More than half of children in the U.S. take one or more medications every week, and more than half of these are over-the-counter drugs. A recent study conducted at New York University School of Medicine revealed that most of the dosing directions for children’s over the counter (OTC) medication are misleading, hard to follow by parents and thereby can increase the risk of over dosage in children. The study was published in the Journal of the American Medical Association.
To examine the correct dosage guidelines on the medications, researchers sampled 200 top-selling cough/cold, allergy, analgesic and gastrointestinal over-the-counter liquid medications for children. It was found that inconsistencies existed between labeled dosage and the provided measuring device. The observations are as follows:
- One-in-four liquid medications did not contain a measuring device, such as a cup, dropper, or syringe.
- Most of the measuring devices (99%) contained unnecessary markings, suggesting dosage amounts not mentioned on the label.
- More than half of the medicines did not use standard abbreviations for terms such as teaspoon or milliliter.
- Some measuring devices showed measurements in milliliters, however, the instructions were for teaspoons or tablespoon.
In 2009, the Food and Drug Administration released voluntary guidelines for dosing instructions after a spate of accidental overdose in OTC children’s medications. The study co-author Ruth Parker, MD, of Atlanta’s Emory University School of Medicine expressed doubt that the FDA’s voluntary guidelines were sufficient for addressing the problem.
Dr. H. Shonna Yin, lead author of the study and assistant professor of pediatrics at NYU School of Medicine said “This study is intended to establish baselines. The plan is to...
take another look in a year or so to see if changes have been made.”
Though the results of the observations are disappointing for the parents and health professionals, but it should be an eye opener for the FDA to take more stringent actions against the dosing directions and drug manufacturers who do not comply with the regulations. Drug makers should take appropriate actions to provide a standardized measuring device and make sure that dosing directions are consistent with markings on the measuring device. I have seen many over-the-counter supplements that say as an example ¼ teaspoon dose per day, but do not provide measuring device to measure the drug.
Parents measure the drug at home using their teaspoon/ tablespoon that in most of the cases is an incorrect measurement. I urge parents to read carefully the dosing directions of over the counter medications before buying it and have a measurement unit at their home in order to avoid accidental over dosing to their children. If you are looking for a reference guide, WHO released a guidance document that gives proper use of over 240 children’s medication.