Cough And Cold Medicine Over-The-Counter (OTC)

Over the counter (OTC) medicines are drugs that you can buy without needing a doctor’s prescription.  For many years, OTC medicines have been used safely to treat coughs, colds, and congestion in adults.  But even though studies were not done in children younger than 12 years old, these same medicines were made into cough and cold products for children.

We now know that it can be dangerous for children to take adult medicines.  Cough and cold medicines do not help your child get better faster.  OTC’s should be used with caution based on your child’s symptoms, age, and weight.

What the FDA and American Academy of Pediatrics (AAP) Say

  • Giving over the counter medicinesYounger than 4 years, do not give cough and cold medicines.
  • Ages 4 to 6, ask your child’s doctor.  Do not give OTC’s unless you have checked with your child’s doctor.
  • Older than 6 years, cough and cold OTC’s can be used if given correctly. 
  • These medicines are not safe if:  
    • Your child receives a dose that is too high for his or her age and weight.  
      • Give the right dose based first on your child’s weight and then his or her age. 
      • Use the measuring cup that comes with the medicine or a pediatric measuring device (Picture 1).  
    • The medicine is given too often. 
    • Your child receives more than one product that has the same medicine in it.  Do not give more than one OTC with the same “active” ingredient listed on the label.  This will help to prevent your child from getting too much of the same type of medicine.

"Active Ingredients"

SeMany cold and cough medicines have more than one active ingredient.  Too much of one ingredient can cause serious harm to a child. It is important to check the label of all OTC’s before giving.

Generic name
"Active Ingredient"
Class Uses

A Few Typical
Product Names

Guafenisen Expectorant ‘Wet’ coughs/mucus Mucinex®, Robitussin®
Dextromethorphan Cough
Reduces cough Robitussin®; anything with
‘DM’ in the name
Antihistamine Allergies, itchiness Benadryl®, Chlor-Trimeton®
Decongestant Nasal stuffiness
congestion or pain
Sudafed®, Sudafed PE®,
Claritin D®
Honey or Agave Cough Suppressant  Reduces Cough Zarbee's®

What You Can Do for a Cold or Cough

  • Have your child drink plenty of fluids, mainly water, chicken soup, or broths.  Limit fruit juice and sports drinks to avoid sugar.  
  • For cough, you can mix 1 to 2 teaspoons of honey in warm lemon water.  However, it is not safe to give honey to children younger than 1 year old.
  • Your child should get plenty of sleep.
  • Use saline nasal spray and a bulb syringe to help congestion before eating or sleeping.
  • Use a cool mist humidifier in your child’s room.  Do not use a warm humidifier; it can cause burns.
  • Older children can suck non-medicated lozenges or hard candy or gargle with warm salt water (use ¼ to ½ teaspoon of table salt dissolved in 8 ounces of warm water) to soothe a sore throat.

Approved Medications

You may still use these medicines to help bring down a fever or help with aches and pains.  Be sure to read the label and give the correct dose.

do not give your children medication containing asprin

  • Acetaminophen (a SEET uh MIN o fin) (Children’s/Infant’s Tylenol®) 
  • Ibuprofen (eye byoo PRO fen) (Children’s or Infant’s Motrin® or Advil®)
  • Do not give your child aspirin or products that contain aspirin (Picture 1). 
  • Do not give your child medicine labeled for use by adults.
  • Always read drug facts on the label for “active ingredients.”  This will help you understand what the medicine is for.  It will also help you make sure you are not giving too much of the same 
    type of medicine if you are using more than one product.

When to Call the Doctor

Call your child’s doctor if:

  • Your child is hoarse, cannot talk, or complains of a sore throat.
  • Cough is high-pitched or has a barking sound.
  • Breathing is difficult or child is wheezing or grunting with breathing.\
  • Your child complains of ear pain, pulls his ears, or rolls his head from side to side.
  • Your child has difficulty swallowing or refuses to take liquids for 4 or more hours.
  • Your child has fever that does not come down or go away after treatment and:
    • Under 2 months, fever is over 100.4 º F by rectum
    • Under age 2 years, after 1 day, fever is over 102º F by rectum or over 103 º F under the arm, on the forehead or by ear.
    • Age 2 or older, after 3 days, fever is over 102º F by mouth or by rectum or over 103º F under the arm, on the forehead, or by ear.  Oral temperatures are not recommended for children younger than 4.
  • Child does not feel like playing or does not “act right”.
  • Your child’s color changes to grayish blue or is very pale.

Cough and Cold Medication Over-The-Counter (OTC) (PDF)

HH-V-225 12/07 Revised 1/19, Copyright 2007, Nationwide Children's Hospital