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Children's Cough Medicines (cont)


Charles Flynn

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The Paediatric Medicines Expert Advisory Group and the Commission on Human Medicines have reviewed over-the-counter products used for treating cough and colds in children, and advised that certain medicines should no longer be used in children under the age of two. The following advice has been issued:

 

• Non-prescription cough and cold preparations containing any of the following active substances should not be used in children under 2 years: brompheniramine, chlorphenamine, dextrometorphan, diphenhydramine, ephedrine, guaifenesin, ipecacuanha, oxymetazoline, phenylephrine, pholcodine, pseudoephedrine and xylometazoline.

 

• Children suffering from a cough or cold should be treated with paracetamol or ibuprofen to lower the child’s temperature, and if they have a cough to use a simple cough syrup (e.g. glycerol, honey or lemon).

 

• For young babies, who are having difficulty feeding, nasal saline drops are recommended to help thin and clear nasal secretions. Vapour rubs and inhalant decongestants, which can be applied to a child’s clothing, can also be used to provide relief from a stuffy nose.

 

• For children aged 2 to 6 years, care should be taken to adhere to the maximum daily dose; not to take with other cough and cold medicines; and the advice of a pharmacist or other healthcare professional should be sought if there are any concerns.

 

The pharmaceutical industry has voluntarily agreed to change the labels on products to remove the dosage instructions for children under 2, and to add additional instructions in relation to children aged 2-6 years. All affected products are currently being changed. Products with the updated advice on their packaging, and in the Patient Information Leaflets, will be in pharmacies and stores by October 2008. A leaflet for patients/carers will be available for additional advice. For older children, cough and cold medicines will continue to be available to help treat symptoms.

 

The following products directly targeted at children aged under 2 are to be removed from open shelves but can still be supplied under the supervision of a pharmacist for older children:

 

• Asda Children’s Chesty Cough Syrup

• Boots Chesty Cough Syrup 1 Year Plus

• Boots Sore Throat and Cough Linctus 1 Year Plus

• Buttercup Infant Cough Syrup

• CalCough Chesty

• Children’s Chesty Cough

 

List of cough medicines to be taken off shelves

"The Daily Telegraph"

 

 

 

 

The following products are currently licensed for use by children under two. They are to be taken off shelves and sold to parents (with children aged two or over) with appropriate dosage instructions.

 

Paediatric Cough Relief

 

Boots Night Time Cough Syrup 1 year plus

 

Tixylix Catarrh Syrup

 

Tixycolds Syrup

 

Bronalin Junior Linctus

 

Junior Meltus Night Time

 

Histalix Syrup

 

Dozal Oral Solution

 

Fedril Paediatric Elixir

 

Medised for Children

 

Kafalin Syrup

 

Ransoms Paediatric Diphenhydramine Linctus

 

Line Range Cough Relief For Children Syrup

 

Calcold

 

Calpol Night

 

Benylin Childrens Night Cough

 

Tixylix Cough and Cold Linctus

 

Paediatric Nirolex

 

Childrens Chesty Cough Syrup

 

Tixylix Chesty Cough Linctus

 

Optrex Expectorant Liquid 50mg/5ml

 

Robitussin Chesty Cough Medicine 100mg

 

Jnr Meltus Chesty Cough With Catarrh

 

Altons Junior Cough Mixture

 

Galloway's Cough Expectorant

 

Liqufruta Garlic Cough Medicine

 

Cupal Expectorant

 

Benylin Childrens Chesty Cough

 

Benylin Childrens Coughs and Colds

 

Otrivine Child Nasal Drops

 

Nasal Drops For Children

 

Iliadin Mini Paediatric

 

Children's Dry Cough 1 Year Plus

 

Tixylix Night Cough

 

Tixylix Dry Cough

 

Galen Pholcodine Linctus 5mg

 

Galen Paed Linctus 5mg

 

Rusco Pholcodine Linctus

 

Cough Relief For Children

 

Benylin Childrens Dry Cough

 

Pinewood Pholcodine Linctus

 

Crescent Pholcodine Linctus

 

Pavacol-D

 

Boots Alternatives Children's Cough Relief

 

Glycerin Lemon and Honey With Glucose and Ipecacuanha

 

Glycerin, Lemon and Honey

 

Glycerin, Lemon and Honey and Ipecac Syrup

 

Lemeze Cough Syrup

 

Cherry Cough Mixture

 

Childrens Blackcurrents Cough Syrup

 

Buttercup Infant Cough Syrup

 

Buttercup Syrup Honey and Lemon

 

Bell's Chesty Cough Compound of Glycerin, Lemon and Ipecacuanha

 

Glycerin, Lemon and Honey with Glucose and Ipecacuanha

 

Beehive Balsam

 

Children's Cough Expectorant

 

Anglian Pharma Troublesome Coughs

 

Hill's Balsam Chesty Cough Liquid for Children

 

Glycerin, Lemon, Honey and Ipecacuanha Linctus

 

 

 

 

 

 

A range of products will remain on general sale for use in children under 2 years old. These include simple cough medicines containing glycerol, lemon or honey. Single-constituent paracetamol and ibuprofen products are not affected by this advice.

 

According to a BBC news report, a spokeswoman for the MHRA said that this action had been taken as a precautionary measure after it was found that many parents were unwittingly overdosing children, and those aged under two were particularly at risk because of their small size. She added that there had been an increase in "adverse reactions to the products, although this had been more widely observed in the US where improved packaging had since been introduced.

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