Over the counter medicine

If a medicine doesn't require a prescription, many parents assume it's safe for their child to take. That's not always the case. Children often need smaller doses than adults take, while other medications aren't meant for kids at all. At Children’s Health℠, we want all kids to feel better, but we also want them to be safe.

What are over-the-counter medicines?

Over-the-counter, or OTC, medicines are any medications you can buy at a drug or grocery store without a prescription. They include many common cold and cough medicines, pain relievers and allergy relief drugs. Some OTC medications, including those for fever and pain, have been studied for safety, dosing and effectiveness in kids. Most haven't.

Common over-the-counter medications for kids

• Allergy medications: Antihistamines provide relief from allergy symptoms and can also help with itching and rashes. Go with non-drowsy medications (Claritin) rather than those that can affect a child's alertness (Benadryl).
• Anti-diarrhea medicines: Some anti-diarrhea medicines work by slowing bowel movements (loperamide). Others also help control nausea and vomiting (bismuth, rehydration fluids). Use bismuth for mild diarrhea and rehydration fluids for moderate to severe cases.
  • Loperamide (Imodium A-D—not for use by kids under 6)
  • Bismuth (Pepto-Bismol, Kaopectate)
  • Rehydration fluids (Pedialyte, Enfalyte)
• Antifungal creams: Antifungal creams (Lotrimin, Mycostatin, Micatin) can clear up diaper rash. Barrier ointments made with zinc oxide (A&D) or petroleum jelly (Vaseline) can help prevent it.
• Cold medicines: Always talk to your doctor before giving any OTC cold medication to your child—even if it's labeled for kids. Cold medicines often contain several different kinds of drugs that can cause reactions in some kids. Many also contain acetaminophen, so you may be giving your child an extra dose if she's already taking Tylenol.
• Cough medicines: Cough medicines may break up mucus, suppress the urge to cough or soothe the throat. Cough medicines for kids include:
  • Liquid cough medicines (Children's Robitussin, Vick's Children's Cough Medicine)
  • Menthol throat lozenges (can be a choking hazard for young children)
• Decongestants: help relieve a runny nose and stop postnasal drip. Ask your doctor before giving spray decongestants to kids under 6 or any decongestant to children younger than 4. Decongestants include:
  • Nasal sprays: oxymetazoline (Afrin Children's, Kids Sinol)
  • Oral decongestants: pseudophedrine (Children's Sudafed, Dimetapp, Triaminic AM)
• Fever medications: Acetaminophen and ibuprofen can help reduce fever in children. DO NOT give aspirin to a child unless your doctor says it's okay. Aspirin has been linked to Reye's syndrome in children.
• Pain relievers: Pain medicines can help with headache, sprains or other minor joint and muscle pain. They include:
  • Acetaminophen (Tylenol)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) include ibuprofen (Advil) and naproxen (Aleve)
• Sore throat relief: Help soothe sore throat pain. Common treatments include:
  • Sprays to numb pain: dyclonine (Cepacol - not for use by kids under 6) and phenol (Chloraseptic Kids)
  • Lozenges: Sucking on throat lozenges sooth a sore throat but be careful due to the choking risk (Sucrets and Cepacol Cherry)

Supplements and vitamins

Many OTC dietary supplements, including vitamins and herbal medicines, haven't been tested for safety or effectiveness in kids. Because children's bodies are still developing, they don't always metabolize supplements the way adults do. That can mean different side effects, especially in infants and younger children. The National Center for Complementary and Alternative Medicine (NCCAM) offers the following cautions:

• Supplements can interact with other medications your child is taking. A common example is that vitamin C slows down the body's ability to process acetaminophen (Tylenol). 
• The hormone melatonin (a sleep aid) can alter the levels of other hormones in young children. Kids with medical conditions including diabetes, kidney or liver disease, cerebral palsy and other hormonal disorders shouldn't take melatonin.
• St. John's Wort is often given to kids for anxiety or depression, but it can have dangerous interactions with several medications.
• Though generally safe for gastrointestinal disorders, probiotics shouldn't be given to critically ill children.
• Parents should avoid giving multivitamins to healthy children who eat a varied diet. It's possible for kids to get too much Vitamins A and C, copper, folic acid, iron, selenium and zinc. A better choice is to supplement just those vitamins healthy kids don't get enough of such as vitamins D and E, as well as calcium.

Always check with your doctor if you're planning to give your child supplements for any condition.

A word of caution

Children’s Health knows you want your child to feel better. We want the same thing. But over-the-counter medicines that work for adults, don’t always work for kids. Carefully read the labels on any medications before you give them to your child. Also, "active ingredients” are the same in many common childhood medicines, so you could be giving your child too much if she's taking more than one drug at a time. A little extra caution can prevent serious harm. Our health care professionals are on hand to answer any questions you have about over-the-counter medicines. Just ask.