The variety and amount of Over The Counter (OTC) medications available nowadays can make a trip to the drug store quite confusing.  Not only are there multiple brands for each type of product, but there’s no clear idea of what can be used together, or what should never be used together.  This post will discuss the medicines usually prescribed by your doctor or usually purchased by people for their children during the winter. I will not discuss doses, you should ask your pediatrician if they recommend any of these, and which dose they prefer you to use.

Medicines for fever.

There are two medicines for fever, acetaminophen and ibuprofen.  Some people prefer one over the other for fever or achiness, which is fine, as there are medicines that work better for some people than others.  It’s like Coke and Pepsi-they’re similar, but different. We don’t really recommend that they be used together, but with high persistent fever a popular way of treating it is alternating the two every 4 hours.  

*Acetaminophen (Tylenol, FeverAll, etc): can be used at all ages, although often not recommended younger than 4-6 weeks because doctors want to know when kids that age have a fever.  It comes as a liquid, chew, swallow pill, or suppository. It can be given every 4 hours, as needed. Make sure that any dosing you do for small children is done by weight, not age, as they can have widely different weights at young ages.

*Ibuprofen (Advil, Motrin, etc.): only recommended for over 6 months of age due to how the body deals with it.  It comes as a liquid, chew, or swallow pill. I have seen a few pharmacies make suppositories, but they aren’t OTC.  It can be given every 6-8 hours. The same weight based dosing applies as with acetaminophen.

Medicine for cough and congestion.

There are multiple medications for cough and congestion, often mixed together to make up one OTC product with many functions.  When you’re looking for a medicine for your child make sure you look at the active ingredients to make sure you’re not giving them the same thing in another product.  As with the fever reducers, some work for some people, and some work for others. Also, these medicines not recommended by the American Academy of Pediatrics for under 12 years old, although they often are recommended by individual practitioners.  

*Diphenhydramine (Benadryl): an antihistamine.  Helps with runny nose, watery eyes, itchy eyes, sneezing.

*Brompheniramine:  an antihistamine. Helps with runny nose, watery eyes, itchy eyes, sneezing.

*Dextromethorphan (Triaminic Cold and Cough, Robitussin Cough, etc): cough suppressant.

*Guaifenesin (Mucinex, Wal-Tussin, etc): an expectorant.  Helps thin and loosen mucus in the airway and clearing congestion.

*Phenylephrine (Sudafed PE, Wal-Phed PE): decongestant.  Shrinks blood vessels in the nose. Helps dry up the mucus in your nose and throat.

*Pseudoephedrine (Sudafed, Wal-phed 12 hour, etc): decongestant.  Shrinks blood vessels in the nose. Helps dry up the mucus in the nose and throat.

*Honey: has been shown in a study that mixed it in tea to work as good cough suppressant.  It also tastes better. Not to be used below one year old.

*Vicks chest rub: has been shown, when used under the nose, to help open nasal passages.  Study was done on those over 2 years old. If unable to tolerate under nose, or younger than two, can put on chest.  

*Zinc (Zicam): theoretically makes it harder for the cold virus to function in your nose.  Has not been shown to work in children. The nose spray can cause permanent loss of smell.

Medicine for allergies.

Allergies are actually a year ‘round problem. They can cause itchy eyes, sneezing, runny nose, cough, sore throat, and sinus pressure, which can be annoying for some people.  They can also lead to things like sinus infection and ear infection.

*diphenhydramine (benadryl): short acting antihistamine (only lasts a few hours).  Use when having more allergy symptoms than usual. Not really meant to be taken every day.

*loratadine (claritin), cetirizine (zyrtec), fexofenadine (allegra), levocetirizine (xyzal): these are all long acting antihistamines (last about 24 hours).  They are meant to be taken every day, and can take a day or two to truly see the full effect.

*nasal steroid (Flonase, Rhinocort, Nasacort, etc): helps to reduce sneezing, congestion, and itchy watery eyes.  Meant to be taken every day, and can take a few days to see the full effect. Effect somewhat dependent on proper technique.

*nasal decongestant (Afrin, etc): shrink swollen blood vessels in the nose.  Can work well, but has a rebound effect that makes the symptoms worse than when you started.  Don’t use more than twice a day for three days (then throw it away so you won’t be tempted to use it more).

Helpful hints.

*As long as your child has a fever, you can give an anti-fever medication along with a cough medicine.

*It’s helpful to keep a record of what medication, dose, and time you give something to your child. It’s easy to forget when you gave something, and it can get even more confusing with two people giving meds.