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Cold and Cough Medication Guide
Many parents have stood in the medicine aisle at the local drug store staring at the many different options. Choosing between cough suppressants, expectorants, antihistamines and decongestants or any possible combination of these can literally give parents a headache. As a pediatrician and a parent, I've tried to design a helpful guide to help you sort your way through the many cold medications.Choosing the right medication Choosing the correct medication is easier if you understand your child's symptoms and how cold and cough medications work. Here is a quick review.
Four major cold medication ingredients: Cough and cold medications come either as one of the following types of medicines, or a combination of two, three or all four ingredients:
 Helpful Tip: The brand name of the medication is not important, and don't get confused by the long scientific names of the ingredients. Under the name brand on the front label will be listed the types of ingredients (i.e. decongestant, cough suppressant, etc) that are in the bottle. This should make your buying decision easier. Also, it is okay to use more than one medicine at a time, as long as you are not overlapping any of the above four types of medications. For example: you could use an antihistamine/decongestant combination along with a cough suppressant/expectorant combination. Warning: All four types of cough and cold medications are NO LONGER APPROVED for kids younger than 2 years of age. All bottles of cold and cough meds that have dosing labels for kids under 2 have been taken off the shelves and are no longer available. The reason for this is two-fold: First, there have been a number of infants and young children harmed by accidental overdoses of these meds when a parent mixed different meds together OR gave too high a dose, this is the reason that the FDA decided to step in and make them no longer available. Second, there has been very little research done on young kids to prove that cold and cough meds are safe and/or effective. Even though they seem to work well and rarely cause any problems when dosed properly, the FDA felt it was prudent to put a hold on their use until further safety and efficacy data become available. And we agree. In addition, the FDA is considering removing cough and cold meds for kids age 2 to 5, and possibly ages 6 to 11 as well, due to the lack of safety and efficacy research in these age groups. The decision for these ages is expected to come in February 2008. What can parents do in the meantime to relieve cough and congestion when their young kids catch a cold or flu? Symptom Guide
Here are some common symptom scenarios and how to treat them. You can click on the recommended medication for a list of brands to use, as well as dosing information. Don't forget that these medications are not curing the problem they simply offer temporary relief. Dry cough: Cough Suppressant
If your child has an annoying cough, especially from a dry itchy throat, but not
a lot of runny nose or congestion – then use a cough suppressant alone before
bedtime.
Mild productive cough: Expectorant
If your child's cough is very mild – only a few coughs per hour – and it is not
interfering with sleep; or if he has chest congestion with mucous that is
difficult to cough up, then I recommend an expectorant. This will thin the
mucous that is causing the cough and make it easier to cough up.
Cough, Chest congestion: Cough Suppressant/Expectorant
If your child has a wet, productive cough that is interfering with sleep or
daily activity but does not have a bothersome runny nose or sinus congestion, I
recommend a cough suppressant and expectorant combination. It is okay to use a
cough suppressant alone if that is all you have.
Nasal congestion: Decongestant
If your child has nasal congestion without severe itchy, runny nose, a
decongestant should help. It will also help dry-up mild mucous. An expectorant
can help if the mucous is really thick, but is not necessary. Decongestants can
interfere with sleep (unless they are combined with an antihistamine) so this
combination is best for daytime use.
Cough, Chest congestion, Nasal congestion: Cough
Suppressant/Decongestant/Expectorant
If your child has a wet, productive cough with chest congestion and nasal or
sinus congestion but not itchy runny nose, then I recommend a cough suppressant,
decongestant combination. An expectorant can help if the mucous is really thick,
but is not necessary. Decongestants can interfere with sleep (unless they are
combined with an antihistamine) so this combination is best for daytime use.
Some preparations will also contain Acetaminophen (fever reducer), which will
help relieve any aches or fever that your child may have.
Nighttime cough, Nasal congestion, Runny nose, Chest congestion:
Antihistamine/Decongestant/Cough Suppressant
This combination is great for an itchy, runny nose, nasal congestion and
frequent cough that are interfering with sleep. This is good for nighttime use
because the antihistamine will make your child drowsy. Some preparations will
also contain Acetaminophen (fever reducer), which will help relieve any aches or
fever that your child may have.
Runny nose, Nasal congestion: Antihistamine/Decongestant
Like above, but without the annoying cough. This combination is great for an
itchy runny nose, and nasal congestion that is interfering with sleep. This is
good for nighttime use because the antihistamine will make your child drowsy.
Some preparations will also have Acetaminophen (fever reducer), which will help
relieve any aches or fever that your child may have.
Recommended Brand Names
Organized by category, this list will help you decide which medication you should choose for your child's particular symptoms. Click on any of these medications for additional information, including dosing and side effects.
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