Medicines: Using Them Safely

Giving kids medicine safely can be tricky. And many parents feel the pressure when their child needs a medicine, knowing that giving too much or too little could cause serious side effects. Here are some tips that can help.

What Are the Basics of Medicine Safety?

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 to give the medicine (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 to store the medicine safely and how long to keep it
• common side effects or reactions
• interactions with other medicines your child takes
• what happens if your child misses a dose

Other things to know:

• The dosages of prescription and OTC medicines depend on a patient's weight. So 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.
• 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.
• 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. Use OTC drugs that ease symptoms like aches, pains, or fever (like acetaminophen and ibuprofen) as your doctor recommends.
• Always talk to your doctor first to be sure an OTC medicine is safe for your child.

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 prescribed for 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.
• 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 are of 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.
• 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.

How to Safely Give 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 About Side Effects of Medicines?

After giving your child a dose of medicine, watch 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  or has trouble breathing or swallowing after taking a medicine, call 911 or go to the ER right away. These could be symptoms of a serious allergic reaction that needs emergency care.

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

Note: Never give aspirin to kids or teens, 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.

What Else Should I Know?

Using medicines safely also means knowing when they're not needed. Often, simple 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 and drink plenty of clear liquids (such as water, juice, and broth) to avoid dehydration.

Always check with your doctor if you're not sure whether your child needs a medicine.