Pediatricians Warn Overmedication Can Occur

If Multiple Medications Are Used to Treat the Common Cold

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Amid the controversy about over-the-counter cold medicines, many pediatricians have voiced an added concern this cold season: they fear that parents may not appreciate how easy it is to give a child an overdose of cold medication.

A new survey of pediatricians, conducted at the recent Annual Meeting of the American Academy of Pediatrics (AAP), shows that 61 percent of respondents are very concerned that, by combining common over-the-counter cold and fever medications, parents may unwittingly give their children an overdose of medication, putting children's health at risk. A mere three percent of pediatricians surveyed said that they were not very concerned about this potential for overdose, whereas another 36 percent said they were somewhat concerned that parents may give their children too much cold medicine(1).

The 290 pediatricians surveyed cited parental confusion over the variety of cold medications on the market as the primary reason for this overdose potential. Seventy-three percent of pediatricians said that they are very concerned that some parents are confused when selecting over-the-counter medications, which could lead them to select the wrong medicines for their children(2).

"It is essential that parents read the label of an over-the-counter cold medication carefully before selecting a medicine for their child because the risk to children from the misuse of cold medications is still widely underestimated," said James Kaltenback M.D., Pediatrician, South Jersey Pediatric Associates, a division of Children's Health Associates.

The pediatricians' chief concern is that children may be getting an overdose of fever reducers, which can affect the liver or the kidney. Some children's cough and cold medications contain a fever reducer, such as acetaminophen or ibuprofen. But often, parents who are unaware of these ingredients may give their children an additional fever-reducing medication. For this reason, 64 percent of the surveyed pediatricians believe it is very important that children's cold medications do not contain fever reducers(3).

Pediatricians alert parents that while over-the-counter cold medications do not require a doctor's prescription, they are not without risk. One example is the over-the-counter fever reducer acetaminophen, found in some children's cold medicines from well know brands such as Tylenol(R), Dimetapp(R), and Triaminic(R). Acetaminophen became the preferred fever reducer in the 1970s after studies showed a link between aspirin and Reye's syndrome, a potentially fatal disease in children and teens(4a).

Recent studies indicate that too much acetaminophen could adversely affect a child's health(4b). Therefore, it is not surprising that when recommending an over-the-counter cold remedy for their patients, 73 percent of pediatricians surveyed considered it very important that PEDIACARE does not contain acetaminophen or ibuprofen. Further, 78 percent said that it is very important that PEDIACARE does not contain PPA (phenylpropanolamine)(5a), an ingredient found in some cold medicines that has been linked to an increased risk of stroke(5b). "It is important that parents select a cold medication developed for children, such as PEDIACARE," said Dr. Kaltenback. "PEDIACARE does not include PPA and, since it does not include acetaminophen nor ibuprofen; this greatly reduces the chance of accidental antipyretic overdose."

About Children's Colds Colds, which are caused by viruses and transmitted primarily by sneezing and coughing, are the most common illness in children. In fact, a child is likely to have as many as ten colds by the time he or she reaches age two(6). Symptoms of the common cold include a runny or stuffy nose, sneezing, watery and itchy eyes, coughing, and sore throat(7). A fever may be the sign of a more serious illness, such as the flu, which may warrant a call to the doctor's office. There is no cure for the common cold, so the best thing parents can do is to make their children more comfortable by treating their symptoms and ensuring that they get plenty of rest(8).

There are a variety of over-the-counter medications for children, but it is important that parents read medicine labels and ingredients carefully before selecting the most appropriate cold remedy. This is especially important if a child is receiving more than one medication because some of the same ingredients may be in each product. It is also important that parents choose a medication that is indicated for children and follow dosing instructions precisely.

PEDIACARE (pseudoephedrine, chlorpheniramine, and/or dextromethorphan) is one of the most trusted brands of cough and cold medicines for children. Introduced in 1984, PEDIACARE comes in liquid form for children ages 6 to 12, and in drop form for children up to age three. Developed specifically for children, PEDIACARE helps relieve a child's nasal congestion, sneezing, watery and itchy eyes, and coughing.

The PEDIACARE family of products is available in gentle, alcohol-free formulas with flavors that enhance compliance. PEDIACARE comes in child-resistant safety packaging and easy-to-read, symptom-specific labeling with clear dosing directions. PEDIACARE does not contain fever-reducing medications, which are not always necessary when treating a cold.

Pharmacia Corporation (NYSE: PHA) is a leading global pharmaceutical company created through the merger of Pharmacia & Upjohn with Monsanto Company and its G.D. Searle unit. Pharmacia has a broad product portfolio, a robust pipeline of new medicines, and an annual investment of more than $2 billion in pharmaceutical research and development. Pharmacia's Consumer Healthcare division helps people live healthier lives by bringing to market consumer healthcare products for hereditary hair loss, smoking cessation, upper respiratory ailments and skin irritation.

References:

1.'American Academy of Pediatrics Convention Study,' Oct. 31, 2000. Prepared by Wirthlin Worldwide.

2. Ibid

3. Ibid

4a. American Academy of Pediatrics 'A Guide to Children's Medications.' http://www.aap.org/family/medications/htm.

4b. Brody, Jane, "With Tylenol and Children, Overdosing is Perilously Easy." The New York Times, Jan. 25, 2000.

5a. American Academy of Pediatrics Convention Study, Oct. 31, 2000. Prepared by Wirthlin Worldwide.

5b. R. Horwitz, M.D., et al. Yale University School of Medicine. "Phenylpropanolamine and Risk of Hemorrhagic Stroke: Final Report of the Hemorrhagic Stroke Project." May 10, 2000.

6. American Academy of Pediatrics, 'Common Colds and Young Children.' http://www.aap.org.

7. National Institute of Allergy and Infectious Diseases of the National Institute of Health, 'Fact Sheet on the Common Cold.' http://www.niaid.nih.gov/factsheets/cold.htm

8. American Academy of Pediatrics, 'Common Colds and Young Children.' .