Over-the-Counter Dangers and Children
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Every year, children DIE from taking children's over-the-counter cough and cold medications.
Potentially life-threatening side effects are suffered by thousands of children because of these medications.
Children overdose on OTC medications even when given the “recommended dose”
Early signs of overdose:
NOTE: It is difficult even for doctors, to tell the difference between the early signs of overdose and “the normal” symptoms of a child being sick — always tell the doctor if you have given over-the-counter cough and cold medications to your child.
Late signs of overdose: Irregular heartbeat, seizures, coma, death.
Medical experts recommend never giving these medications to children under 6 years old.
The CDC, FDA, and the American Academy of Pediatrics warn about the dangers of using conventional children's cough and cold medications.
IN THE NEWS
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Is it safe to give your child something for the sniffles? |
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Acetominiphen overdose in children - more common than you think |
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Cold and Cough Medicines: Information for Parents |
Read more articles about
over-the-counter medications and children, below |
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Be informed. Read independent news reports about the dangers of Children's Over-the-Counter Cough and Cold medications:
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Is it safe to give your child something for the sniffles? |
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Acetominiphen overdose in children - more common than you think |
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MDs back cold syrup warning for tots, FDA says medicines should not be given to kids younger than 2 |
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Cold and Cough Medicines: Information for Parent s “7,000 children ages 11 and younger go to hospital emergency rooms after taking cold and cough medicines…” “Children between the ages of 2 and 5 are most often affected.” |
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FDA: Public Health Advisory Nonprescription Cough and Cold Medicine Use in Children FDA Recommends that Over-the-Counter (OTC) Cough and Cold Products not be used for Infants and Children under 2 Years of Age |
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AMERICAN ACADEMY OF PEDIATRICS URGES CAUTION IN USE OF OVER-THE-COUNTER COUGH AND COLD MEDICINES |
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CDC - MMWR: Infant Deaths Associated with Cough and Cold Medications --- Two States, 2005 |
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What the Experts Say: A reference list of scientific and medical research resources.
Below are medical references on the general toxicity, heart problems, neurological problems, allergic reactions, and psychosis associated with children's cough and cold medicine. Included are also studies of addiction and abuse to these medications by older children. Also included is evidence that indicates conventional children's cough and cold medicines are no better than placebos in relieving cough.
General Toxicity of Children's Cough and Cold Medications
American Academy of Forensic Sciences. Registry of Human Toxicology . Colorado Springs, CO: American Academy of Forensic Sciences; 1978
American Academy of Pediatrics, Committee on Drugs Use of codeine- and dextromethorphan-containing cough remedies in children . Pediatrics 1997; 99:918-920 [Abstract/ Free Full Text]
Baselt RC. Disposition of Toxic Drugs and Chemicals in Man . 5th ed. Foster City, CA: Chemical Toxicology Institute; 2000 Cetaruk EW, Aaron CK Hazards of nonprescription medications . Emerg Med Clin North Am 1994; 12:483-510 [Medline]
DeZeeuw RA, Johnkman JHG. Genetic differences in oxidative drug metabolism . In: Proceedings of the International Association of Forensic Toxicologists; Groningen, Netherlands. 1988:53-64 Food and Drug Administration. Public Health Advisory Subject: Phenylpropanolamine . Available online at: www.fda.gov/cder/drug/infopage/ppa/advisory.htm
Gadomski A, Horton L The need for rational therapeutics in the use of cough and cold medicine in infants. Pediatrics 1992; 89:774-776 [Abstract/ Free Full Text]
Holt GA, Hollon JD, Hughes SE, Coyle R. OTC labels: can consumers read and understand them? Am Pharm . 1990; NS30:51-54
Holt GA, Dorcheus L, Hall EL, Beck D, Ellis E, Hough J. Patient interpretation of label instructions . Am Pharm . 1992; NS32:58-62 Katona B, Wason S. Dextromethorphan danger . N Engl J Med. 1986; 314(15):993. ISI | PUBMED
Konrad D, Sobetzko D, Schmitt B, Schoenle EJ. Insulin-dependent diabetes mellitus induced by the antitussive agent dextromethorphan . Diabetologia. 2000; 43(2):261-262. FULL TEXT | ISI | PUBMED
Lake CR, Gallant S, Masson E, Miller P Adverse drug effects attributed to phenylpropanolamine: a review of 142 case reports . Am J Med 1990; 89:195-208 [CrossRef] [Medline]
Litovitz T, Manoguerra A Comparison of pediatric poisoning hazards: an analysis of 3.8 million exposure incidents . Pediatrics 1992; 89:999-1006 [Abstract/ Free Full Text]
Myer P, Bryant B, Cartwright GW Overdose with a combination decongestant, antihistamine and antitussive syrup . Indiana Med 1985; 78:766-768 [Medline]
Pender ES, Parks BR Toxicity with dextromethorphan-containing preparations: a literature review and report of two additional cases . Pediatr Emerg Care 1991; 7:163-165 [Medline]
Pentel P Toxicity of over-the-counter stimulants . JAMA 1984; 252:1898-1903 [Abstract]
Rammer L, Holmgren P, Sandler H. Fatal intoxication by dextromethorphan: a report on two cases . Forensic Sci Int. 1988; 37(4):233-236. FULL TEXT | ISI | PUBMED
Shaul WL, Wandell M, Robertson WO. Dextromethorphan toxicity: reversal by naloxone . Pediatrics. 1977; 59(1):117-118. FREE FULL TEXT
Heart Problems from Children's Cough & Cold Medicine
Burton BT, Rice M, Schmertzler LE Atrioventricular block following overdose of decongestant cold medication. J Emerg Med 1985; 2:415-419 [CrossRef] [Medline]
Bye C, Hill HM, Hughes DT, Peck AW A comparison of plasma levels of L(+) pseudoephedrine following different formulations and their relation to cardiovascular and subjective effects in man . Eur J Clin Pharmacol 1975; 8:47-53 [CrossRef] [Medline]
Conway EE, Walsh CA, Palomba AL Supraventricular tachycardia following the administration of phenylpropanolamine in an infant . Pediatr Emerg Care 1989; 5:173-174 [CrossRef] [Medline]
Gardin JM, Schumacher D, Constantine G, Davis KD, Leung C, Reid CL Valvular abnormalities and cardiovascular status following exposure to dexfenfluramine or phentermine/fenfluramine. JAMA 2000; 283:1703-1709 [Abstract/ Free Full Text]
Rostagno C, Caciolli S, Felici M, Gori F, Neri Serneri GG Dilated cardiomyopathy associated with chronic consumption of phendimetrazine . Am Heart J 1996; 131:407-409 [CrossRef] [Medline]
Weesner KM, Denison M, Roberts RJ Cardiac arrhythmias in an adolescent following ingestion of an over-the-counter stimulant . Clin Pediatr 1982; 21:700-701 Neurological Problems from Children's Cough & Cold Medicine Au WY, Cheng TS, Siu TS, Tam S. Cerebellar degeneration and folate deficiency due to cough mixture abuse . Haematologica. 2005; 90(suppl):ECR28. FREE FULL TEXT
Au WY, Tsang J, Cheng TS; et al. Cough mixture abuse as a novel cause of megaloblastic anaemia and peripheral neuropathy . Br J Haematol. 2003; 123(5):956-958. FULL TEXT | ISI | PUBMED
Graudins A, Fern RP. Acute dystonia in a child associated with therapeutic ingestion of a dextromethorphan containing cough and cold syrup . J Toxicol Clin Toxicol. 1996; 34(3):351-352. ISI | PUBMED
Kernan WN, Viscoli CM, Brass LM, Phenylpropanolamine and the risk of hemorrhagic stroke . N Engl J Med 2000; 343:1826-1832
Nairn SJ, Díaz JE. Cold-syrup induced movement disorder . Pediatr Emerg Care. 2001; 17(3):191-192. FULL TEXT | ISI | PUBMED
Allergic Reactions from Children's Cough & Cold Medicine
Cook J, Stith M, Sahn EE. Bullous mastocytosis in an infant associated with the use of a nonprescription cough suppressant . Pediatr Dermatol. 1996;13(5):410-414. ISI | PUBMED
Knowles SR, Weber E. Dextromethorphan anaphylaxis . J Allergy Clin Immunol. 1998;102(2):316-317. FULL TEXT | ISI | PUBMED
Psycosis from Children's Cough & Cold Medicine Dodds A, Revai E. Toxic psychosis due to dextromethorphan hydrobromide . Med J Aust. 1967;2:231 Miller SC. Dextromethorphan psychosis, dependence and physical withdrawal . Addict Biol. 2005;10(4):325-327.
Polles A, Griffith JL. Dextromethorphan-induced mania . Psychosomatics. 1996;37(1):71-74. FREE FULL TEXT
Sharma A, Dewan V, Petty F. Acute psychosis with Coricidin cold medicine . Ann Pharmacother. 2005;39(9):1577-1578.
Walker J, Yatham LN. Benylin (dextromethorphan) abuse and mania . BMJ. 1993;306(6882):896. ISI | PUBMED
Addiction & Abuse of Cough Medicine by Older Children
Bryner JK, Wang UK, Hui JW, Bedodo M, MacDougall C, Anderson IB. Dextromethorphan abuse in adolescence: an increasing trend : 1999-2004. Arch Pediatr Adolesc Med. 2006;160(12):1217-1222. FREE FULL TEXT
Cranston JW, Yoast R. Abuse of dextromethorphan . Arch Fam Med. 1999;8(2):99-100. FREE FULL TEXT
Darboe MN, Keenan GR Jr, Richards TK. The abuse of dextromethorphan-based cough syrup : a pilot study of the community of Waynesboro, Pennsylvania. Adolescence. 1996;31(123):633-644. ISI | PUBMED
Falck R, Li L, Carlson R, Wang J. The prevalence of dextromethorphan abuse among high school students . Pediatrics. 2006;118(5):2267-2269. FREE FULL TEXT
Fleming PM. Dependence on dextromethorphan hydrobromide . Br Med J (Clin Res Ed). 1986;293(6547):597. ISI | PUBMED
Joffe A. Your role in curbing prescription and OTC drug abuse by adolescents . Contemp Pediatr. 2006;23:97-102. McCarthy JP. Some less familiar drugs of abuse . Med J Aust. 1971;2(21):1078-1081. ISI | PUBMED
McFee RB, Mofenson HC, Caraccio TR. Dextromethorphan: another "ecstasy"? Arch Fam Med. 2000;9(2):123. FREE FULL TEXT
Murray S, Brewerton T. Abuse of over-the-counter dextromethorphan by teenagers . South Med J. 1993;86(10):1151-1153.
Noonan WC, Miller WR, Feeney DM. Dextromethorphan abuse among youth . Arch Fam Med. 2000;9(9):791-792. FREE FULL TEXT
Schwartz RH. Adolescent abuse of dextromethorphan . Clin Pediatr (Phila). 2005;44(7):565-568. FREE FULL TEXT
Children's Cough and Cold Medications are no better than Placebos
Clemens CJ, Taylor JA, Almquist JR, Quinn HC, Mehta A, Naylor GS Is an antihistamine-decongestant combination effective in temporarily relieving symptoms of the common cold in preschool children? J Pediatr 1997; 130:463-466 [CrossRef] [Medline]
Hutton N, Wilson MH, Mellits D, Effectiveness of an antihistamine-decongestant combination for young children with the common cold: a randomized, controlled clinical trial . J Pediatr 1991; 118:125-130