Cough and cold is the most common reason for health care visits to pediatricians and general physicians. Colds and coughs are quite common especially in young children attending play school and daycare. Most of these are due to viral respiratory viruses like rhinovirus, metapneumovirus etc. Almost all of these viral infections are self limiting and get better in a period of 5-7 days without any medicines without any serious complications. The symptoms can be disturbing to the child as well as parents leading to a lot of stress and worry. This leads to overuse of cough syrups. Many of these cough syrups are available over-the-counter (OTC) allowing easy access to parents and caregivers even without prescription.
Does cough syrup help in treatment of cough and cold?
Cough syrups usually do not provide a significant relief in symptoms of cough or cold. Cough syrups also do not make the viral infection go away faster.
What are the contents in cough syrups?
The cough medicines can have different contents which include cough suppressants (like dextromethorphan, levodropropizine), anti-histamines (like chlorpheniramine, diphenhydramine, levocetirizine etc), expectorants (like ambroxol, guaifenesin and ammonium chloride etc), bronchodilators (like salbutamol, levo-salbutamol, terbutaline). Some cough mixtures also contain fever medicines like paracetamol.
What can be the side effects of cough syrups?
Minor side effects like dizziness, headache, restlessness, hallucinations and increased sleepiness are observed. In rare cases especially if overdoses children can get slow breathing, changes in heart rhythm and low blood pressure.
What are the common reasons for getting side effects due to cough syrups?
There are many ways in which cough syrups can lead to side effects. Most of the cough syrups are a mixture of 2-3 or more medicines in differing doses across different brands of different companies. For eg. One cough syrup might have dextromethorphan as 5 mg in 5 ml while the other might have 10 mg per 5 ml. This leads to a lot of confusion. Most parents are unaware about the doses recommended and give it by a rough idea (e.g. half teaspoon etc). Proper measurement with a measuring cup or syringe is usually not done, leading to inappropriately high doses. In addition it might be used more than the recommended number of times. In addition children might be getting 2-3 syrups with overlapping content. They might be taking more than one product containing the same drug. For example, taking both a fever medicine containing paracetamol and cough syrup containing paracetamol. Overdosing with cough medicines is quite common and is the most important reason for side effects with cough syrups. Most data from the USA and Canada has suggested that many deaths in children have happened due to overdosing with cough syrups.
Which is the best cough syrup for children?
Cough is a body’s natural defense mechanism. Most coughs and colds improve on their own and do not require much treatment. It is important for parents to see their doctor to get the child examined to understand if the cause of cough is a simple viral infection or a tonsillitis, pneumonia or wheezing leading to cough. In that case your doctor shall prescribe proper medicines. We advise parents not to use cough medicines on their own as it can lead to many side effects.
