Medicine use in children

Date Updated: 11/19/2024

Some children need to take medicines when they are young, whether it's to treat a common cold or an ongoing condition. Many medicines have side effects that parents and healthcare professionals must consider before giving them to a child. Young children are at higher risk of side effects of some medicines due to a smaller body mass. Their bodies may not be as efficient at breaking down and processing medicines compared to adults.

Before giving any medicine to a child, read the label or look up the medicine's website to make sure it is safe for children. If you still aren't sure, ask your healthcare professional.

The KIDs List

Key Potentially Inappropriate Drugs in Pediatrics, also known as The KIDs List, is a list of medicines that may be harmful to children. It shows which medicines have a higher risk of harmful reactions in children. This list gives the names of medicines, their risks and their recommended use. The KIDs List is a great resource for understanding the harmful effects of some medicines on children. However, if you aren't sure if a medicine should be given to your child, contact your healthcare professional.

Some common medicines that may harm children include medicine for diarrhea, aspirin, cold medicine, opioids, and teething creams and gels.

Antidiarrheals

Antidiarrheals are medicines used to treat diarrhea. They are typically sold without a prescription. However, prescription antibiotics or other medicines may be given to people with prolonged diarrhea.

Antidiarrheal use should be avoided in children because they can make diarrhea worse. If your child's diarrhea lasts longer than 24 hours, contact their healthcare professional.

Aspirin

Aspirin is a medicine that reduces pain, fever and inflammation. Aspirin is generally avoided in children and adolescents for pain. Giving aspirin to children who have a viral infection is linked to Reye's syndrome, a rare condition that affects all organs of the body, especially the liver and brain. However, aspirin may be used to treat certain conditions in children, such as Kawasaki disease. Your healthcare professional can tell you when aspirin is safe to give.

Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen sodium have replaced most aspirin use in people under 18 years of age. These medicines carry their own risks such as gastritis, so talk to your healthcare professional about the best choice for your child.

Cold medicine

Cold medicines that can be bought without a prescription are used to treat a cough and other cold symptoms. These medicines contain ingredients that can be harmful to children. In children under 2 years of age, cold medicines can cause serious complications such as breathing troubles and fatal overdoses. Overall, cold medicines aren't recommended for children under 12.

Pain relievers such as acetaminophen (Tylenol, Children's Tylenol) and ibuprofen (Advil, Children's Motrin) may be given to help with fever, aches and sore throat. Always read the label before giving children any medicines. If you still aren't sure if a medicine is safe, contact your child's healthcare professional.

If your child's fever goes over 100.4 degrees Fahrenheit (38 degrees Celsius) or your child has blue lips, trouble breathing, severe headache or ear pain, see a healthcare professional at once.

Opioids

Opioids are medicines that relieve pain. They may come from the poppy plant or can be man-made. Opioids travel through the blood and attach to receptors in the brain. This blocks pain messages and can boost feelings of pleasure. However, using opioids often can lead to dependence and addiction.

There are no guidelines for opioid use in children. These medicines may be used for moderate to severe pain, such as after surgery for a short amount of time or for cancer pain. Talk to your child's healthcare professional about nonopioid alternatives. Some opioids, including fentanyl and morphine, are given to people of all ages. Opioids such as oxycodone and hydromorphone may be given to children older than 6 months. Opioids such as codeine and tramadol should never be given to children.

The risks of giving certain opioids to children may include breathing troubles, sedation, constipation, nausea, vomiting, itching and death. Long-term opioid use in childhood increases the risk for misuse in young adulthood, including the use of the opioid heroin.

Teething creams and gels

Teething creams and gels are often given to babies to ease the discomfort that comes with teething. Some topical medicines marketed for teething contain benzocaine or lidocaine. These numbing agents should not be used in children as they can be dangerous.

When used in children, benzocaine can cause a rare condition called methemoglobinemia (met-hee-mo-glo-bih-NEE-mee-uh) that affects how oxygen is carried throughout the body. Symptoms of methemoglobinemia include vomiting, headache, shortness of breath, changes in skin color, low oxygen levels, high heart rate and tiredness. Lidocaine use in children can cause heart problems, severe brain injury, seizures and death.

Medicine safety for parents

Medicine safety includes knowing how to properly give, store and dispose of medicines.

Giving medicines. Always read the label on the medicine before giving it to your child. If the medicine is a prescription, follow the instructions given by your healthcare professional. Only give the dose stated on the label. If the medicine came with a dosing device such as a syringe or cup, only use that device to ensure proper dosing.
Storing medicines. Keep medicines out of reach of children. Store them in a lockbox or safe if the medicines are hazardous, including opioids. Think about where kids can get into medicine, such as in purses and nightstands, and move these medicines. Store medicines in their original containers. Consider products you may not think of as medicine such as vitamins, creams and eye drops. Store these safely as they also can harm children.
Disposing of medicines. Be sure to safely dispose of unused and expired medicines. Many communities offer take-back programs, and pharmacies may have drop boxes for unused medicines. Find your closest drop-off location on the Drug Enforcement Administration website. If these aren't options, mix medicines with kitty litter or coffee grounds and throw the mixture in the garbage.
Teaching children about medicine safety. Tell your child that medicines should only be taken from a trusted adult, never on their own. Let your child know the risks of taking medicine without an adult's help.