Using Over-the-Counter Drugs to Treat Cold Symptoms

Over-the-counter (OTC) drugs are sold in pharmacies and other stores without a doctor's prescription. There are dozens of OTC drugs on the market for common cold symptoms — a runny nose, congestion, sore throat, headache or cough — but just because they're easy to get doesn't mean they always work, or that they're safe. The best treatment for a cold is still plenty of rest and liquids. Do not give cough and cold medications to babies and children under 6 years old without first talking to your doctor — the only exceptions are drugs used to treat fever, such as ibuprofen and acetaminophen.

What should I do if my child has a cold?

Offer plenty of fluids and encourage rest. Colds are caused by viruses that cannot be cured with drugs — they simply need to run their course. However, more serious problems can start out looking like a cold. Contact your doctor if your child has an earache, a fever lasting more than 72 hours (or any fever in a child under 6 months), excessive sleepiness, crankiness or fussiness, trouble breathing, less urination, or a cough that lasts more than a week or causes choking or vomiting.

Should I use OTC medications when my child has a cold?

Except for pain and fever drugs, there is no proof that cough and cold medicines work — in fact, some side effects can make your child feel worse. There is also a risk of giving too much medicine, such as acetaminophen on top of a cough syrup that already contains acetaminophen. Never use more than one product at the same time unless advised by your doctor.

Cough syrups

Coughing can be helpful — it's a sign the body is clearing mucus that irritates the airway, and syrups that stop this normal response can be harmful to children. Many OTC products contain dextromethorphan (DM) and/or diphenhydramine; codeine is another cough suppressant, usually available only by prescription. Most studies of these drugs have been done in adults — the few done in children show no benefit.

Decongestants

Oral decongestants (pills or syrups) are from the same drug family as adrenaline, and reduce swelling and stuffiness in the nose. They can offer some relief but won't cure the problem, and can cause a fast heartbeat, restlessness or insomnia in children.

Antihistamines

Antihistamines are usually used to dry up a runny nose or reduce sneezing caused by allergies, and can ease itching from hives, chickenpox or insect bites. They won't help someone with a cold, and can cause side effects like drowsiness if used that way.

Nasal drops or sprays

Nose drops or sprays containing normal saline can soften mucus and help your child breathe more easily. Do not use nasal drops or sprays that contain drugs, and don't use hypertonic (3% or extra strong) nasal drops without talking to your doctor.

Pain and fever relievers

The most common OTC pain relievers are acetylsalicylic acid (ASA), acetaminophen and ibuprofen. Products containing ASA (such as Aspirin) should never be given to children or teenagers for fever from colds, chickenpox or influenza, because it can cause Reye's syndrome — a sickness that can cause brain and liver damage.

For fever and mild-to-moderate pain, use acetaminophen (Tylenol, Tempra, Panadol) or ibuprofen (Advil, Motrin) — available as infant drops, toddler liquid or chewable tablets. Ibuprofen should only be given if your child is drinking reasonably well, and not to babies under 6 months without talking to your doctor first. Don't combine ibuprofen and acetaminophen with any other pain or fever reliever unless your doctor advises it, and read labels carefully — different cold medicines can contain the same drug, risking a double dose.

Natural health products

"Natural" doesn't always mean safe — some substances can be harmful in excess, and others can cause side effects or allergic reactions. Even products safe for adults may not be safe for children, whose growing bodies can respond differently. Natural health products can also interact with other drugs, even nonprescription ones — talk to your child's doctor before giving any natural health product.