Cough and Cold Medications
Over the counter (OTC) medications are generally used to reduce symptoms. They do not change the course of the illness. The times when symptomatic medications are most useful are for more restful sleep or to allow a child to return to school. Use medications when symptoms are caused significant discomfort. All medications have possible side effects so observe your child carefully and only continue to use the medication if it makes a noticeable improvement for your child. For young children (<2 year old) avoid OTC medications (except for Tylenol© and ibuprofen) unless directed by health care provider.
Be sure to check out related page on pain medications (Tylenol and ibuprofen) if you have questions regarding dosing and use of OTC analgesics.
Combination products are common which can include anywhere from two ingredients to some more than four. We recommend using single ingredient products which give the parent the most control in dosing accurately and not causing you to give a medication that may not be needed at that time.
There are many “home remedies” that do not contain medications. They often work as well or better than OTC medications and have much fewer side effects. These include:- Plain tap water can be used or saline mixed from ½ to 1 tsp of salt in one cup of water. This can be used as often as needed for thick nasal congestion that is interfering with sleep or feeding.
- Corn syrup 1/2 to 1 tsp as needed for cough. It soothes the throat and works equally well as dextromethorphan containing cough medications (i.e. Robitussin©)
- Warm liquids can be used to break up coughing spasms, croup, nasal congestion, and sore throats. Increasing fluid intake in any child ill with fever is very helpful.
Benadryl© (diphenhydramine)
Benadryl© is an antihistamine that is primarily used for allergic disorders. This include allergic skin rashes like hives and poison oak. It is also helpful for seasonal allergies. In older children it can be used as an occasional sedative (like for that long plane ride). In general it should not be used for common cold symptoms at is not helpful and may increase chance for ear infection. It ts to be given no more often than every six hours. Not routinely recommend for children under one year of age unless advised by your healthcare provider.
| Weight (pounds) | Liquid tsp (12.5 mg/5ml) | Chewable Tablets (12.5mg tablet) | Capsules (25 mg) |
| < 1 year old | call your doctor | — | — |
| 22—32 | 3/4 tsp | — | — |
| 33—43 | 1 tsp | 1 tablet | — |
| 44—54 | 1 1/2 tsp | 1 1/2 tablets | — |
| 55-109 | 2 tsp | 2 tablets | 1 capsule |
| 110+ | — | 4 tablets | 2 capsules |
Cough suppressant (dextromethorphan)
Cough suppressants are often found in single ingredient products like Robitussin© or in combinations with other products. There is only one cough suppressant ingredient on the market currently which is dextromethorphan. Expectorants have not been shown to have any benefit. Cough and cold symptoms are generally not recommend for children under age one since infant’s symptoms rarely improve with these medications and side effects are common. Brand names are listed below for example only, not to imply any particular endorsement. Always read labels to know what strength you have.
Cough suppressant medications come in many different strengths. Read the bottle carefully and then consult this table!
| Weight (pounds) | Liquid tsp (7.5 mg/5ml) [Robitussin pediatric cough] |
Liquid tsp (10 mg/5ml) [Robitussin DM] |
Liquid Tsp (15 mg/5ml) [Robitussin maximum strength] |
| < 2 year old | not recommended | not recommended | not recommended |
| 22—32 | 3/4 tsp | — | — |
| 33—43 | 1 tsp | 3/4 tsp | — |
| 44—54 | 1 tsp | 1 tsp | — |
| 55—65 | 1 1/2 tsp | 1 tsp | — |
| 67—87 | 2 tsp | 1 1/2 tsp | 1 tsp |
| 88—109 | 2 tsp | 2 tsp | 1 tsp |
| 110—131 | — | 2 1/2 tsp | 1 1/2 tsp |
| 132+ | — | 3 tsp | 2 tsp |
