FDA: Cold medicines too risky for tots
Updated: 2008-01-17 17:01
The reason: There's no evidence that these oral drugs actually ease cold symptoms in children so young — some studies suggest they do no good at all. And while serious side effects are fairly rare, they do occur. Indeed, the Centers for Disease Control and Prevention last year reported that more than 1,500 babies and toddlers wound up in emergency rooms over a two-year period because of the drugs.
"It's one thing if you're curing cancer, but we're talking about a self-limiting illness," said Sharfstein. "If there's really no evidence of benefit, you don't want to risk the rare problem. Then you're left with tragedy that you can't justify."
Specialists are back to recommending old-fashioned steps, such as plenty of fluids and rest, saline drops to loosen stuffy noses, and humidifiers while sleeping.
Why is this an issue now? Child versions of cold remedies came on the market decades ago, when scientists thought that what worked in adults would automatically work in children. Scientists today know that is not always the case.
In fact, FDA never formally allowed infant-targeted cold remedies in the first place; Ganley said they evolved through a legal loophole.
But the FDA is investigating an even bigger question: Are OTC cold remedies safe and effective for children under 12? The agency's advisers last fall called for no use just by the under-6 crowd, but did recommend more research to determine the medicines' effects in children overall.
The drug industry says these medicines are used 3.8 billion times a year in treating children's cough and cold symptoms and are safe for those over 2.
Health groups acknowledge that while low doses of cold medicine don't usually endanger an individual child, the bigger risk is unintentional overdose. For example, the same ingredients are in multiple products, so using more than one for different symptoms can quickly add up. Also, children's medicines are supposed to be measured with the dropper or measuring cap that comes with each product, not an inaccurate kitchen teaspoon.
An internal FDA working group has a February deadline to recommend to agency leaders any action for 2- to 11-year-olds, Ganley said. The goal is a spring announcement.
Meanwhile, the FDA's advice for children over 2:
- If you try these drugs, carefully follow label directions.
- Avoid giving a child more than one product. If you do, make sure they don't contain some of the same or similar ingredients.
- Understand that these drugs only treat symptoms. Colds are viruses, and the drugs will not make them go away any faster.
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