give Kids Medicine for Coughs and Colds.
    https://www.fda.gov/consumers/consumer-updates/when-give-kids-medicine-coughs-and-colds
  3. Leslie A. Briars, The Latest Update on Over-the-Counter Cough and Cold Product Use in Children.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3461939/
  4. Program on OTC Oral Pediatric Cough and Cold Medicines.
    https://www.chpa.org/public-policy-regulatory/voluntary-codes-guidelines/program-otc-oral-pediatric-cough-and-cold
  5. Over-the-counter cough and cold medicines for children.
    https://www.gov.uk/drug-safety-update/over-the-counter-cough-and-cold-medicines-for-children
  6. Cough, Cold & Flu.
    https://www.knowyourotcs.org/symptom/cough-cold-and-flu/
  7. Medicines for Cough and Common Cold in Children.
    https://www.drugoffice.gov.hk/eps/do/en/consumer/news_informations/dm_36.html#a.
  8. Cough And Cold Medicine Over-The-Counter (OTC).
    https://www.nationwidechildrens.org/family-resources-education/health-wellness-and-safety-resources/helping-hands/cough-and-cold-medicine-over-the-counter-otc
  9. Otrivine.
    https://www.medicines.org.uk/emc/files/pil.6156.pdf
  10. Cough and cold medicines for children – changes.
    https://www.tga.gov.au/behind-news/cough-and-cold-medicines-children-changes
  11. Colds in Children.
    https://www.mottchildren.org/posts/your-child/colds-children
  12. Use Caution When Giving Cough and Cold Products to Kids.
    https://www.fda.gov/drugs/special-features/use-caution-when-giving-cough-and-cold-products-kids
  13. Cold, cough, allergy, bronchodilator, and antiasthmatic drug products for over-the-counter human use.
    https://www.ecfr.gov/current/title-21/chapter-I/subchapter-D/part-341
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Dr. Dur Afshar Agha is a consultant pediatrician with around 26 years of experience in various medical facilities both in Pakistan and Saudi Arabia. She has headed the Department of Preventive Pediatrics at the prestigious, Children’s Hospital and Institute of Child Health in Pakistan and is a life member of the Pakistan Paediatric Association.

Read full bio of Dr. Dur Afshar Agha
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