Here's what you should know about over-the-counter medicines for your baby

It is very easy to buy medication over the counter at your pharmacy. These medications are as potentially dangerous as any prescription medication so it is important to know what you are buying.

It cannot be said enough that over the counter (OTC) medications are for symptomatic relief, meaning that they treat the symptoms and not the cause of the illness.

Ingredients to watch out for:

- Dextromethorphan in cough suppressant syrups

• Respiratory depression (breathing difficulties)

- Pseudoephedrine in decongestants

• Heart rhythm changes
• High blood pressure

- Antihistamines in both decongestants and cough suppressants

• Drowsiness, loss of consciousness
• Heart rhythm changes

These three ingredients are used most frequently to achieve relief from congestion and coughing and have significant side effects, especially when used in young children and when given in the incorrect dose.

It is important to note that the doses of these medications have not been accurately studied in children. The side effects of some medications have led to a global warning about the safety of products that contain these preparations.

All medications containing these ingredients must not be used in children under 2 years of age and their use in children from 2 to 6 years of age is discouraged.

While bearing this warning in mind, here are some symptoms and the medications that are commonly available for treating them.

• Also see: Your family’s medicine cabinet checklist 

Now that you've learned what to avoid, here are a few safety guidelines to follow. 

Commonly used medicine for pain and fever in children

* Paracetamol

Commonly found in: 

Panado, Calpol, Tylenol

Use: 

Fever control, mild to moderate pain.

Dose:

2mg per kilogram per dose and this can be given 6 hourly. The syrups are available in concentrations of 120mg per 5ml.

Safe for: 

All ages but must be avoided in children with liver or kidney disease.

Available in:

Syrup, drops, tablets and suppositories. Syrups allow more flexibility in dosing but suppositories are well tolerated and are better for vomiting children

NB: Paracetamol does not sedate a child.

* Paracetamol and combination medications for pain and fever

Commonly found in: 

Stopayne, Lentogesic, Stilpane, Painagon

Use: 

Combination medications are specifically designed for pain relief. They have no advantage over paracetamol for the relief of fever.

Dose:

2.5ml per 6kg of body weight.

Safe for: 

Only children over the age of 2 years.

Common side effects:

Sedation, constipation, dizziness and at very high doses, could cause difficulty in breathing.

NB: These medications are a combination of paracetamol, codeine phosphate and promethazine. 

Promethazine is an antihistamine that sedates the child and has an effect on relieving cramps. 

Codeine phosphate is a cough suppressant as well as a pain reliever and is similar to dextromethorphan.

• Also see: 10 medicine dos and don’ts    

* Paracetamol and ibuprofen combination

Commonly found in: 

Lotem

Use:

Anti-inflammatory agent, pain relief, fever.

Dose:

2.5ml per 10kg body weight – given 8 hourly.

Safe for: 

Only children over the age of 2 years.

Common side effects: 

Tummy ache, diarrhoea, prolonged use can cause bleeding in the stomach.

NB: Not to be used in dehydrated children or children with vomiting and diarrhoea.

Must be taken with food and must not be taken for more than 48 hours without speaking to your doctor.

* Diclofenac

Commonly found in: 

Voltaren

Use:

Anti-inflammatory, excellent pain relieving properties, lowers fever.

Dose: 

1 to 3mg per kilogram per day divided into three doses- 12.5mg suppository given every 8 to 12 hours.

Safe for:

Only children over the age of 2 years without a doctor's authorisation.

Common side effects:

Tummy ache and possibly bleeding in the stomach if used for long periods.

NB: Not for children with asthma, bleeding tendencies, dehydration, vomiting and diarrhoea. Must be taken with food.

Medications for mucus (snotty nose or wet cough)

Mucolytics

These products are used to thin out or liquify mucus or phlegm in the chest and upper airway to allow easier coughing. They won't stop the cough, but will cause more coughing until the mucus is cleared. 

Commonly found in: 

Acetylcysteine (Solmucol), Bromhexine (Bisolvon, Bronkese), Carbocisteine (Mucosirop, Flemex, Mucospect)

NB: The preparations are generally safe for children over two years of age and are typically used for coughs and colds.

Follow the manufacturer's package insert for the correct dose.

Medications for a wheezy chest

Bronchodilators

Bronchodilators relax the smooth muscle surrounding the airways and therefore relieve a tight chest. They are known as asthma pumps or inhalers but are also available in syrup form, which should only be prescribed if the child is unable to use the inhalers. The oral formulations are more concentrated than the pumps and cause more side effects, and their onset of action is slower, although the duration of action is longer.

Commonly found in: 

b2 Agonists (Ventolin, Berotec), Hexoprenaline (Ipradol)

Dose:

Dosage of the oral medication depends on the weight of the child. The inhalers are a standard dose and can safely be used 6 hourly during attacks of tight chest. The inhalers must be used with a spacer and mask in young children.

Common side effects:

Tremors, nervousness, rapid pulse, dizziness and nausea. Overdose will cause abnormal heartbeats.

Watch out for:

Theophylline (Nuelin, Alcophyllin, Solphyllin)

• These medications exert their action by causing bronchodilation. 
• The side effects of rapid heart rate and feeling jittery and tremulous are greater than for the above group. 
• They should not be given with antibiotics belonging to the macrolide group (Erythromycin, Klacid, Zithromax). This group of medications should only be used under instruction of a doctor.