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SafeMedicationUse Newsletter

Preventing Errors with Children's Medicines
Part 3: Over-the-Counter Medicines


This newsletter is the third in a series that provides suggestions to help prevent errors with children's medicines. The first newsletter in the series gave tips on things to do and questions to ask when a medicine is prescribed and dispensed for your child Part 1 - At the Doctor's Office and Pharmacy). The second newsletter in the series gave information about steps you can take to reduce the chances of a mistake happening when your child is receiving medicine at home or away from home (Part 2 – At Home and Away from Home ). This newsletter provides some additional tips to prevent errors when selecting and/or giving over-the-counter (OTC) medicines to children.

OTC medicines are drugs that can be purchased without a prescription. These medicines are usually intended to relieve mild symptoms and are typically used for just a short time. A parent or caregiver may make a mistake when selecting an OTC product in a pharmacy or another store where this type of medicine can be purchased (such as a grocery store). Mistakes can also happen when OTC medicines are being given at home or away from home (for example, at school, camp or a day care). Fortunately, there are steps you can take to help prevent a mistake with an OTC medicine from harming your child.

Tips for Over-the-Counter (OTC) Medicines
  • Not all OTC medicines are suitable for children. Look for OTC medicines that are made especially for children and choose products that are suitable for the age and weight of your child.
  • AVOID giving OTC cough and cold remedies to children under 6 years of age. There is little evidence that cough and cold medicines are effective in children, and these medicines can cause serious side effects. For more information about cough and cold medicines in children, see the text box below.
  • Check the list of ingredients in the medicine carefully. Make sure the medicine does not include any ingredients that your child is allergic or sensitive to. Checking the ingredients can also prevent you from accidentally giving more than one medicine with the same active ingredient.
  • Read the directions on the package carefully. Check the dose of medicine that is recommended for your child's weight or age and how often to give it. Sometimes the dose recommendations are based on both weight and age. If the dose suggested for your child's weight is different from the dose suggested for your child's age, ask your pharmacist or another healthcare professional for advice.
  • For liquid medicines, always use a proper measuring device (such as an oral syringe, a special measuring spoon or a medicine cup). Read more …
  • Beware of possible interactions with other medicines your child is taking. If your child is taking prescription medicines or OTC medicines for another problem, ask your doctor or pharmacist to recommend an OTC medicine that will be suitable for your child. As much as possible, use the same pharmacy to obtain prescription and OTC medicines for your child. When you purchase an OTC medicine, tell the pharmacist, in case there could be an interaction with another medicine that your child is already taking.
  • AVOID giving acetylsalicylic acid (also known as Aspirin or ASA) or other similar drugs called "salicylates" to children, unless you have first consulted with a health professional. These drugs have been linked to a potentially life-threatening condition called Reye's syndrome when used in children and teenagers during viral illnesses such as chicken pox or the flu.
  • Remember that natural products (such as vitamins, minerals, herbal remedies and traditional medicines) may interact with OTC and prescription medicines. Not all natural medicines are suitable for use in children. Use the same care when selecting and giving a natural product as you would with any medicine.
  • Even though OTC medicines can be obtained without a prescription, remember that a mistake with an OTC medicine could harm your child. Many of the suggestions provided in the first two newsletters of this series also apply to OTC medicines. suggests that you also review those earlier newsletters before giving your child any OTC medicine.
  • Be sure to contact a healthcare professional if your child develops any symptoms that concern you.
Cough and Cold Medicines: Not Suitable for Children Under 6

There is no cure for the common cold. As such, cough and cold medicines are intended only to relieve the symptoms of a cold, not as a cure. These products have been on the market for many years, but recent research has shown that they do not work well in children. Also, they can cause serious side effects, especially in younger children. Therefore, Health Canada advises parents to AVOID cough and cold medicines completely for children under 6 years of age. More information and a list of the medicines to avoid are available on the Health Canada website:

If cough and cold medicines are being given to a child older than 6 years, remember to choose products suitable for the age and weight of your child. Follow the instructions carefully. Giving too much of the medicine may be harmful. Many cough and cold products contain several different medicines to relieve different symptoms. Using more than one product at the same time may cause harm because the person receives too much of a particular medicine that is included in different products. Always check with your pharmacist or healthcare provider before using more than one cough and cold product and before combining a cough and cold product with a medicine used to relieve pain or fever.

Cough and cold medicines can also be harmful when given with other kinds of medicine, and some cough and cold medicines should not be used by people with certain medical conditions. Ask your pharmacist or healthcare provider for advice if your child is already taking a prescription medicine or another over-the-counter medicine, or if your child has a medical condition, even if the condition is not being actively treated.

ISMP Canada gratefully acknowledges the expert review of this newsletter and of Parts 1 and 2 of the series by Rabih Dabliz, Pharm D and Spiros Konstas, RN.

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