Over-The-Counter (OTC) Medicines for Babies and Children

Over-the-counter (OTC) medicines are medicines you can buy without a prescription. They can come as pills, capsules, powders, or liquids. They are sold in drugstores and supermarkets.

OTC medicines have a label on the bottle or box. Always read this before using the medicine. It tells you:

• How much medicine to give

• How often to give it

• What the medicine contains

• Warnings about using the medicine

• If it is safe for children of certain ages

Safety tips for OTC medicine

The US Food and Drug Administration (FDA) and other groups have safety tips for how to give OTC medicines to children:

• Always talk with your child's healthcare provider or pharmacist before giving your child any OTC medicine. This is extra important the first time you give your child a medicine.

• Don't give OTC cough and cold medicines to babies and small children without talking with a healthcare provider first.

• Don't give OTC medicines to babies and children under the age 2. This is because of possible serious life-threatening side effects.  

• Know your child's weight. Medicine doses for babies and young children are based on age and weight. 

• Follow the directions for age and weight. If the advised age is not your child's age, don't give the medicine.

• If no dose is shown on the bottle or package for children under 12 years old, ask your child's healthcare provider or pharmacist if it's OK to give the medicine to your child. Ask how much you should give. Ask when you should give it.

• Don’t use a kitchen teaspoon to give medicine. They vary in size. Liquid medicines often come with a cup, spoon, or syringe. Use these instead. They will measure the right dose.

• To mix medicine with milk or formula, put the medicine in 1 ounce of milk. Have your child drink that. Then feed the rest of the formula or milk as normal.

• Always measure and give medicine with a bright light on. Dim light may cause you to give the wrong medicine or the wrong dose.

• Never let young children take medicine by themselves.

Take care with combination medicines

Many OTC cough and cold medicines have more than 1 active ingredient. This is so it can treat more than one symptom. This is called a combination medicine.

You need to make sure your child does not get too much of any ingredient if they take several medicines. It’s important to read all labels. For example, many cold medicines have acetaminophen. Giving more than one medicine that contains it may lead to overdose. Keep track of what you give your child, and what it contains.

Combination medicines may cause more side effects. Medicines with antihistamines and decongestants can cause side effects like hyperactivity, sleeplessness, and irritability in children. Don’t give medicines with more than 1 active ingredient to children under 6 years of age.

Don’t combine prescriptions, supplements, or combination medicines without talking to a healthcare provider or pharmacist.

Check the ingredients

Check every label. The ingredients for a medicine may change. For example, an OTC medicine for diarrhea changed. It now has bismuth subsalicylate. Any product with "salicylate" or aspirin on the label is not safe for children under age 19. This is because of the risk of a rare but sometimes deadly condition called Reye syndrome. It most often affects the brain and the liver.

Look at medicine strength

Medicines with the same brand name can be sold in different strengths. This includes baby, children, and adult formulas. Take care with medicine strength. Baby drops of some medicines are stronger than the liquid of the same medicine for toddlers or children. This is because babies may not be able to drink a large amount of medicine to get a correct dose. Don't give higher doses of baby drops to a toddler. The drops are too strong.

More safety tips

Here are some other important tips:

• Talk with your child's healthcare provider or pharmacist to find out what mixes well and what doesn't. Medicines, vitamins, supplements, foods, and drinks don't always mix well with each other.

• Don't call medicine candy. If children find medicine at a later time, they may think it's candy and eat it.

• Always use child-resistant caps and store medicines in a safe place. Relock the cap after each use. Be extra careful with any products that have iron. Iron poisoning is a main cause of poisoning deaths in young children.

• Check the outside package for damage such as cuts, slices, or tears. Check the label on the inside package to make sure it's the right medicine. Make sure the lid and seal are not broken. Check the color, shape, size, and smell of the medicine. If you notice anything abnormal, ask a pharmacist.

Types of OTC medicines

There are many types of OTC medicines. Brand names can change and store brands are common. Read the labels to know what the active ingredients are in all products. Types of OTC medicine include:

• Analgesics. These are medicines that treat pain and fever. Use care with different forms of these medicines. Some are stronger than others. Common analgesics for babies and children are acetaminophen and ibuprofen. Ibuprofen is not advised for children under 6 months of age. Acetaminophen is not advised for children under 12 weeks of age. For a fever at that age or younger, contact a healthcare provider. Don't give aspirin to children younger than 19. It can cause a rare but sometimes deadly condition called Reye syndrome.

• Antihistamines. These treat runny noses, itchy eyes, and sneezing caused by allergies (but not colds). Some can make your child sleepy. These are not advised for children younger than 2. Use only with a healthcare provider's OK in young babies or children with asthma. These medicines include chlorpheniramine, diphenhydramine, and loratadine.

• Expectorants. These can help loosen mucus. Guaifenesin is an expectorant. It helps thin mucus so it can be coughed or sneezed out more easily.

• Cough suppressants. These numb the body’s reflex to cough. Coughing is needed to clear mucus and bacteria from the lungs. Check with a healthcare provider before giving your child a cough suppressant.

• Decongestants. These can relieve stuffiness caused by allergies or colds. They do this by shrinking the inner parts of the nose to make breathing easier. They should not be used for more than 2 to 3 days in a row. Decongestants taken by mouth can have a number of side effects. These include irritability, sleeplessness, and dizziness.

• Anti-diarrhea. These medicines are often not needed. Take your child to a healthcare provider if they have diarrhea. Make sure to give your child plenty of fluids. Talk with your child's provider before giving them these medicines. Don’t give medicine with bismuth subsalicylate to a child younger than 19. Don’t give medicine with loperamide to a child younger than 2.

• Laxatives. These help relieve constipation. They work in several ways. Some add fiber or water to stool to make it more bulky. This can make it easier for intestines to move it. Some coat the surface of the stool to make it more slippery. Some soften the stool so it passes more easily. Others cause the intestines to move in a stronger way. Don't give babies or children laxatives without talking with your child's healthcare provider. Laxatives include glycerin suppositories, magnesium hydroxide, mineral oil, and psyllium.