For years, doctors in the United States have been warning parents not to give their children aspirin. The reason is a rare disorder called Reye’s syndrome, which for some unknown reason can develop in children (and occasionally in adults) who have taken aspirin to relieve symptoms of a recent viral infection, such as the flu, the common cold, or chickenpox. Although Reye’s syndrome occurs only in one in a million cases, when it does strike, it can be fatal. It attacks the brain and liver, and unless it is diagnosed early on, it causes death within a few days. There is no cure for Reye’s. Treatment typically involves reducing the elevated pressure the disease causes in the brain.
Here’s What’s New
Since 1986, the United Kingdom has reduced the incidence of Reye’s by banning the use of aspirin for anyone younger than age 12. The U.K.’s Medicines Control Agency has now expanded the limit to age 16 because of the Reye’s-related death of a 13-year-old who is thought to have taken aspirin.
The Bottom Line
Do not give aspirin to any child younger than age 16. Use Tylenol (acetaminophen) instead.
Should you bother taking cough medicine?
The two medications most people ask for when they have a cold or the flu are antibiotics and cough medicine. Doctors now know better than to give you antibiotics at the drop of a hat like they once did. That’s because most upper-respiratory infections are due to a virus against which antibiotics are useless. Taking them only increases your likelihood of developing antibiotic resistance, and then when you really need them in the future, they may not work.
Cough medicines are another matter. They usually contain two kinds of ingredients, one to loosen respiratory congestion (an expectorant) and the other to suppress the cough. Surely there isn’t any harm in this — or is there?
Here’s What’s New
Representatives of the American College of Physicians-American Society of Internal Medicine, a group that represents more than 100,000 doctors, have concluded that cough syrups are usually a waste of money. There’s apparently little or no evidence that the expectorants they contain provide any benefit for upper- or lower-respiratory tract infections (despite the manufacturers’ insistence to the contrary). If you need to loosen mucus, the best way to do it probably is to drink more fluids.
What about something to stop the cough? Most suppressants contain codeine or one of its derivatives, and they do stop a dry, irritating cough. The downside is their side effects, such as constipation and drowsiness. If your cough is loose, it’s not a good idea to suppress it, because the cough is nature’s way of getting rid of the phlegm.
The Bottom Line
There is some disagreement about these recommendations. Expectorants probably don’t do much good, although everyone agrees that they can do no harm. As for suppressants, I think that if a dry, hacking cough is interfering with your sleep, you should take cough syrup. However, if the cough is already loose, a suppressant will prevent you from getting rid of mucus in your respiratory tract. First try the other time-honored alternatives, such as hot beverages and chicken soup, and keep the cough syrup handy just in case. If you weaken and do take a couple of teaspoons, don’t worry about it. Just make sure you have a laxative handy and be prepared for a little drowsiness.
Dr. Isadore Rosenfeld’s legions of fans follow his regular column in Parade magazine and his popular Sunday-morning television series Sunday Housecall on FOX News Channel. In addition to his numerous scientific publications and medical textbooks for doctors, he has written nine New York Times bestsellers, including Breakthrough Health 2004: 167 Up-to-the Minute Medical Discoveries, Treatments, and Cures That Can Save Your Life, from America’s Most Trusted Doctor! He is a distinguished member of the faculty at New York-Presbyterian Hospital/Weill Medical College of Cornell University and attending physician at New York Presbyterian Hospital and Memorial Sloan-Kettering Cancer Center.
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