When are medicines recommended for children?

While some children may find their illness clears up on its own, others will need medicines to treat the illness or prevent it from getting worse. Your doctor or pharmacist will usually know whether your child needs medicine, as well as the most appropriate and safest option. They can explain why they have chosen this medicine and its benefits for your child’s health.

Children's medicines differ from adults’ medicines because children absorb and process medicines differently. When your doctor prescribes a medicine for your child, the dosage is calculated to specifically suit their age, size and health condition, so it is important you give your child the dose your doctor prescribed.

Which medicines are available for children over the counter?

Some children’s medicines are available over the counter without a prescription. However, most should be discussed with a healthcare professional — including the pharmacist — before you give them to your child. These include:

• medicines to reduce pain and fever, including paracetamol and ibuprofen which are generally safe when dosing instructions are followed
• cough and cold medicines to treat runny noses, congestion and coughs — these are not recommended for children aged under 6 years, and only with a doctor or pharmacist’s recommendation for ages 6 to 11 years
• antihistamines to treat allergy symptoms, which are not recommended for children under 6 years, and only with a doctor or pharmacist’s recommendation for ages 6 to 11 years
• puffers containing salbutamol for asthma, which should be used only after an initial prescription or recommendation from a doctor

Are there any medicines I should not give to my child?

All medicines, whether they are over the counter or only with a prescription, can be dangerous if used incorrectly. Some medicines that are safe for adults — such as iron supplements — can be poisonous for children. Before giving your child any medicine, including vitamins or supplements, check with your pharmacist that the formulation and dosage is right and that it won’t interfere with other medicines your child might be taking.

Pharmacists are experts in medicines and are readily accessible health professionals who can answer your questions about children’s medicines.

Cough and cold preparations, antihistamines and decongestants, although widely available, are not recommended for children aged under 6 years and only with a healthcare provider’s recommendation for children aged 6 to 11. Research has found these medicines are generally not effective and carry a significant risk of side effects in children.

In some children with asthma, anti-inflammatory medicines (also known as NSAIDs) such as ibuprofen can cause an asthma flare up. If your child has a history of asthma and you notice they develop a runny nose or wheezing within 2 hours of taking ibuprofen, they may be sensitive to anti-inflammatories and you should avoid giving them to your child.

Paracetamol is a commonly-used pain medicine that is available over the counter without a prescription. Paracetamol for children is sold in clearly marked packaging with dosage instructions by age and weight. However, paracetamol overdose is common among Australian children and can be dangerous.

To ensure you give them the right amount, check the package for recommended dosage based on your child’s age and always measure using the syringe or measuring cup provided. There are 2 different strengths of paracetamol for children, so make sure you have the correct one. Do not combine paracetamol with other medicines unless directed by a doctor.

What should I know about prescription medicines?

Understanding what your child has been prescribed will make you more confident about giving them the medicine. It is important you know the full name of the medicine, what it is used for and how to give it to your child. Ask your doctor or pharmacist to explain:

• what the medicine is used for
• how long your child needs to use it for
• how to give it to your child and details of the dosage
• whether it should be taken before or after meals
• which possible side effects your child might experience, and what to do if this happens
• the interactions with food or other medicines you need to watch out for
• whether it should be stored in the refrigerator or at room temperature

Which side effects should I look out for?

All medicines have side effects, but it can be hard to predict how your child will react to a medicine they haven’t tried before. Every child is unique, and medicines affect every individual differently. However, some common side effects that you should look out for include:

• an upset stomach
• vomiting
• headache
• dizziness or drowsiness
• skin rash or itchy skin

Your healthcare professional can give you information about the specific side effects that can occur after taking different medicines. You can read more in the Consumer Medicines Information (CMI) leaflet that comes with the medicine.

In rare situations, a medicine can cause a severe, life-threatening allergic reaction called anaphylaxis. Symptoms of anaphylaxis can include:

• difficulty breathing and/or noisy breathing
• wheeze or persistent cough
• swelling of the tongue
• swelling or tightness in the throat
• difficulty talking or hoarse voice
• persistent dizziness or collapse
• becoming pale and floppy (in infants or young children)

If your child has difficulty breathing, or any of the symptoms of anaphylaxis, this is a medical emergency. Call triple zero (000) and ask for an ambulance.

If your child experiences a reaction to a medicine, take note of when it started, what you saw and how it made your child feel. If your child developed a rash or swelling, it can be helpful to take a photo. Contact your child’s doctor or pharmacist as soon as possible or take your child to the closest hospital emergency department.

Use the healthdirect Symptom Checker tool to help you decide when you should see your child’s doctor.

Are antibiotics OK for my child?

Antibiotics are very helpful medicines when used appropriately. You can discuss whether your child needs antibiotics with your doctor. Many childhood infections don’t need treatment with an antibiotic, including viral infections, infections that get better by themselves or infections that need physical treatment, such as a dental infection that needs to be drained.

There are, however, times when antibiotics play an important role in treating bacterial infections. These include preventing the spread of bacterial infection in the body which could otherwise become severe or lead to hospitalisation to prevent severe infection or hospitalisation. If your child needs an antibiotic, your doctor will select an antibiotic that is most suitable for their infection and will consider the most suitable dose and length of treatment. Always make sure your child finishes the prescribed course of antibiotics — even if they start to feel better.

Some antibiotics come in different forms (for example, tablets, capsules, creams or liquids). If your child finds it difficult to take one form, ask your doctor or pharmacist if there is a different way to take the medicine — one that your child may prefer.

How should I store my child's medicine?

It is important to store all medicines safely. When prescribed medicines are not taken as directed, they are considered poisons. Children are particularly at risk of poisoning because they are naturally curious, and young children tend to put things in their mouths as part of their normal development.

Poisoning happens most often in children under 5 years of age, with toddlers aged 1 to 3 years at greatest risk.

If you think your child has swallowed a medicine not intended for them, take the container and the child to the phone and call the Poisons Information Centre (13 11 26). If your child collapses, stops breathing or has difficulty breathing or has a seizure, call triple zero (000) and ask for an ambulance.

Preventing accidental poisoning is everyone’s responsibility. Here are some safety tips to remember:

• Call medicines by their proper names. Do not confuse your child by referring to medicines as ‘lollies’.
• Children often imitate adults, so try and avoid taking medicines in front of your child.
• Put away the medicine immediately after using it.
• Check the storage instructions on the medicine’s packaging. For example, some medicines need to be refrigerated.
• Store your medicines high up, out of children’s reach. Consider installing a child-resistant lock on your medicine cupboard.
• Clean out your medicine cupboard regularly. Take any unwanted and expired medicines to your local pharmacy for disposal.

Other questions to ask your doctor

My child doesn’t like to take tablets — is there an alternative?

Ask your pharmacist if the medicine is available in a liquid form, or if you can crush or break the tablet, or pull apart the capsule (for example, if you want to sprinkle the medicine on food or dissolve it into a drink). Not all tablets can be broken since some medicines have a protective coating to slow down release and allow the medicine to be gradually absorbed into the body. Depending on the medicine concerned, crushing a coated tablet or removing the capsule might interfere with this process, causing your child to get too much medicine too quickly and to experience side effects.

Always check with your pharmacist before breaking apart any tablets or capsules.

I have 2 children with similar symptoms — can they share the medicine?

Every child is unique, and medicines affect every individual differently. Never share medicines among children, even if symptoms seem similar. Your doctor or pharmacist will make specific recommendations for each child, based on their age, weight and health background.

Resources and support

For more information and support, try these resources:

• Your local pharmacist will have more information about medicines.
• The healthdirect Symptom Checker can help you decide what to do if you notice symptoms that may indicate a side effect or adverse reaction.
• Use the healthdirect Find a Health Service tool to locate your nearest GP or nurse clinic.
• Read the Royal Children’s Hospital brochure for practical tips on how to give medicine to your child.
• Watch the NPS Medicinewise video series for tips on how to safely give medicines to children.