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Dosing Confusion Common With Kids' Liquid Medicines

Study: Packaging for OTC Products Hard for Parents to Understand

Teaspoon, Tablespoon Confusion

DeWalt says one of the biggest areas of confusion involves teaspoon and tablespoon dosing recommendations.

He says people often confuse the two and use tablespoons, which are typically three times the size of teaspoons, when instructions call for teaspoons.

“This happens all the time,” he says. “Most of the time there is no real harm. But if it happens with, say, Tylenol several times a day for several days, there could be issues with liver toxicity. Or if it happens with Benadryl that can knock a child out.”

Devices for delivering medicines often have extra markings that are not necessary for following label directions.

In the newly published analysis, four out of five measuring devices included these superfluous markings.

And some products included units of measurement that hardly anyone understands, such as "drams" and "cubic centimeters."

“I couldn’t tell you what a dram is, and it’s a safe bet that very few people can,” DeWalt says.

In an editorial published with the study, DeWalt recommended that milliliters be adopted as the standard unit for delivering liquid medications.

Yin says if this happens, efforts to educate the public and health care providers about this unit of measure will be needed.

“This is not a term many parents understand,” she says. “And doctors, nurses, and pharmacists will need to use this term. There has to be a united front, or it will just add to the confusion.”

Consumer Healthcare Products Association Responds

In a statement released Tuesday afternoon, the trade association representing the over-the-counter drug industry says it is working with federal officials and others to simplify dosing for consumers.

"The OTC medicine industry takes very seriously its responsibility to help parents and caregivers safely and correctly administer OTC pediatric medicines to children," the Consumer Healthcare Products Association (CHPA) statement reads.

Last November, the CHPA approved dosing guidelines for liquid drugs that also called for the inclusion of appropriate dosing devices in over-the-counter liquid medications. The group also recommends the adoption of milliliters as the preferred unit for dosing with the abbreviation to read "mL."

"CHPA's voluntary guidelines, supported by the American Association of Poison Control Centers, were developed as part of a public-private partnership, called the PROTECT Initiative, with the CDC and other stakeholders," the statement reads.


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