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Give a cold shoulder to cough medicines for your kid, say experts


By Sumit Kumar, Section Health
Posted on Tue Oct 23, 2007 at 02:21:35 AM EST

The Food and Drug Administration (FDA) in the US has voted in favour of a ban on over-the-counter cold and cough medicines meant for children below the age of six years.

Welcoming the FDA stance, which claimed that there was little proof that such medicines eased cold and cough symptoms in children, paediatrics in Delhi said a ban on similar drugs is required in India as well.

CHILL PILLS

  • Don't give your child cold and cough medicines without getting them clinically examined.
  • Never give drugs on the recommendation of chemists.
  • Don't give a combination without consulting a doctor.
  • Avoid frequent use of vapour rubs & nasal drops * Give child time to recover & don't start self-medication.
  • Watch out for any signs of your child reacting to any of the medicines

Over-the-counter drugs are medicines that can be sold without prescriptions, as opposed to prescription drugs. The FDA panel said there were rare reports of such medicines causing serious harm in children.

Children are more susceptible to cold than adults and might suffer from it six to 10 times a year. Some of the common cold and cough medicines available over the counter are antihistamines (for allergies) expectorants (used in cough syrups and clears the nasal tract), suppressants (medicines that suppress cough), decongestants (used to relieve nasal congestion), bronchial dilators and mucolytes.

``It is quite common for people to not consult a doctor for common cold and cough. OTC cough and cold medicines can do little harm to adults but for children, especially those below the age of five years, they can sometimes be fatal,'' said Dr S K Mittal, department of paediatrics, Max Healthcare.

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Dr Sanjeev Bagai, HOD paediatrics at Rockland Hospital, added that what anxious parents don't know is that most of these cough and cold medicines are prescribed in proportion to the body weight and hence, in children it can easily lead to an overdose.

Said Dr Anita Bakshi, paediatric intensivist, Apollo Hospital: ``More than content of these medicines, it is the possibility of an overdose that is worrying. Many of the cough syrups have codeine which is an alkaloid found in opium and can be harmful for children.''

In fact, it has been proposed earlier that droppers, cups and syringes should be standardised for children to avoid any chances of an overdose.

Doctors also add that it is quite common for parents to give their children a combination of medicines which can prove to be hazardous for the child. For instance, antihistamines combined with cold medicines can lead to drying up of respiratory secretions and trigger acute cardio vascular and respiratory events. Similarly, expectorants and decongestants shouldn't be used in combination with antipyretics (used in medicines to reduce fever).

``I get a lot of cases where children develop complications after parents give them OTC drugs without consulting a doctor. There is a medicine known as phenylpropanolamine which has been banned in the US because it can precipitate acute vascular stroke and intracranial haemorrhage. Yet, many paediatric formulation available without prescriptions contain this,'' added Bagai.

The symptoms of overdose to OTC medicine include headache, vomiting, vertigo, restlessness, insomnia and breathing difficulty. In infants, neurological depression, dry mouth constipation, rash, altered blood counts and blurring of the vision are some serious symptoms.

Certain medicines, especially ephedrine (used in decongestants) and those used as drops cause hypertension in children. Prolonged use can lead to headaches, palpitations and visual defects. Antihistamines shouldn't be used by asthmatics either.

Drops are not much safer. In fact, drops are more concentrated than syrups and have more potential to cause harm. Similarly, various popular decongestive therapies which are applied on the skin and chest and often carry a strong odour can lead to serious broncho spasms.

An FDA report presented recently shows that from 1969 to 2006, at least 54 children died after taking decongestants and 69 died after taking antihistamines.

From: Times Of India, Oct-23-07

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