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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




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




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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