Why adult cold medicine is not good for children

If you feel like everyone’s getting sick right now, you’re not wrong. Seasonal illnesses—including the flu, RSV, and COVID—are surging strongly and leaving families scrambling to stock up on medicine. A recent children’s Tylenol and ibuprofen shortage has left shelves empty and added to the stress of caring for a sick child. The pharmacies that do have some children’s pain relief medication available are limiting purchases. With a lack of options, one alternative parents and caregivers might think of doing is giving adult cold medication.

But this is the wrong move. Medical experts say that under no circumstance should parents give adult doses or cut up adult medications to give to children. “Adult medicine has not been necessarily tested or approved for use in kids, so you’re putting your own child at risk for more complications,” says William Chu, pediatrician and medical director at Pediatrix Primary + Urgent Care of Texas. Not only is it ineffective but if administered incorrectly, it could be fatal. 

No meds is better than the wrong meds 

Depending on the age, children have no need to take over-the-counter (OTC) meds when they are sick. According to the American Academy of Pediatrics, children less than 4 years old shouldn’t be given cough and cold medication. Most cases resolve on their own, plus these medicines are not very effective for this age group. “The research doesn’t show that there’s a lot of benefit to giving cough and cold medicines to kids,” says Chu. “Most of the time it’s more risky to give, and by giving adult medicines you’re only increasing the risk with none of the benefit.” If your kid is between 4 to 6, Chu advises exercising extreme caution on using OTC pain relievers and consulting a doctor first.

[Related: Is it flu or RSV? It can be tough to tell.]

Younger kids, for instance, are unable to swallow pills, so giving them a Tylenol pill to swallow could be a choking hazard. Additionally, giving adult medications incurs serious side effects, including nausea, stomach pain, and even death. “Very high doses of these cough and cold medications can be fatal for children,” says Norma Perez, a pediatrician with AltaMed Health Services based in California.

The extensive list of side effects stems from the ingredients in medicine. Decongestants, for example, are stimulatory and a high dose of it could increase blood pressure and cause seizures. Dextromethorphan, a common cough suppressant, can slow breathing, increase heart rate, and induce a coma if an excess is ingested. Acetaminophen and ibuprofen are safe at normal doses, but large amounts could lead to severe liver damage, drowsiness, and abdominal pain. 

Medication doses are intentionally different for adults and children 

Most medicines have overlapping ingredients to treat multiple symptoms, which could increase the risk of an overdose. And the chances of a child overdosing on adult pain relievers is very high because of body size. Drugs like “acetaminophen and ibuprofen are not based on age but weight,” says Perez. “Depending on how much they weigh, that’s what we calculate for what’s an appropriate dose for children.” The one or two pills recommended on the bottle have been calculated for an adult weight, and that dose could be higher than normal for a child. One exception is if a child weighs over 95 pounds or who is over the age of 12. Chu says it’s generally safe for teenagers to have adult doses of OTC medicines.

Cutting up a pill or tablet won’t help lower the dose, warns both experts. “A lot of these medications are not designed to be effective when you break it up,” says Perez. What’s more, you’re still providing a “guesstimate” of an appropriate dose; there’s no way of knowing whether you’re providing too much or too little to your child. Crushing up medicine could also make it harder for a child to ingest. Chu says “it may be difficult to swallow a jagged pill or if it’s ground and mixed with something there is going to be a taste issue.”

[Related: Here are the cold and flu remedies that actually work]

What’s a caregiver to do?

If you’re still having trouble finding children’s pain relievers, there is some good news. A lot of home remedies are helpful for relieving flu, RSV, and COVID symptoms. Honey soothes sore throats and is possibly better than usual treatment of care such as OTC cold medication and antibiotics. It also helps with cough suppression, including coughs produced by post nasal drip. “The thickness coats and protects the throat, giving you relief,” explains Perez. Honey also has antimicrobial properties that can destroy pathogens responsible for upper respiratory tract infections. She recommends giving half to a full teaspoon of honey to kids older than one year of age. 

To help with nasal congestion, a humidifier or a steamy shower could alleviate that stuffiness, especially if done right before bed. The hot steam helps to thin out mucus allowing for clearer lung and nasal airways. The relief provided from steam inhalation will help kids breathe more comfortably, and in turn, sleep more comfortably. Another way to help with a stuffy nose is by using OTC nasal sprays every two to three hours, though both experts warn not to make your own at home. You can buy nasal saline sprays at your local pharmacy and depending on the symptoms.

With all these respiratory viruses, Chu says caregivers have a right to be worried. The best course of action is to manage your child’s symptoms and keep them comfortable. If there’s any lingering concerns, see your pediatrician or take your child to urgent care.