Children's Cough Medicines (cont)
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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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