Medicines: Using Them Safely

Medicine Safety

Giving kids medicine safely can be complicated. And many parents feel the pressure when a young child needs a medicine, knowing that giving too much or too little could cause serious side effects.

Using medicines safely means knowing when they're needed — and when they're not. Always check with your doctor if you're not sure.

Often, home care is the best bet for a quick recovery. For instance, kids who have the flu or a cold should:

• get lots of rest
• drink plenty of clear fluids (such as water, juice, and broth) to avoid dehydration

If your child has a stuffy nose, saline (saltwater) drops can thin nasal secretions. A cool-mist humidifier or a warm-air vaporizer keeps moisture in the air, helping to loosen congestion. If you use a humidifier or vaporizer, clean and dry it well every day to prevent the build-up of bacteria and mold.

What to Know

To safely use prescription or over-the-counter (OTC) medicines, talk with your doctor or pharmacist before giving them to your child.

When giving your child medicines, you'll need to know:

• the name and purpose of the medicine
• how much, how often, and for how long the medicine should be taken
• how the medicine should be given. For example: taken by mouth; breathed into the lungs; inserted into the ears, eyes, or rectum; or applied to the skin
• any special instructions, like whether the medicine should be taken with or without food
• how the medicine is stored
• how long the medicine can be stored safely before it needs to be discarded
• common side effects or reactions
• interactions with other medicines your child takes
• what happens if your child misses a dose

Other things to know:

• Because the dosages of prescription and OTC medicines depend on a patient's weight, make sure the doctor and pharmacist have updated information about your child's weight and age. Too little medicine can be ineffective and too much could be harmful. Also, different medicines have different concentrations of ingredients. So always check the bottle and ask the pharmacist if you have questions.
• Make sure the doctor and pharmacist know if your child has any allergies or takes other medicines regularly.
• Sometimes, medicines are given on an as-needed basis such as for pain or discomfort. OTC drugs that relieve symptoms like aches, pains, or fever (like acetaminophen and ibuprofen) should be used as your doctor recommends.
• Do not give cough or cold medicines to your child unless the doctor says it's OK, especially to kids under 6 years old. These products offer little benefit to young children and can have serious side effects. Many cough and cold products for children have more than one ingredient, which might increase the chances of accidental overdose if taken with another medicine.
• Always talk to your doctor first to be sure an OTC medicine is safe for your child.
• Many prescription medicines should be taken until finished as prescribed by the doctor — even if your child feels better before that. For example, antibiotics kill bacteria , so it's important to finish all doses even after symptoms stop. Otherwise, the infection could come back.

Aspirin Alert!

Never give aspirin to kids, especially during viral illnesses. Using aspirin during an illness caused by a virus (such as the flu, chickenpox, or an upper respiratory infection) can cause Reye syndrome. This potentially life-threatening disease can cause nausea, vomiting, and extreme tiredness that progresses to a coma.

Some OTC medicines (including some that treat headache and nausea) contain aspirin. So always read labels and check with your doctor or pharmacist before using them. Also, some aspirin-containing medicines use words other than aspirin, such as salicylate or acetylsalicylate. Avoid those too.

Medicine Safety Basics

For safe medicine use:

• Always check with your doctor if you're unsure whether symptoms need medical treatment.
• Never use leftover medicines. For example, pharmacists will sometimes dispense more liquid medicine than is needed in case some is spilled or measured incorrectly. If you have leftover liquid medicine, throw it out. For medicines taken as needed, keep an eye on the expiration date to make sure you don't give an outdated medicine.
• Never give your child medicines that have been prescribed to someone else, whether it's an adult or child. Even if two people have the same illness, they may need different drugs with different dosages and directions.
• Never give a child a medicine that is meant for adults.
• Check with your doctor or pharmacist before giving two types of medicines with the same ingredients to your child.
• When buying OTC medicines, check the packaging for possible tampering, and don't use any medicine in a cut, torn, or sliced package. Check the expiration date too.
• Work with a local pharmacist so that your family's medicine history is in a central location. Consult your pharmacist if you have questions about any medicine, including information about possible side effects or reactions.

Giving Medicines to Kids

Double check. First, check to make sure you have the correct prescription. Many prescription and medicine bottles look the same, so make sure your child's name is on the label and it's the medicine that the doctor recommended or prescribed.

Be especially careful when reaching into the medicine cabinet in the middle of the night — it's easy to grab the wrong bottle when you're sleepy.

Read all instructions. Both prescription and OTC medicines usually come with printed inserts about common side effects and further instructions on how to take the medicine. Be sure to read all information carefully before beginning the medicine. The label may instruct you to shake a liquid medicine before using so that the active ingredients are evenly distributed throughout it. Call the doctor or pharmacist if you have any questions.

With or without food? All prescription medicines have labels or instructions about how to take them. For example, "take with food or milk" means the medicine may upset an empty stomach or that food may improve its absorption. In this case, your child should eat a snack or meal right before or after taking the medicine.

Another common instruction on prescription medicines is "take on an empty stomach," in which case your child should take the medicine 1 hour before or 2 hours after a meal because food may prevent the medicine from working properly or may delay or reduce its absorption. Some medicines interact only with certain foods or nutrients, such as dairy products, so be sure to check the label for other instructions.

The right dose. Giving the correct dose is important because most medicines need to be taken in a certain amount and at certain times to be effective. The dose will be written on the prescription label or, on OTC medicines, should be printed on the package insert, product box, or product label.

Measure carefully. You can dispense medicine in a variety of ways. For babies who can't drink from a cup, try a dosing syringe, which lets you dispense the medicine into your baby's mouth, making it less likely to be spit out. Be careful, though — many come with a small cap on the end that can be a choking hazard to young children. Store a medicine syringe in a safe place out of the reach of kids.

Other options for young kids are:

• plastic droppers
• cylindrical dosing spoons, which have a long handle that's easier for children to grab
• if your child can drink easily from a cup without spilling, the small dosage cups that come with many medicines

Never use tableware or a kitchen spoon to measure medicine because these don't provide standard measurements. Instead, get a measuring device designed to deliver accurate medicine doses from your local pharmacy or drugstore.

Some medicine dispensers for infants and toddlers look like pacifiers. With these, you put the medicine in a small measuring cup attached to a pacifier, and then give the pacifier to the baby to suck. Most of the medicine slips past the taste buds, making it go down easily.

Whatever method you use, it's important that your child takes all the medicine each time. If a dose is missed, never give two doses at once to "catch up."

What if My Child Doesn't Want to Take the Medicine?

Try these tips to get kids to take "yucky" medicines:

• Some kids may prefer it if medicines are chilled. Check with your pharmacist to see if chilling the medicine is safe because refrigeration may alter the effectiveness of some drugs.
• Before mixing a medicine with food or liquid, check with your pharmacist to make sure that it won't harm its effectiveness. Mixing the medicine with a small amount of liquid or soft food (such as applesauce) may make it more appealing. Use only a small amount of food and make sure your child eats all it to get the complete dose of medicine. Avoid mixing medicine in a baby's bottle — a baby who doesn't finish the bottle might not get all it.
• If you use a syringe, try squirting the medicine (a little bit at a time) on the inside of the child's cheek, where there are no taste buds.
• If your child has trouble swallowing a tablet or capsule medicine, ask your pharmacist if you can crush it and mix it with soft food (such as pudding or applesauce). (The effectiveness of some drugs may be harmed by crushing.)
• Some pharmacies offer flavorings such as chocolate, cherry, grape, and bubblegum to make drugs like antibiotics and cough syrup more appealing to kids. Ask your doctor or pharmacist about the safety of flavoring in medicine, especially if your child has an allergy to dyes or sweeteners.

Never call medicine candy to try to get your child to take it. This can backfire, and a child could accidentally overdose by taking dangerous medicine thinking it's a tasty treat. Instead, explain that medicine can make your child feel better, but must always be taken with you or another caregiver supervising.

If your child spits out or vomits medicine, don't give another dose — call your doctor for instructions.

And, if your child isn't getting better or gets worse while taking the medicine, talk to your doctor.

What About Side Effects?

After giving your child a dose of medicine, be on the lookout for side effects or allergic reactions. The pharmacist or product packaging may warn you about specific side effects, such as drowsiness or hyperactivity.

If your child has side effects such as a rash, hives, vomiting, or diarrhea, contact your doctor or pharmacist. Penicillin and other antibiotics are among the most common prescription drugs to cause an allergic reaction.

If your child develops wheezing, has trouble breathing, or difficulty swallowing after taking a medicine, seek emergency help by calling 911 or going to the emergency department immediately. These could be symptoms of a serious allergic reaction that requires emergency care.

Sometimes children have unusual reactions to medicines, such as hyperactivity from diphenhydramine, which usually makes adults feel sleepy. Tell your doctor if this happens.

How Should We Store Medicine?

Be as careful about storing medicines as you are about giving the correct dose. Read the medicine's instructions. Some drugs need to be refrigerated, but most should be stored in a cool, dry location away from direct sunlight.

Your bathroom's medicine cabinet is a poor choice for storing most medicines because of the humidity and moisture from the tub or shower. Instead, store medicines in their original containers in a dry, locked location that kids can't reach. Above-counter kitchen cabinets are great spots if they are away from the stove, sink, and hot appliances.

Child-resistant caps can be hard even for adults to open. But protect your kids by re-locking and recapping child-resistant bottles properly. Kids can sometimes open the cap, so it's important to lock away all medicines. If any visitors to your house have medicine in their bags, purses, or coat pockets, make sure they put those out of sight and out of reach.

If your child accidentally takes medicine, call the Poison Control Center right away for guidance at 1-800-222-1222. Put this number in your cellphone and post it where others can see it in your home.

How Can We Safely Dispose of Medicines?

The best way to dispose of unwanted medicines is through a medicine disposal site.

The U.S. Drug Enforcement Administration (DEA) periodically hosts National Prescription Drug Take-Back events. Temporary collection sites are set up in communities for safe disposal of prescription drugs. There are also permanent sites in many areas. Visit the DEA website to find a disposal site near you.

If you can't dispose of your medicines at a disposal site, keep these suggestions in mind:

• When disposing of medicines, make sure they stay out of the reach of children and don't contaminate the environment.
• Check the package for specific instructions on how to dispose of the medicine. Do not dispose of medicines in the toilet unless the package says it's OK.
• Break down tablets or capsules and mix them with another substance, like used coffee grounds or kitty litter. That way, kids and pets won't try to get to the medicine. Next, put the mixture in a bag or container and seal it closed, then toss it into a garbage can.
• Return the medicine to a local pharmacy. Many pharmacies take back expired pharmaceuticals. Each pharmacy has a different policy, so contact yours to see if it will accept them.
• Local household hazardous-waste collection facilities often take expired medicines. These are the places where antifreeze, oil, and used batteries are taken for proper disposal. Each facility has a different policy about unused medicine, so call first.
• Take special care to dispose of unused pain medicines promptly to prevent the potential for theft/abuse.
• Put needles in the trash in a thick plastic container (like a laundry detergent container) or a metal can (like a coffee can) where the lid has been carefully secured.