WebMD Ask the Pharmacist

Treating Colds and Flu: Ask the Pharmacist

Oct. 12, 2010. Pharmacist, Maria Marzella Sulli, PharmD, answers questions about treatments for cold and flu symptoms.

Question:

Is it true that you can't give children Robitussin and Motrin together, not even on the same day?

Answer:

No. It is not true. There are no significant interactions reported between Robitussin and Motrin. Robitussin contains guaifenesin, an ingredient that helps break up chest congestion. Motrin contains ibuprofen, which is used to decrease fever, pain, and inflammation. The two medications can be used together safely. Always speak to your pharmacist before taking an over-the-counter product. He or she can help you find the best one for you in order to avoid dangerous drug interactions.

Question:

My 10-month-old son has an ear infection and a cough. The doctor prescribed Augmentin ES 600-42.9/5 for him and the pharmacist said to keep it refrigerated. It was left out overnight and warmed to room temperature. Should I still give it to him or should I call the doctor to re-prescribe the medicine?

Answer:

While it is best to keep Augmentin refrigerated at all times to maintain efficacy, I am uncertain as to whether or not the efficacy was compromised because it was left out of the refrigerator all night. It does not become dangerous to use after it has been left out of the refrigerator. But it may not work to cure your son's infection and could prolong his illness.

To be on the safe side, I would suggest getting a new prescription. Without knowing anything else about your son's situation, I would say that is the way to ensure he continues to get the most effective form of the medication.

Question:

My 22-month-old has strep throat and we started amoxicillin tonight. Is it safe to give her Tylenol as well for the fever?

Answer:

Yes. It is safe to combine Tylenol with amoxicillin. I suggest you speak with your pharmacist first, who can help you choose the best product and tell you how much Tylenol to give your child based on how much your child weighs.

Question:

Can acetaminophen and ibuprofen be taken together for a fever?

Answer:

While there are no drug interactions between acetaminophen and ibuprofen, it is usually unnecessary to take both medications to treat a fever. Doing so can cause confusion, and dosing errors have been reported when parents try to alternate ibuprofen and acetaminophen to treat children's fevers.

Be sure to talk to your pharmacist before giving your child anything to treat a fever. He or she can help you choose the best product and determine the right dose to give your child.

Question:

Will they combine the regular flu shot with the H1N1 flu shot this year?

Answer:

Yes. When you receive the 2010 seasonal flu vaccine, it will contain protection against the H1N1 strain of the flu. Flu vaccines are recommended for all children over 6 months of age. Remember, if it is the first time your child is receiving the flu vaccine, and if they are under 9 years old, they need to get 2 doses.

Question:

Can I give my 7-year-old Dimetapp Cold and Allergy as well as Delsym for her cough?

Answer:

Dimetapp Cold & Allergy contains two ingredients, one for runny nose and allergy symptoms (brompheniramine), and one for congestion (phenylephrine). Delsym, used to quiet dry coughs, contains dextromethorphan. There are no interactions between these three medications and they can be used safely together if needed.

You should always talk to your pharmacist to ensure safe use of over-the-counter cough and cold products. He or she can help you choose the best product for your symptoms and tell you how much is recommended for your child.

Question:

Can I give my 16-year-old Claritin (generic version loratadine) with Tylenol cold/sinus?

Answer:

Tylenol Cold products usually contain an antihistamine called chlorpheniramine, which is an older version of the type of ingredient found in Claritin. They both are antihistamines. Since both contain antihistamines, it is not recommended to use them at the same time. This could increase the risk of side effects.

You should always check to see which ingredients are in the product you are choosing, so as to be sure you are not giving your child too much of one type of ingredient, which commonly happens when you combine combination products. Always check with your pharmacist before taking over-the-counter products; he or she can help you choose the right products for your symptoms and help you avoid dangerous overdoses and interactions.

Question:

My 4-year-old daughter is currently taking a steroid nasal spray. Is it OK to also give her children's Tylenol Plus Cough and Runny Nose?

Answer:

While there are no drug interactions between steroid nasal sprays and the ingredients in Tylenol Plus Cough and Runny Nose, you should only give your 4-year-old that type of combination product if you have been directed to do so by her pediatrician. Generally, as a pharmacist, I do not recommend combination cough and cold products, especially in children. They often cause confusion and contain ingredients that the child may not need at the time. You should always check with your pharmacist before giving your child an over-the-counter medication to treat their cough or cold.

Question:

My son is 7 and can swallow pills. He is running a fever. Can I give him one 200 mg ibuprofen pill? He weighs 53 lbs.

Answer:

The proper dose of ibuprofen for your son, based on his age and weight, is 200 mg. Therefore, it would be fine to give him one 200 mg tablet every 6 to 8 hours as needed for his fever.

Question:

Can children take Sudafed and Motrin at the same time?

Answer:

Yes. It is safe to use Sudafed and Motrin -- there are no dangerous drug interactions. Always check with your pharmacist before giving your child an over-the-counter medication to make sure it is safe and will be effective for their symptoms.

Question:

Can Cheratussin be given to a 4-year-old?

Answer:

If you are referring to Cheratussin AC, that is a prescription product and it should not be given to anyone other than the person for whom it was prescribed. If it was prescribed for your 4-year-old, it is safe, as long as it was prescribed at the proper dose. Your pharmacist should check the dose for your child when processing your prescription.

Question:

How much Tylenol can I give a 6-year-old, weighing 45-50 lbs?

Answer:

It is always a good idea to speak with your pharmacist before giving your child an over-the-counter medication like Tylenol. The proper dose for a child of that height and weight would be 10 mL, or 2 teaspoonfuls of the Children’s Tylenol liquid, which would provide 320 mg of acetaminophen. If you do not want to use liquid, you can give a 6-year-old two Junior Strength Tylenol meltaways, which would be the same dose.

Question:

What does the "DM" in a cough medicine mean?

Answer:

"DM" refers to one of the ingredients on the cough medicine. It stands for dextromethorphan, which is a cough suppressant often used to quiet a dry, annoying cough.

Question:

My son was misdiagnosed with swine flu and actually had RSV and pneumonia. Does Tamiflu have any side effects that we need to worry about since he had the other things wrong with him instead of swine flu?

Answer:

No. There are no significant long-term side effects associated with Tamiflu when the child ends up not having the flu.

Question:

Can you treat whooping cough with over-the-counter medications?

Answer:

No. Whooping cough should not be self-treated with over-the-counter medications. If whooping cough is suspected, the person needs to be seen immediately by a physician and receive antibiotic therapy. Whooping cough is dangerous, especially in infants, so it is important to seek medical attention promptly if whooping cough is suspected.

Question:

What symptoms would I notice if my child was having an allergic reaction to ibuprofen?

Answer:

Allergic reactions to medications can present with several types of symptoms. The most severe type of allergic reaction, called anaphylaxis, causes swelling of the face, lips, and tongue, and difficulty breathing. This type of allergic reaction can be life threatening. So it is important to call 911 and seek emergency treatment if these symptoms are present.

Allergic reactions that are less severe usually cause hives, itching, and rashes. Any type of allergic reaction can occur at any time, even after using the drug many times, so it is important to recognize the symptoms and seek help if any of these symptoms occur.

Question:

My 15-year-old granddaughter takes Trileptal. What over-the-counter treatment can she take for a cold?

Answer:

To properly answer this question, I would need more information about your granddaughter, such as her weight, symptoms, reasons for using Trileptal, etc. There are different types of medications used for colds and I would really need more information about her specifically to provide good advice. You should consult your personal pharmacist before giving her any over-the-counter medications for a cold, because he or she can help you find the best one for her specific needs.

Question:

Can you give a child acetaminophen and an antihistamine at the same time?

Answer:

Yes. It is OK to give a child an antihistamine at the same time as acetaminophen. You should consult your pharmacist before doing so though, to be sure that you are giving the proper dose based on the child's weight and age.

Question:

Are these two drugs related: hydroxyzine and diphenhydramine?

Answer:

Yes. They are related. Both hydroxyzine and diphenhydramine are antihistamines used to treat allergic reactions. Both cause drowsiness and dry mouth as side effects. Hydroxyzine is available only by prescription, but diphenhydramine is available over-the-counter.

Question:

My 8-year-old daughter gets a lot of ear pain and headaches. We give her Junior Motrin, but it's really hard to find in our location. Is there another type of pill that you would recommend for her and maybe one that is found more in stores? Thanks!

Answer:

Why is Motrin Junior strength not available where you are? I would suggest you talk to the pharmacist in your area, who can help you find a suitable substitute. I am not familiar with medications that are readily available in your area.

Question:

My son accidentally took my husband's Zestril blood pressure medicine. He is 12 years old. He thought it was his Singulair. Should we go to the ER?

Answer:

You should call the poison hotline any time someone takes a medication that is not intended for them. The universal poison control number is 800-222-1222. They will be able to provide you with advice on how to handle the situation. You should keep all of your prescriptions out of the reach of children, and store medications for different people in the household in different areas to avoid mix-ups.

Question:

My wife said I couldn't give our granddaughter black licorice because she's on medication. What drugs/medications can interact with black licorice candy?

Answer:

First, you need to be sure the licorice contains licorice. Many candies widely sold (like Twizzlers and black jelly beans) do not contain any real licorice.

Real black licorice, taken from the licorice plant, contains a substance that can affect blood pressure and cause liver toxicity and cardiovascular problems if taken in high amounts. Real black licorice candy is best avoided in people with heart disease, but licorice-flavored candies will not be a problem.

Question:

I gave my child an antihistamine more than 12 hours ago. Now he has a fever and I want to give him a dose of Children's Tylenol. Is this OK?

Answer:

Yes. It is OK to give your child Tylenol if they have taken an antihistamine. There are no drug interactions to be worried about between the two medications. Always consult your pharmacist before giving your child over-the-counter medications. He/she can help you find the best product and advise you on how to give your child the proper dose.

Question:

Can I give my daughter ibuprofen after a dose (2 hours ago) of Robitussin CF?

Answer:

Yes. There are no interactions between Robitussin CF and ibuprofen. They can be given together. Always consult your pharmacist before giving your child an over-the-counter product.

Question:

Why can't you give children "baby" aspirin?

Answer:

Basically, there is no need for children to get aspirin now that acetaminophen and ibuprofen are available over-the-counter and approved for children. These are safer alternatives, and it is best to just avoid giving aspirin to children entirely.

Aspirin has been linked to causing a rare but severe reaction called Reye's syndrome in children who have certain viral illnesses. Reye's syndrome can be fatal and causes damage to the liver and the brain.

Question:

My 3 1/2-year-old is taking an antibiotic called cephalexin. Is it OK for her to take children's Pepto-Bismol with this? She takes 6 mL twice a day. The prescription drug is 200 mL.

Answer:

Children's Pepto-Bismol contains calcium carbonate, an antacid. It is safe to take with cephalexin with calcium carbonate. There are no drug interactions to be concerned about.

If you are trying to treat diarrhea caused by an antibiotic, I suggest you talk to your pharmacist or pediatrician. Children's Pepto-Bismol does not treat diarrhea.

Question:

My 2-year-old has had diarrhea for almost three days now. Is it safe to give him Pepto-Bismol along with Pedialyte? He weighs 34 1/2 lbs.

Answer:

No. You should not give Pepto-Bismol to children under the age of 12. If your son has had diarrhea for three days, it is important for you to consult the pediatrician to find out what is causing it. Pedialyte can help him avoid becoming dehydrated. But he needs to be examined by a doctor as soon as possible.

Question:

Can I give my 14-year-old son acetaminophen for fever if I gave him ibuprofen earlier this morning?

Answer:

As long as it has been 6 hours since the ibuprofen, you can give him acetaminophen now.

Question:

My daughter has cold-like symptoms and the doctor gave her C-Phen DM oral. He said to give her Tylenol for kids for fever. Does the acetaminophen interact with the C-Phen? If not, how long should I wait to give her the C-Phen after the acetaminophen?

Answer:

There are no drug interactions to be concerned about between the C-Phen DM and the acetaminophen found in Tylenol. The two medications can be given together. Anytime you have questions about mixing medications, you should always consult your pharmacist.

Question:

If my son had the flu shot last year, is it still good for this year?

Answer:

No. It is not. The formulation for the flu shot changes each year, based on predictions about which flu strains will be most common. The flu virus mutates very easily and rapidly, which is why we need to get flu shots every year.

Question:

My husband takes gabapentin, hydrocodone, venlafaxine, and hydroxyzine. What over-the-counter meds can he take for congestion and coughing that will not interact with his regular meds?

Answer:

To provide you with the best advice, I would need to know more about your husband’s medical history and current symptoms. In general, decongestants that contain pseudoephedrine would be safe considering his medications.

As far as the cough goes, it would depend on the type of cough he has. If it is a loose cough, it would be safe for him to use guaifenesin, an expectorant, to help him bring up the phlegm that’s making him cough. Guaifenesin would not interact with is medications. I suggest you talk to your pharmacist who can collect more specific information from you and make the best recommendation.

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