The U.S. Food and Drug Administration (FDA) has issued a warning to warn of the caution in the use of cough and cold medications (IFP) for children under 2 years of age.

The reason for the appearance of this warning was 3 cases of death of children aged 1 to 6 months, resulting from taking cold medicines. In post-mortem blood samples from all children, pseudoephedrine was detected at concentrations of 4,700 to 7,100 ng / ml, despite the fact that taking the drug at therapeutic doses in children 2 to 12 years of age results in the creation of plasma concentrations between 180 and 500 ng / ml. Dextromethorphan and acetaminophen were also detected in the blood of two patients, while carbinoxamine, which was part of the medication taken by children, was absent. In addition, from 2004 to 2005, nearly 1,500 American children under 2 years of age required medical care related to the development of adverse effects when taking PPP.

It should be noted that there is currently no FDA approved dosage regimen for over-the-counter cold medicines for children under 2 years of age. In the instructions that accompany the drugs, it is recommended to "consult a doctor" about the possibility of their use and dosage in children in this age group. At the same time, practitioners often extrapolate the doses used in children in the older age groups and adults or calculated per kg of patient body weight to children in the younger age groups, suggesting that there are no significant differences. in the pathogenesis of diseases and the pharmacodynamics of drugs. In addition, according to systematic reviews of controlled trials, the effectiveness of reducing acute cough and other symptoms of upper respiratory tract infections in children under 2 years of age with PPP does not exceed that of placebo..

The high risk of toxic reactions, the lack of dosage recommendations and the small number of publications confirming the efficacy of PPP in children under 2 years of age do not allow the use of these drugs in this age group without medical prescription.. If the drug has been prescribed, it is extremely important to strictly adhere to the prescribed dosing schedule.

Doctors are encouraged to conduct health education with parents of children, explaining the importance of a strict dosage of cold medicines and informing the treating doctor that the child has taken these medicines to avoid a overdose due to duplication of active components. All cases of the development of adverse events in young children with the use of PPP should be immediately reported to the appropriate regulatory authorities.

As an alternative to cold medicines in children, it is recommended to use nasal drops and sprays containing physiological saline to moisten the nasal cavity and thin the secretion, as well as rubber pears for its aspiration.