Sunday, November 04, 2007
Children's Cough Medicine
Use cough mix for kids with care. Children's Cough Medicine
Should parents here be alarmed over the recent US recall of some over-the-counter infant medicines for coughs and colds? Shefali Srinivas finds out more
Children under six should not be given medicines which relieve coughs and colds, a US advisory panel has warned.
The Food and Drug Administration (FDA) panel voted two weeks ago to recommend not using over-the-counter remedies, which contain ingredients like antihistamines, cough suppressants and decongestants.
According to the panel, there was no proof that the medicines helped relieve cold symptoms in children and there were serious concerns about their safety, especially in children under two.
A study by the Centers for Disease Control and Prevention found that at least 1,519 children younger than two had serious health problems in 2004 and 2005 after having been treated with common cold medicines. Three children died and adverse reactions included hallucinations, confusion, dizziness and irregular heartbeat in some cases.
The panel felt that the medications were also not useful for children between six and 11, though it did not recommend discontinuing their use for this age group.
It was convened to address a citizen petition filed by a panel of paediatricians and public health experts with the agency in March this year.
The petition was filed after some deaths of children in the central United States were linked to the use of a cough and cold remedy containing carbinoxamine, an antihistamine.
Since the panel's recommendation, several leading over-the-counter cold remedy makers in the US have voluntarily withdrawn products sold for infants.
The products included Concentrated Tylenol Infants' Drops Plus Cold & Cough and Dimetapp Decongestant Plus Cough Infant Drops.
They are not sold in Singapore though these brands have other products here for children.
An added precaution is that over-the-counter drugs are not sold for babies under two years of age. They must be prescribed by a doctor.
According to the Health Sciences Authority (HSA), there have been no local reports of fatal adverse drug reactions associated with cough and cold syrups. But it is taking the review panel's recommendations seriously.
'HSA is already in the process of reviewing the labelling of all other cough and cold products for use by children,' a spokesman said.
Experts advising the FDA panel said that paediatric cold medicines were approved in the early 1970s, when there was almost no evidence that they worked. It was assumed that drugs which worked in adults would also be helpful in children.
Since then, researchers have learned that adults and children can react to medicines very differently.
The medicines criticised by the panel are those commonly sold to treat coughs, runny noses and congestion, available in Singapore under brand names such as Actifed, Dimetapp and Rhinathiol.
Common ingredients include:
Antihistamine: Given to help with sneezing, a runny nose and watery eyes. In syrups, the compound used is usually tripolidine hydrochloride.
Pseudoephedrine/phenylephrine: These are decongestants, which work by narrowing blood vessels in the lining of the nose. This reduces how much blood flows through the area so that swollen tissue inside the nose shrinks and air can pass through more easily.
Dextromethorphan: Anti-tussive which means it is used to suppress coughs. In adults, it has been shown to cut the number of coughs from 20 times an hour to 16 times an hour.
A consultant paediatrician from Kinder Clinic, Dr S. Sivasankaran, said the use of antihistamines is not recommended in infants under nine months of age.
'If they are over one year, we prescribe cold remedies on a case-by-case basis. We don't always recommend them,' he said.
But he also noted that most over-the-counter remedies for kids are safe when used in the right dosage.
For parents like Ms Melissa Rudge, 32, the key advantage of cough and cold medicines is that they help sick and unhappy children sleep.
But she does not buy any drugs over the counter and adheres to dosages recommended by the doctor. 'It really does help him stop coughing and go to sleep,' said the mother of a three-year-old boy.
Ms Ng Yong Wei, manager at Unity Healthcare, a retail pharmacy chain, said that parents asking for drugs for children under two are directed to consult a doctor for a prescription.
The pharmacist on duty will also explain to parents what the right dosage should be.
According to the FDA panel, well-meaning parents may overdose their child without realising it, which has been the case in most of the bad reactions.
When used properly, their products are safe, said the makers of cough and cold remedies.
Because colds generally resolve themselves, the experts recommend that parents of sick infants or children avoid the drugs and instead use other remedies to make their children feel more comfortable. These include vaporisers, hydrators, saline nose drops, steam inhalation, and taking soup and other fluids.
Labels: Children cough midicine, Cough Mix
