By Vincent Iannelli, MD
Medically reviewed by Daniel Combs, MD
Fact checked by Nick Blackmer
An increasing number of reports about injuries and deaths from over-the-counter medicine has raised awareness that these OTC products can be dangerous.
Many more over-the-counter medicines can be helpful though—as long as you use them at the correct dosages and at the proper times.
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Pain and Fever
Pain and fever reducers are perhaps some of the more useful over-the-counter medicines. These include Tylenol (acetaminophen) and Motrin or Advil (ibuprofen).
Medicines containing salicylates, including aspirin (acetylsalicylic acid), should not be given to children or teens because of the risk of Reye’s syndrome. Parents should also avoid medicines like the Kaopectate and adult formulations of Pepto Bismol, which contain bismuth subsalicylate. The pediatric formulation of Pepto Bismol does not contain salicylates.1
Colds and Coughs
A large variety of cold and cough medicines are available for kids, but remember that the FDA warns that they should not be used for infants and toddlers under age 2 years. Most manufacturers have gone even further and have stopped marketing them to children under age four and some experts wonder if they are even useful for older kids.
Major brands of over-the-counter cold and cough medicines for older children include:
Children’s Delsym Cough Plus Chest Congestion
Children’s Dimetapp Cold and Cough
Little Noses Decongestant Nose Drops
Children’s Mucinex Congestion and Cough
Pediacare Children’s Cough and Congestion
Children’s Robitussin Cough and Chest Congestion
Children’s Sudafed Cold Plus Cough
Triaminic
Vicks Children’s Cough Congestion
For Babies
Few products are approved for use by babies and younger infants, so only use those that are or get the advice of your pediatrician before using other products off-label that are intended for older children. Commonly used over-the-counter medicines for babies include:
Mylicon Infants’ Gas Relief
Orajel Baby cooling gels for teething
Aquaphor Healing ointment or cream
Desitin diaper rash cream or ointment
Enfamil Fer-In-Sol iron supplement drops
Enfamil Poly-Vi-Sol multivitamin supplement drops
Itching
Anti-itch creams and lotions are essential over-the-counter medicines to have in your medicine cabinet if your kids spend any time outside, as they will likely often have insect bites, poison ivy, and other itchy rashes.
In addition to oral Benadryl (diphenhydramine), some good choices to treat itching include:
Hydrocortisone cream 1%
Calamine lotion
Natural colloidal oatmeal cream or lotion
Gold Bond anti-itch cream
Sarna lotion
Caladryl Clear
Itch-X anti-itch spray or gel
Domeboro astringent solution
Benadryl Extra Strength Itch Relief gel or spray (not to be used on large areas or with oral Benadryl)
Rashes
In addition to anti-itch creams and lotions and moisturizers, other over-the-counter medicines for rashes you may want to have include:
Neosporin First Aid Antibiotic ointment
Polysporin First Aid Antibiotic ointment
Lotrimin AF Antifungal for athlete’s foot, jock itch, and ringworm
Lamisil AT for athlete’s foot, jock itch, and ringworm
Tinactin cream for athlete's foot and ringworm
Constipation
Preventing constipation with a healthy diet that is high in fiber is best for children, but when they do get constipated, these medicines are often helpful:
Miralax: polyethylene glycol laxative for adults, but often used off-label by pediatricians for younger children
Pedia-Lax: docusate sodium laxative, oral liquid
Pedia-Lax: magnesium hydroxide laxative, chewable tablets
Pedia-Lax: glycerin laxative, rectal liquid or suppository
Fleet for children: enema
Phillips Milk of Magnesia
Fletcher’s Laxative for Kids: senna laxative
Stomach Issues
Stomachaches, in addition to those that are caused by constipation, are a common problem for many kids. These over-the-counter medicines are sometimes useful:
Culturelle for Kids: probiotic supplement
Digestive Advantage Daily Probiotics + Lactose Support: for children 8 years or older with lactose intolerance
Pepto Kids: calcium carbonate antacid to help relieve heartburn in children
Emetrol: nausea relief
Dramamine Chewable: prevents motion sickness in children
Best Choice Fiber Laxative: fiber supplements for children 6 years or older
Tums: antacid for children 12 years or older
Since the causes of stomachaches are sometimes difficult to sort out, it usually best to see your pediatrician before giving your child an over-the-counter treatment on your own though.
Allergies
Like cold and cough medicines, parents often turn to over-the-counter allergy medicines to treat their children’s allergy symptoms. This is even more common now that Claritin, Zyrtec, and Flonase are available over the counter.
Children’s Benadryl: diphenhydramine for children 6 years or older
Children’s Claritin Allergy: loratadine solution for children 2 years or older
Claritin RediTabs: loratadine tablets for children 6 years or older
Claritin D 12 hour or 24 hour: loratadine and pseudoephedrine tablets for children 12 years or older
Zyrtec syrup or chewable tablets: cetirizine for children 2 years or older
Zyrtec D 12 hour: cetirizine and pseudoephedrine tablets for children 12 years or older
Opcon-A: allergy relief eye drops for children 6 years or older
Naphcon A: allergy relief eye drops for children 6 years or older
Zaditor: allergy relief eye drops for children 3 years or older
Children’s Flonase: nasal steroid for children 4 years or older
Other Conditions
Some other over-the-counter medicines that can be useful include:
Reese’s Pinworm Itch Relief: for children 12 years or older
Neo-Synephrine Regular: nasal decongestant spray for children 12 years or older
Neo-Synephrine Mild: nasal decongestant spray for children 6 years or older
Ayr Saline Nasal Gel: helps moisturize dry noses and may prevent nose bleeds
Hibiclens: antiseptic/antimicrobial skin cleanser for recurrent skin infections, including MRSA
Nix shampoo: permethrin treatment for head lice
Rid shampoos: piperonyl/pyrethrum treatment for head lice
Compound W: wart remover
Benzoyl peroxide cream, pads, or gel for acne
What to Avoid
Medicines that you should likely avoid altogether include:
Aspirin: While it is no longer called Baby Aspirin, parents should still remember to not give chewable aspirin to kids unless specifically advised to do so by their pediatrician
Baby Orajel Homeopathic teething tablets and gels2
Ipecac syrup: Parents were once told to keep ipecac in their home to induce vomiting in case of accidental poisonings. These days, you should just call poison control.
Confused about all of the over-the-counter medicines you see on pharmacy shelves these days?
Be sure to talk to your pediatrician about which medicines they recommend you use and which you should avoid, either because they don’t work, cause too many side effects, or are just plain dangerous.
Sources
National Library of Medicine. Reye syndrome.
National Center for Complementary and Integrative Health. In the news: homeopathic teething gels and tablets.
By Vincent Iannelli, MD
Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years.
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