Over-the-Counter Medicines

Over the counter medicines (OTCs) are those which can be purchased without a prescription.  Just because a prescription is not needed to obtain these medications, does not mean they are harmless.  It is very important to read and understand the instructions that are given with the medicine or that your physician has given you.  Using OTCs incorrectly can be dangerous.

Common OTCs for children include:
Fever reducer and/or pain reliever
Acetaminophen (brand name:  Tylenol)
Ibuprofen  (brand names:  Motrin, Advil)

Please refer to our website information regarding fever (click here for link) for more information about these medicines and the appropriate dosages.

Diphenhydramine (brand name: Benadryl)
Loratadine  (brand name: Claritin)
Cetirizine (brand name: Zyrtec)

These medicines can help symptoms that are due to allergies (click here to link) (runny nose, itchy nose, itchy eyes, watery eyes, scratchy throat.)  They DO NOT help with symptoms due to colds and coughs caused by viruses.

These medicines can also help relieve itching from insect bites, chicken pox, and hives (itchy skin rash due to an allergic reaction.)

Sleepiness is a common side effect of antihistamines, though significantly less so with loratadine (Claritin); cetirizine (Zyrtec) has more drowsiness than loratidine, but far less than Benadryl.  However, there are some children who have increased activity, nervousness, and irritability as side effects of antihistamines.  Therefore, it is usually a good idea to avoid giving a child an antihistamine for the first time at bedtime.

Pseudoephedrine (brand name: Sudafed)
Phenylephrine (the new decongestant replacing Sudafed in most OTC products)

Decongestants have not been shown in studies to provide any significant benefit in terms of relieving congestion in children.  In addition, they can cause difficulty sleeping, a feeling of anxiety, “hyper” behavior, and rapid heart beat.  Therefore, they are best avoided, especially in younger children (less that 12 years old.)

Saline (salt water) nose drops
Before young children are old enough to learn to sniffle or blow their noses to relieve congestion, saline nose drops may help them.  If the child is sleeping and eating well, despite a stuffy nose, there is no need to treat.  However, a baby/child who is having a lot of problems sleeping or eating due to nasal congestion may benefit from use of saline nose drops.  These drops can be purchased at a pharmacy or you can make your own with ¼ teaspoon of salt mixed into one cup of warm water.  Drop 2 or 3 drops of the salt water solution into each nostril, then squeeze the bulb syringe, gently insert it into the child’s nostril, and let go.  This will suction out the drops and, hopefully, some mucus too.  Try not to suction a child’s nose more than 4 times a day, to avoid irritation.

Cough suppressants
Dextromethorphan (brand names:  Robitussin, Delsym, Pediacare Cough, Triaminic Cough, Nyquil)

Coughing is a very useful mechanism that the body has for clearing out mucus and germs from the lungs.  Coughing, though, is unpleasant and can make it difficult for children to sleep. Most coughs are due to cold viruses and there is not a lot that can be done to improve a cough until the virus has run its course. 

Unfortunately, there is little to no evidence showing that cough suppressants are 
effective in relieving cough.  Some things to try that may help the child with a cough that is bothering him/her are:
Encourage lots of fluids during the day
Elevate the head of the bed at night.  This is best done by lifting the mattress at one end and placing some towels or blankets underneath the mattress so it is raised to about a 30 degree angle.
Using a cool-mist humidifier or vaporizer in the bedroom at night.  Make sure you clean it well at least once a week.
In recent studies comparing the use of honey to dextromethorphan, parents reported improved sleep and less cough in the children who received honey.  Give your child 1 tsp of honey before bedtime.  Remember: never give honey to a child less than 12 months old.

Combination cold medicines
Cold medicines typically contain a decongestant, antihistamine, and sometimes a cough suppressant and/or acetaminophen or ibuprofen.  There is no evidence that these medicines relieve cold symptoms, and they definitely do not help children get over a cold faster.  In addition, there are many potential side effects to these medicines, including sedation, irritability, sleeplessness, and hyperactivity.  These medicines are not recommended for children.

Hydrocortisone cream
This can be used for mild patches of eczema (dry, itchy skin), poison ivy, or insect bites.
It shouldn’t be used on chicken pox, burns, infections, open wounds, or broken skin.  If it is not helping within a couple of days, please call our office.

Medicines for gastrointestinal problems
There are many OTC medicines for gas, heartburn, diarrhea, and constipation (click to link to topic).  It is best to talk to us before using these medicines.
Call us at (301) 625-2800
Please call us with any questions

Silver Spring Pediatrics
Drs. DeConcini, Schooler, Zang, Wang, Yee & Marcus
Image courtesy cochranechild.wordpress.com