How to keep away from opioids in cold meds


Parents would agree how miserable cold and flu season can be when their child is sick. When the cough kicks in, parents logically look for ways to help. Grocery store shelves have several choices of cold medicine for children, and doctors can prescribe stronger medicines to help relieve severe symptoms.

Cough medicines and syrups with codeine have long been prescribed to adults to relieve serious coughs. But, is it safe to give children? That’s the question the Food and Drug Administration intends to revisit at an upcoming Pediatric Advisory Committee meeting.

The dangers of some cold medicines

The FDA is concerned about prescribing medications containing opioids to children. Opioids are a class of drugs that reduce pain by affecting the nervous system and include morphine, oxycodone, the aforementioned codeine and others.

To be clear, the issue does not focus solely on cold medicines containing opioids but all opioid-based medications. In fact, the FDA already restricted use of cough medicines containing codeine in children and recommends against its use in nursing mothers.

So, what can a parent do for a child with a horrible cough?

Gina Montion, MD, is a pediatrician who sees patients at the Banner Health Center on Greenway in Phoenix. She provided answers to why opioids could be a concern for children.

“The main risk is respiratory suppression and, frankly, stopping breathing,” said Dr. Montion. “Opioids also cause significant constipation, sometimes nausea or itchy reactions.”


Because of these issues, doctors will not typically prescribe cough suppressants and syrups with codeine with the rare exception being for an older teenager. This leaves over-the-counter medicines.

Cold medicine for children

“Generally, the cough medicine part of cough and cold medications tastes terrible,” Dr. Montion said. “I tend to avoid it because of that; however, it’s generally regarded as safe, if one desires to use it.”

For children 2 and over with bad coughs, Dr. Montion recommended 1 to 2 teaspoons of honey at bed time and every two hours, if needed. To help with a sore throat associated with a cough, Dr. Montion suggested Tylenol, ibuprofen or sore-throat suckers. A nightly shower and a cool-mist vaporizer placed about a foot away from the head of the bed can also help.

Dr. Montion said, in cases where there is a lot of thin nasal drainage, a dose of Zyrtec can help. For infants, parents can use a Nose Frida, or nose aspirator, to gently remove congested mucous from the nostrils.

The good news is, if you feel your child needs an over-the-counter cough syrup or cold medicine, you won’t have to worry about making sure it doesn’t have codeine in it—especially if it’s labeled specifically as a cold medicine or cough syrup “for kids” or “for children.” Those with opioids are available only by prescription.

And, as always, be sure to talk to your child’s doctor if you have concerns or if the cough doesn’t clear up in a few days.

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