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Cold, Flu, & Cough Health Center

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Kids & Cold Drugs: Questions, Answers

Experts Answer Your Questions About Children's Cough and Cold Medicines
WebMD Health News
Reviewed by Louise Chang, MD

Oct. 22, 2007 -- Would you give an over-the-counter cold or cough medicine to your 5-year-old child?

Before last week, most of us would have said "yes." Indeed, a 1994 study found that in a given month, more than a third of U.S. 3-year-olds were getting a dose of cold or cough medicine. Now more than 30 of these preparations are marketed for children.

But by a 13-9 vote, an FDA advisory committee says these medicines should never be given to kids under age 6. The FDA is not required to obey its advisory committees. Until the FDA acts, the products will remain on drugstore shelves (except for cough/cold products aimed at kids under age 2, which the industry voluntarily withdrew from market before the committee met).

WebMD's message boards have buzzed with questions and comments from concerned parents. To respond, WebMD spoke with two experts.

One is Ian Paul, MD, associate professor of pediatrics at Penn State Children's Hospital. Paul is a member of the American Academy of Pediatrics' executive committee on clinical pharmacology and therapeutics.

The other is Michael Shannon, MD, MPH, professor and chairman of emergency medicine at Children's Hospital Boston and Harvard Medical School. Shannon is one of the 16 leading pediatricians and public health experts who petitioned the FDA to stop the marketing of cough and cold medicines to young children.

Your questions and the experts' answers:

When they say "cold and cough medications," what types of drugs are they talking about?

We are talking about four different medications. The first is a cough suppressant, dextromethorphan or DM. Second are the decongestants,pseudoephedrineand phenylephrine. Third is the expectorant, guaifenesin. And fourth are the antihistamines: brompheniramine, chlorpheniramine maleate, diphenhydramine -- Benadryl -- and others.

Aren't any of these types of drugs effective?

None has been shown effective for children. There are some data showing that pseudoephedrine, a decongestant, has some efficacy in adults. For the rest, the data are pretty weak and the effect size is pretty small. There is mixed data in adults, and you can question whether this means there it is a clinically significant effect. But those tested in children are not shown to be superior to inactive placebo.

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