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Ask David L. Hill, MD, FAAP Your Own Ques...
David L. Hill, MD, FAAP
David L. Hill, MD, FAAP, Doctor
Category: Pediatrics
Satisfied Customers: 416
Experience:  Adjunct Assistant Professor of Pediatrics, UNC Medical School. Vice President, Cape Fear Pediatrics.
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Why is Dimetapp not recommended for children less than 6 years

Resolved Question:

Why is Dimetapp not recommended for children less than 6 years of age?
If giving a fraction of the recommended dose for younger age child what are the potential risks?
Submitted: 6 years ago.
Category: Pediatrics
Expert:  David L. Hill, MD, FAAP replied 6 years ago.
Hi, Dr. Hill here. Thank you for posting to Just Answer! The short answer to your question is, "because it doesn't work." Dimetapp, in its various forms, includes combinations of dextromethorphan, phenylephrine, and a first-generation antihistamine like diphenhydramine. Although dextromethorphan has been sold since before there was an FDA for cough, there has never been a single study demonstrating it is safe and effective for that purpose in children. In fact, multiple studies have shown just the opposite. Likewise, phenylephrine is supposed to clear up stuffy noses, but again study after study has failed to show it does any good. Both of these drugs have substantial toxicities, and overdose is common, especially since many consumers don't realize Dimetapp, Tylenol Cough and Cold, Robitussin Cough and Cold, and Vicks are all different brands of exactly the same combination of medications. When one doesn't work (because none of them do) they reach for another. So what does work? A head-to-head trial found a teaspoon of honey works better than dextromethorphan to relieve cough (YOU MUST NOT USE HONEY IN CHILDREN UNDER AGE 12 MONTHS. Use Karo syrup instead). Saline nose drops work well for congestion. Then, of course, you want to treat an underlying disease such as allergic rhinitis or bacterial sinusitis if one is present. This requires evaluation by a doctor. A child who has had ten ear infections in ten months probably wants evaluation by an ear, nose, and throat specialist and may also benefit from a set of labs to evaluate his immune system.

Edited by David L. Hill, MD, FAAP on 6/25/2010 at 3:03 PM EST
Customer: replied 6 years ago.

So in your opinion would a trial of 1/4 the recommended dose be harmfull for a 10 month old?

Expert:  David L. Hill, MD, FAAP replied 6 years ago.
Yes, it would. We think in terms of risk and reward. The reward is absolutely zero, nada, zilch. We know these medications do nothing but make kids sleepy and cranky and eat poorly, and there are significant numbers of serious reactions each year. I would try a teaspoon of Karo syrup, a humidifier, and saline nose drops (1/2 teaspoon salt in 8 ounces of water).
Customer: replied 6 years ago.
Relist: Answer quality.
Would like one more opinion, please.
Expert:  David L. Hill, MD, FAAP replied 6 years ago.
Please see the following links:
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