Rutgers study finds increase in antihistamine use for colds, following the 2008 FDA advisory to decrease use of cough and cold medicines, despite risks and unclear benefit of antihistamines for children with colds For respiratory infections in children under 12, physicians are increasingly more likely to recommend antihistamines and less likely to recommend cough and cold medicines, a Rutgers study found. Show
Antihistamines are widely used over-the-counter to treat various allergic conditions. However, these medicines have little known benefit for children with colds, and some older antihistamines (e.g., diphenhydramine or Benadryl) cause sedation and occasionally agitation in children. The study, in JAMA Pediatrics, found a sharp decline in cough and cold medicine recommendations for children under 2 after 2008, when the Food and Drug Administration recommended against the medicines for that age group due to safety concerns and uncertain benefits. The American Academy of Pediatrics subsequently recommended avoiding cough and cold medicines in children under 6. “Families often treat their children’s respiratory infections with cough and cold medicines, some of which include opioid ingredients, such as codeine or hydrocodone. However, there is little proof that these medications effectively ease the symptoms in young children,” said study lead author Daniel Horton, assistant professor of pediatrics, Rutgers Robert Wood Johnson Medical School. “Also, many cough and cold medicines have multiple ingredients, which increases the chance of serious accidental overdose when combined with another product.” The researchers looked at national surveys representing 3.1 billion pediatric ambulatory clinic and emergency department visits in the United States from 2002 to 2015. During that period, physicians ordered approximately 95.7 million cough and cold medications, 12 percent of which contained opioids. After the FDA’s 2008 public health advisory, however, physician recommendations declined by 56 percent for non-opioid cough and cold medicines in children under 2 and by 68 percent for opioid-containing medicines in children under 6. At the same time, researchers saw a 25 percent increase in doctor recommendations for antihistamines to treat respiratory infections in children under 12. “Sedating antihistamines such as diphenhydramine [Benadryl] may have a small effect on some cold symptoms in adults,” said Horton. “However, there is little evidence that antihistamines actually help children with colds feel better or recover faster. We do know that these medicines can make kids sleepy and some kids quite hyper.” “It is nice to see physicians are heeding the advice to avoid cough and cold medications for children, but switching them to antihistamines is not necessarily an improvement,” said co-author Brian Strom, chancellor, Rutgers Biomedical and Health Sciences. The American Academy of Pediatrics has various suggestions for treating children with the cold or flu, including use of over-the-counter medicines for pain or fever, honey to relieve cough in children over 1 year old, and plenty of rest and hydration. For more information and suggestions, visit healthychildren.org’s Caring for Your Child’s Cold or Flu information page. In addition to Strom, who is affiliated with Rutgers Center for Pharmacoepidemiology and Treatment Science and the Institute for Health, Health Care Policy and Aging Research, the study was co-authored by Tobias Gerhard, Rutgers Ernest Mario School of Pharmacy. Stop paying too much for your prescriptionsThanks for visiting! GoodRx is not available outside of the United States. If you are trying to access this site from the United States and believe you have received this message in error, please reach out to and let us know. Are you all stuffed up and sneezing away because of a cold? Decongestants and antihistamines can
help. They come in different forms, and they're often mixed into combination drugs that you can buy without a prescription. It pays to do a little homework to make sure you're picking the right medicine for your symptoms. They help reduce swelling in the passageways of your nose, which relieves the feeling of pressure and improves the flow of air. You'll be able to breathe a whole lot better. Decongestants come in pill form or nasal sprays. Don't use the sprays for more than 3 days, or you may get more stuffed up. Some types of them can help relieve your
runny nose and sneezing when you have a cold. They block a chemical your body makes called histamine that makes the tissues in your nose itch and swell. Most
experts say that histamine isn't the major cause of a runny nose when you have a cold. Even so, some of the older antihistamines, such as brompheniramine and chlorpheniramine, can bring relief. Newer antihistamines like
fexofenadine (Allegra) and loratidine (Claritin) have not been shown to work for cold
symptoms. A decongestant called phenylpropanolamine (PPA) was used for years as an ingredient in many cold drugs to clear up a stuffy nose. In 2000, researchers found it was linked to an increased risk of stroke,
especially in women ages 18 to 49. The FDA then banned it from use in all prescription and over-the-counter medications. Today's medicines don’t have PPA, but make sure you don't have any old cold meds in your house that might contain the ingredient. The main one for antihistamines is drowsiness, so it can be tough to take during
the day. That's why they're often included in nighttime cold medicines. Other common side effects include dry mouth, dizziness, and headache. Decongestants may keep you awake and are usually taken during the day. Nasal sprays are less likely to have that side effect and may be helpful at night for congestion. Decongestants can also raise blood pressure. So if your BP is high already, or you've got heart disease, check with your doctor before you use them. They may be able to suggest cold medicines that don't have decongestants in them. There are many over-the-counter decongestants and antihistamines that can help treat your symptoms. They're sold separately or as part of a combo with other cold and pain drugs. If you choose a combination medicine, make sure you know
everything that's in it. Check to see if it has acetaminophen. If so, follow the directions on the label carefully, and don't take acetaminophen along with it, because it could cause serious
liver damage. These over-the-counter antihistamines and decongestants treat cold and allergy symptoms. Type of Decongestant or Antihistamine Cold Medicine Brand Name(s) Symptoms Possible Side Effects Visine-A (Formerly OcuHist) Zaditor Opcon-A Can you take cold and cough medicine with allergy medicine?Don't mix cold and allergy meds, warns FDA
It's sometimes hard to tell if your child's runny nose and sneezes are coming from their allergies or possibly a winter cold. But knowing the difference is critical to avoid over-medication, warns the Food and Drug Administration (FDA).
Can I give my child Zyrtec and cough medicine?No interactions were found between Robitussin Children's Cough & Cold CF and Zyrtec.
Can I give my son allergy medicine and cough medicine?Safety Information for Parents and Caregivers. Children under 2 years of age should not be given any kind of cough and cold product that contains a decongestant or antihistamine because serious and possibly life-threatening side effects could occur.
Can you mix Robitussin and allergy medicine?Interactions between your drugs
No interactions were found between Claritin and Robitussin Cough + Chest Congestion DM Maximum Strength. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
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Can you give allergy medicine and cough medicine together
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