Infant Cough and Cold Medications – Part 2

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

We now have this and most other articles published in the Parkland Shopper on our Website. Please visit us at www.dcp.ca

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

I told you Waterhen was the center of the universe! The breaking edge of medical science is near the Waterhen River, just down from Taylor’s store at the Waterhen Health Unit! In case you missed my last article, let me get you caught up. A few weeks ago, I got to go to Waterhen for the first time. I was invited to speak to an infants, toddlers and parents group about cough and cold medications. The main question was: “Can you give over the counter cough and cold medications to infants and toddlers?” The easy answer is no. I did a little research, gave a presentation to the Waterhen group, then recycled that info for a Shopper’s article. It seems Health Canada is now trying to catch up to Waterhen. They changed the rules on infant and toddler cough and cold medication again.

On Dec 18, 2008 Health Canada said:
Health Canada is advising consumers of the outcome of its review of cough and cold medicines for children under the age of 12.

Health Canada is requiring manufacturers to relabel over-the-counter cough and cold medicines that have dosing information for children to indicate that these medicines should not be used in children under 6.

The relabelling of these medicines will be completed by fall 2009, in time for the next cough and cold season. During the current cough and cold season, medicines will remain on store shelves and in homes with the current labelling, which could include dosing information for children under 6, because many of these products also have dosing information for adults and older children on the same label. As a result, for this cough and cold season, parents or caregivers should consult a pharmacist or a health care practitioner when buying or using these products. These medicines can still be used in children 6 and older, and adults.
This decision is the result of a Health Canada review of these medicines, including the input of a Scientific Advisory Panel convened in March 2008. Health Canada has concluded that while cough and cold medicines have a long history of use in children, there is limited evidence supporting the effectiveness of these products in children. In addition, reports of misuse, overdose and rare side-effects have raised concerns about the use of these medicines in children under 6. The rare but serious potential side-effects include convulsions, increased heart rate, decreased level of consciousness, abnormal heart rhythms and hallucinations. The Scientific Advisory Panel's conclusions and details of the new Health Canada recommendations are posted on the Health Canada Web site.

Health Canada previously issued advice on the use of these medicines in an October 2007 Public Advisory. Based on a preliminary review, Health Canada at that time recommended not using over-the-counter cough and cold medicines in children under 2 years of age, unless instructed to do so by a health care practitioner. The current decision expands on those preliminary recommendations.

Until the relabelling of these products is completed, Health Canada advises parents and caregivers to follow these important guidelines:

□ Do not use these over-the-counter cough and cold medicines in children under 6 years of age.
□ With children older than 6, always follow all the instructions carefully, which includes the dosing and length-of-use directions, and use the dosing device if one is included.
□ Do not give children medications labelled only for adults.
□ Do not give more than one kind of cough and cold medicine to a child. Cough and cold medications often contain multiple ingredients. Combining products with the same ingredient(s) could cause an overdose that may result in harm to a child.
□ Talk to your health care practitioner (doctor, pharmacist, nurse, etc.) if you have questions about the proper use of over-the counter cough and cold medicines.
□ The common cold is a viral infection for which there is no cure. Cough and cold medicines offer only temporary relief of symptoms such as runny nose, cough, or nasal congestion Symptoms can also be managed using a variety of non-medicinal measures such as adequate rest, increased fluid intake and a comfortable environment with adequate humidity.
□ For babies and young children, it is important to rule out serious illnesses that have cold-like signs and symptoms (for example, pneumonia, ear ache or other infections). This is especially important if symptoms do not improve, or if the child's condition worsens.
□ If you are concerned about the child's health (such as if symptoms worsen, last for more than a week, or are accompanied by a fever higher than 38 C or the production of thick phlegm), consult a health care practitioner for a medical evaluation.

For more information please visit:
Health Canda at: www.hc-sc.gc.ca/dhp-mps/medeff/res/cough-toux-eng.php
Canadian Pharmacists Association- Common Colds and Influenza – What you need to know at : www.pharmacists.ca/content/hcp/Resource_Centre/Drug_Therapeutic_Info/pdf/CC-Influenza_InfoforPatients-Parents_CPhA.pdf

As always if you have any questions or concerns about these or other products, ask your pharmacist.