Table 2.

Common Active Ingredients in Pediatric Over-the-Counter Cough and Cold Products

Active IngredientDrug ClassUsual Pediatric DosesAdverse Effects and Toxicity
DextromethorphanAntitussive2–6 y: 2.5–7.5 mg q 4–8 hConfusion, dysarthria, stupor, nystagmus, dystonia, coma, hallucinations, tachycardia, seizures, respiratory depression
7–12 y: 5–10 mg q 4–8 h
GuaifenesinExpectorant> 2 y: 12 mg/kg per day divided into 6 dosesNausea, vomiting, diarrhea, abdominal pain, nephrolithiasis
2–5 y: 50–100 mg q 4 h
6–11 y: 100–200mg Q4H
Phenylephrine hydrochlorideDecongestant4–6 y: 2.5 mg q 4 h prnHypertension, angina, precordial pain, reflex severe bradycardia, peripheral vasoconstriction, arrhythmias, respiratory depression, hallucinations
> 6–12 y: 5 mg q 4 h prn
PseudoephedrineDecongestant< 4 y: 1 mg/kg per dose q 6 hArrhythmias, palpitations, tachycardia, bradycardia, nausea, insomnia, dizziness, psychosis, rash, urticaria
4–5 y: 15 mg q 4-6 h
6–12 y: 30 mg q 4-6 h
DiphenhydramineAntihistamine2–5 y: 6.25 mg q 4 hHypertension, tachycardia, chest pain, confusion, constipation, diarrhea, paresthesia
6–11 y: 12.5 mg q 4 h
LoratadineAntihistamine2–5 y: 5 mgHypotension, hypertension, palpitations, tachycardia, hallucinations
> 6 y: 10 mg
BrompheniramineAntihistamine2–6 y: 1 mg q 4–6 h prnPalpitations, paradoxical reactions, anxiety, circulatory collapse, rash, diplopia
7–12 y: 2–4 mg q 6–8 h prn
Chlorpheniramine maleateAntihistamine2–5 y: 1 mg q 4–6 hHypotension, tachycardia, palpitations, sedations, confusion, depression, hemolytic anemia, nausea, diarrhea, constipation
6–11 y: 2 mg q 4–6 h
ClemastineAntihistamine< 6 y: 0.335–0.67 mg/day divided into 2 dosesSedation, dizziness, disturbed coordination, epigastric distress, difficult urination, hemolytic anemia, wheezing
6–12 y: 0.67–1.34 mg bid
  • q 4–8 h=every 4 to 8 hours, q 4 h=every 4 hours, q 6 h=every 6 hours, q 4–6 h=every 4 to 6 hours, prn=pro re nata (as needed)