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Hi Doctor My Children Are 3 And 5, And Both

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Posted on Wed, 21 Nov 2018
Question: Hi Doctor

My children are 3 and 5, and both have a bad cough that sounds like croup and dry.
We've been giving them Alicol D, which was what was prescribed the last time they had this cough. Now this has Dextromethorphan bromhydrate.......................5 mg, http://slideflix.net/doc/0000/alicol-d

I've been reading about this ingredient today, and have found it's not normally prescribed to children these days. So I'm a little worried about giving this to them.
They are only taking 2.5ml (3 year old) and 5ml (5 year old) every 8 hours (twice a day really). We did give my 5 year old an extra 5 ml today because her cough was really aggravating her.
She also had a fever last night so we gave her some paracetamol half dose (calpol) to bring down the fever.

I don't like giving all this medicine, as I worry that it's bad for the kids.
Could you let me know if it is dangerous giving the Alicol D, as I've read that Dextromethorphan is dangerous for children.

We live in Costa Rica, so don't have access to call help lines to ask for advice on this.

I see the pediatrician tomorrow, but want to be informed and ask her questions about the medicine.
doctor
Answered by Dr. Vaishalee Punj (2 hours later)
Brief Answer:
Dextromethorphan can be given above 2 years of age

Detailed Answer:
Hello and welcome to Ask A Doctor service.

I have reviewed your query and here is my advice. I have seen the detailed ingredients photo.

Dextromethorphan suppresses cough center in brain. That is why it is avoided in babies less than 2 years of age. Similarly pseudoephedrine is avoided in babies less than 2 year of age.
Above 2 years, it is to be given with caution in children. It does suppress cough but it doesnot treat the cause, so mucous may remain inside respiratory tract.
Dextropethorphan dose in children 2-6 years of age is between 2.5 to 5 mg per day. So the dose is medically correct in your children. I personally give a dose of Chlorpheniramine + Phenylephrine in croupy cough. Croupy cough takes a longer to recover than common cold, so no need to panic. Warm fluids also work. See if Alicol (without dextromethorphan) is available over the counter.
In USA, there is trend to give one dose of a corticosteroid syrup for croupy cough.

Hope it helps. Let me know if I can assist you further.
Dr Vaishalee
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Vaishalee Punj (8 hours later)
Thank you doctor, that is a relief that it is ok to give - we just want to give the kids some relief because when they cough so much, you just don't want to see them suffer with all that coughing.
I just read that some kids died from taking dextropethorphan.. they were babies though. It's just scary to hear that over the counter medicine can cause harm.
I was really worried that using dextrophethrophan and paracetamol together might be damaging - but the kids seem a little better this morning. We will see the pediatrician doctor today to get some guidance on what we can give them safely.
It's hard reading all these things online - you just want to make your kids better.
doctor
Answered by Dr. Vaishalee Punj (1 hour later)
Brief Answer:
Your babies will be fine soon

Detailed Answer:
Hi again

I understand your concerns. Medicines can bring harm so should be minimum in children.

Croupy cough can be scary to witness in children, but it does get better. So do not worry. Kids will recover even if you do not give them any medicine. Medicines just make their symptoms better.

Yes you must share your concerns with your pediatrician.
Feel free to write back to me in case of any doubt.
All the best.
Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Vaishalee Punj

General & Family Physician

Practicing since :2003

Answered : 3278 Questions

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Hi Doctor My Children Are 3 And 5, And Both

Brief Answer: Dextromethorphan can be given above 2 years of age Detailed Answer: Hello and welcome to Ask A Doctor service. I have reviewed your query and here is my advice. I have seen the detailed ingredients photo. Dextromethorphan suppresses cough center in brain. That is why it is avoided in babies less than 2 years of age. Similarly pseudoephedrine is avoided in babies less than 2 year of age. Above 2 years, it is to be given with caution in children. It does suppress cough but it doesnot treat the cause, so mucous may remain inside respiratory tract. Dextropethorphan dose in children 2-6 years of age is between 2.5 to 5 mg per day. So the dose is medically correct in your children. I personally give a dose of Chlorpheniramine + Phenylephrine in croupy cough. Croupy cough takes a longer to recover than common cold, so no need to panic. Warm fluids also work. See if Alicol (without dextromethorphan) is available over the counter. In USA, there is trend to give one dose of a corticosteroid syrup for croupy cough. Hope it helps. Let me know if I can assist you further. Dr Vaishalee