Are Prescription Cough and Cold Products Containing Opioids safe to be prescribed for Children and Adolescents?

Answer:
Prescription cough and cold products containing codeine, hydrocodone or normethadone are NOT indicated for use in children and adolescents (younger than 18 years of age)
Key Points:

• There is a risk of opioid toxicity due to the variable and unpredictable metabolism of codeine or hydrocodone.
• The benefits of symptomatic treatment of cough associated with allergies or the common cold do not outweigh the risks of use of opioids in these patients.
• Healthcare professionals are being advised to:
  • avoid prescribing products containing opioids (codeine, hydrocodone, and normethadone) for treatment of cough and cold in patients younger than 18 years of age.
  • counsel patients and parents/caregivers that cough due to cold or upper respiratory infections is self-limited and generally does not need to be treated.
  • use non-opioid alternatives in children and adolescents for whom cough treatment is necessary.
  • should the non-opioid alternatives fail, always counsel patients and caregivers/parents on the risks associated with opioid medications and use the lowest effective dose for the shortest duration of time possible.