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Kids and colds
It's as inevitable as the sunrise; children and colds will find each other. Germs that cause colds spread easily and swiftly from one child to another, especially in enclosed and heavily trafficked places like schools and daycare centers. And unlike adults, who get an average of two to four colds a year, children haven't yet built up a good working resistance to infection?-- which is why they usually succumb to some five to 10 colds a year.
Children's colds generally last five to seven days and feature some combination of sore throats, stuffy noses, sneezes, coughs, and congestion. The bad news is that colds can't be cured, because they are caused by stubborn viruses. Although its symptoms can be eased, a cold just has to run its course.
So, what's a parent to do? Over-the-counter drugs can provide somewhat limited, temporary relief from cold symptoms, but perhaps the best advice is age-old?-- make sure your child gets plenty of rest and drinks a lot of liquids like herbal tea and water. And serve up the chicken soup! It might not be medicine, but it feels good. Some experts also believe it's beneficial in that it loosens mucus secretions and hastens the body's natural efforts to get rid of the bugs.
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Is It a Cold, the Flu, or Something More Serious?
For both kids and adults, it's easy to confuse colds and flus. The illnesses share many of the same symptoms, but the severity differs. Here are some tips that medical experts provide on how to distinguish between the two. (Not every case of a cold or flu displays every symptom.)
Cold symptoms
- Slight body pain
- Mild to moderate chest discomfort and congestion
- Hacking cough
- Mild fatigue
- Sneezing
- Sore throat
- Stuffed-up and runny nose
- Fever and headache rarely occur
Flu symptoms
- Symptoms can last anywhere from a week to 10 days; can lead to bronchitis and pneumonia
- Body aches and pains, often severe
- Chest discomfort and congestion
- Cough, often severe
- Extreme exhaustion that often appears early
- Fatigue, which may last up to three weeks
- High fever (102?F to 104?F) lasting three to four days
- Headache
- Sinus or nasal symptoms may be accompanied by an earache
- Sneezing, sore throat, and stuffed-up or runny nose are not as common as in a cold
Be sure to contact your doctor if your child has any of the following: - Worsening or persistent symptoms after seven to 10 days
- A fever that does not fall in 48 to 72 hours or exceeds 102?F
- Difficulty breathing or swallowing
- Thick, greenish-brown, or bloody phlegm
- Enlarged or tender lymph nodes in the neck
- Asthma, bronchitis, diabetes, congestive heart failure, cancer, poor health, or a weak immune system
- Severe sinus, ear, chest, facial, or forehead pain
- Less common symptoms of the flu, including nausea, vomiting, or abdominal pain
- Blue lips, nails, or skin
- Shaking chills
Prevention
The best prevention for the common cold is good hygiene. Since colds are so contagious, encourage your children to wash their hands with soap and water frequently?-- for example, after touching other kids, using the toilet, blowing their noses, playing arcade games, or opening doors at the mall. They should also wash their faces more than once a day. Teach them to cover their mouths when they cough, to wipe their noses with disposable tissues (so the mucus doesn't touch their hands), and to throw the tissues away immediately.
At home, keep all furniture surfaces and doorknobs clean. Keep a watchful eye on toddlers, who will put just about anything in their mouths, placing them at even higher risk of picking up a virus. If your children do fall ill with a cold, keep them at home to avoid infecting others.
Picking the Right Medication For Fever
Remember that medications can't cure a cold or flu. With rest and a little TLC, the viral condition will run its course in one to two weeks, whether its symptoms are treated or not. While there are medications that can give kids limited, temporary relief from cold symptoms, you should be aware of some precautions that apply to their use.
Medical experts warn that cold remedies can harm infants and very young children because their bodies haven't yet fully developed the ability to break down drugs. Also, drug dosage levels for the very young are best determined based on their weight. That's why the experts recommend you consult your pediatrician for help deciding what's appropriate?-- and in what dose?-- if your child is younger than 2 years old.
In particular, don't give your child aspirin. The American Academy of Pediatrics (AAP) warns against giving aspirin to children younger than 18, particularly those with flu or chickenpox symptoms, to avoid the serious and sometimes fatal degenerative liver disorder known as Reye's syndrome. In addition, the AAP advises that giving your child more than one combination cold medicine to treat different symptoms can be dangerous; some of the same ingredients may be in each product and you'll be doubling the dose before you know it.
Acetaminophen (the main ingredient in Tylenol) and ibuprofen (found in Advil) are the only pain-relieving medications you should give to children to reduce their fevers, sore throats, and headaches. Don't use ketoprofen, naproxen, sodium salicylate, choline salicylate, or any other salicylate. Also, the AAP reminds parents that many cold medicines contain acetaminophen. If you're already giving your child acetaminophen to relieve aches and pains, be careful. You could end up overdoing it.
Keeping Kids Comfortable
It can be upsetting to see your child suffering from a cold. But there are ways besides medications to make the wee one feel better. Here are some tips:- Give plenty of fluids (juice, water, or carbonated beverages) to help loosen phlegm, soothe a sore throat, and, most importantly, prevent dehydration
- Encourage your child to rest
- Apply ointment to soothe irritated lips and nostrils
- Consider using a humidifier to ease the discomfort of blocked nasal passages (be sure to follow the instructions for keeping it clean)
- Let children over the age of 5 suck on cough drops or hard candy to produce saliva, which soothes the throat
- To ease the pain of a sore throat, help a child over age 7 gargle with salt water (a half-teaspoon of salt in eight ounces of warm water)
Babying a Baby
Although babies can't gargle, suck on cough drops, or take many of the other steps that can soothe older children, there are ways you can make them more comfortable.
Place a few saline drops in your infant's blocked nasal passages to loosen mucus. To clear loosened phlegm from stuffed noses, gently use a rubber suction bulb, also known as a nasal aspirator. And to prevent irritation, lightly apply some petroleum jelly around the nostril openings.
Even though it may be painful to hear your baby cough during a cold, coughing is helpful because it clears mucus from the lower part of the respiratory tract. That's why the American Medical Association (AMA) advises against giving cough-suppressant medicines to a child under 3 years old unless your doctor prescribes it.
Most of all, remember to give plenty of fluids?-- and warm, loving hugs.
Colds and Daycare
The AMA suggests that children 12 months old or younger might be better off -- and less likely to pick up germs -- if you arrange for a babysitter in your own home, or place your child in a small daycare home rather than a standard daycare center. That's because the greater concentration of kids in daycare centers makes it easier for colds to be passed around -- and colds more frequently cause complications in babies than in older children.
If you do place your child in a daycare center, the Centers for Disease Control and Prevention in Atlanta advise that you choose a facility that you've determined is well-ventilated and clean. Operators of the center should keep windows or doors open a little, or employ an air ventilation system. All common surfaces and toys should be cleaned or disinfected each day, and the children ought not to be crowded together, particularly at nap time.
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Analgesic (Acetaminophen)
Analgesics work to relieve pain, fever, and inflammation. They inhibit the formation of prostaglandins, substances that cause inflammation and pain. Many analgesics are also antipyretics, which means that they help reduce fever. Acetaminophen is a very safe analgesic often used in children's products. Unlike other nonprescription analgesics, acetaminophen has no anti-inflammatory properties. Additionally, it is less likely to cause stomach irritation.
Analgesic (NSAID)
Analgesics work to relieve pain, fever, and inflammation. They inhibit the formation of prostaglandins, substances that cause inflammation and pain. Many analgesics are also antipyretics, which means that they help reduce fever. Ibuprofen is a very safe analgesic often used in children's products. It is part of the NSAID (nonsteroidal anti-inflammatory drugs) class of analgesics.
Antihistamines
In an allergic reaction, body cells secrete a substance called histamine which causes itchiness, watery eyes, and other symptoms. Antihistamines are a versatile class of drugs used to alleviate the effects of allergic reactions in the respiratory system and treat motion sickness and insomnia. Antihistamines work by blocking histamine's effect on certain secretory cells and by drying mucous membranes. Their use in cold-relief preparations is somewhat controversial. Some studies have shown that colds do not cause increased histamine release in the body, making the effect of antihistamines in relieving cold symptoms minimal. They may, however, offer some relief to the cold sufferer due to their sedating effect and mild drying effect on the nasal passages.
Antitussives
Antitussives are cough suppressants which work by directly depressing the brain's cough center, lowering the sensitivity of cough receptors and interrupting transmission of cough impulses to prevent you from coughing. They also relax the smooth muscles in the throat and bronchial passages. All this leads to a reduced urge to cough.
Decongestants
Decongestants are drugs that unstuff clogged nasal passages and improve breathing for allergy sufferers. They work by significantly constricting, or narrowing, blood vessels to decrease blood flow to the nose. This shrinks the swollen tissues and reduces secretions, allowing you to breathe more easily. Oral decongestants have a longer lag before taking effect, but they last longer. While not associated with rebound congestion, they are more likely to produce side effects.
Expectorants
Expectorants are substances that increase sputum secretions in the respiratory tract, thinning mucus and phlegm and making them easier to cough out of the lungs. It may be useful in helping dry, irritating coughs become more useful. Only one nonprescription ingredient, guaifenesin, has been approved by the FDA as an expectorant.
| Analgesics (Acetaminophen) | Ingredient | Description |
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| Acetaminophen | ? | Safe and effective for treating minor aches and pains and fever relief. Less likely to cause stomach irritation than aspirin and NSAIDs. Consult a doctor before taking this drug if you have liver or kidney disease. | | Analgesics (NSAIDs) | Ingredient | Description |
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| Ibuprofen | ? | Stronger than acetaminophen or aspirin in relieving pain and reducing inflammation. Fewer side effects than naproxen and ketoprofen. Should not be used by anyone with gastrointestinal or bleeding disorders. | | Ketoprofen | ? | Effective in both relieving moderate pain and reducing inflammation. Stronger than acetaminophen or aspirin in relieving pain. More likely to cause gas, bloating, diarrhea, nervousness, and irritability than ibuprofen and naproxen. Should not be used by anyone under age 16 or with gastrointestinal or bleeding disorders. | | Naproxen | ? | Effective in both relieving moderate pain and reducing inflammation. Stronger than acetaminophen or aspirin in relieving pain. Naproxen has a longer duration of action (eight to 12 hours) than ibuprofen and ketoprofen. More likely to cause drowsiness, shortness of breath, and ringing in the ears than ibuprofen and ketoprofen. Should not be used by children under age 12 or anyone with gastrointestinal or bleeding disorders. | | Analgesics (Salicylates) | Ingredient | Description |
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| Aspirin (Acetasalicylic Acid) | ? | Present in many over-the-counter analgesics. Long-term use may be associated with greater risk of side effects such as stomach upset. Never administer to children with flu-like symptoms or fever (see Reye's syndrome). | | Choline Salicylate | ? | A salicylate salt comparable to aspirin. Less irritating to the stomach. | | Magnesium Salicylate | ? | Comparable to aspirin but less potent and less irritating to the stomach. | | Sodium Salicylate | ? | Comparable to aspirin. People on a low-sodium diet should be cautious. | | Antihistamines | Ingredient | Description |
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| Brompheniramine | | Considered safe and effective with very few serious side effects and a low risk of drowsiness. | | Clemastine | | A newer approved antihistamine found in long-acting products. | | Chlorcyclizine | | Safe, effective, and popular, with few known side effects. FDA approved, but not commonly found in nonprescription products. | | Chlorpheniramine | | This antihistamine has a proven low frequency of side effects. Effective against allergic runny nose and sneezing. | | Dexbrompheniramine | | A former prescription drug generally accepted as the most active form of brompheniramine maleate. Because of its strength, it can be taken in lower doses. | | Diphenhydramine | | A popular and effective antihistamine, but it has a strong sedating effect. | | Phenindamine | | Fast-acting and effective but known to produce more side effects than most antihistamines, including dry mouth, overstimulation, drowsiness, and insomnia. | | Pheniramine | | Safe and effective against hay fever and other allergies. | | Pyrilamine | | Highly effective against hay fever but with many reported side effects including drowsiness, listlessness, irritability, loss of appetite, and nausea. But even at high doses this drug is not likely to produce fatal toxic effects. | | Thonzylamine | | One of the oldest and generally considered least-toxic of the antihistamines. FDA approved, but not commonly found in nonprescription products. | | Triprolidine | | Safe and effective with a low incidence of side effects, the most common of which is drowsiness. | | Antitussives | Ingredient | Description |
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| Codeine Preparations | ? | Extremely effective. Only certain states allow codeine to be purchased over-the-counter. May cause drowsiness and constipation. Can be habit-forming if taken in large amounts. Medical supervision is recommended before taking this drug. | | Dextromethorphan | ? | Extremely effective. Overdoses may lead to bizarre behavior, respiratory depression, and drowsiness, among other effects. Do not use if you are taking an MAO inhibitor. | | Diphenhydramine | ? | Very effective. May cause drowsiness. Also offers antihistamine properties. | | Decongestants | Ingredient | Description |
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| Phenylephrine | ? | Fast acting and effective. When taken orally provides significant decongestant effect, but can also raise blood pressure and increase heart rate. Safest in low doses. | | Pseudoephedrine | ? | Good marks in clinical and scientific studies of cold sufferers. Side effects are minimal and include drowsiness, headache, and insomnia. Avoid if taking MAO inhibitors. | | Ephedrine (Conditionally Approved) | ? | Safely taken orally or inhaled, but can cause tension, nervousness, tremor, and sleeplessness. Appears to reduce nasal congestion in high doses. No longer sold in most nonprescription products because it can be used to produce illicit drugs. | | Phenylpropanolamine (Conditionally Approved) | ? | Studies show the effectiveness of phenylpropanolamines as nasal decongestants. However, there are concerns over potentially dangerous side effects, including increased blood pressure. | | Expectorants | Ingredient | Description |
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| Guaifenesin | ? | Also known as glycerol guiacolate. Effective and safe as an expectorant, especially during the initial stages of a cold with cough. Do not administer to children under age 2 without a doctor's supervision. |
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FDA-Approved Uses
Analgesics
- For the temporary relief of minor aches and pains associated with the common cold, flu, sore throat, headache, toothache, and muscular aches.
- This product is an analgesic (pain reliever) and helps reduce fever.
Antitussives
- Temporarily relieve cough due to minor throat and bronchial irritation associated with a cold.
- Relieve your cough to help you rest.
Oral antitussives
- Calm the cough control center and relieve coughing.
- Non-narcotic cough suppressant for the temporary alleviation of cough.
Decongestants
- Temporarily relieve nasal congestion due to sinusitis, the common cold, hay fever, and other upper respiratory allergies (allergic rhinitis).
- Reduce swelling of nasal passages; shrink swollen membranes.
- Promote nasal and/or sinus drainage.
Expectorants
- Help loosen phlegm (sputum) and thin bronchial secretions to rid the bronchial passageways of bothersome mucus.
- Help loosen phlegm (sputum) and thin bronchial secretions to make coughs more productive.
Which Drug to Choose- It's best to use only those medications specific to your child's symptoms. Don't just buy combination products with drugs to treat symptoms your child does not have.
- If your child is coughing, use an antitussive.
- If your child has a fever, use an analgesic.
- If your child is producing phlegm and needs to clear his or her throat, use an expectorant.
- If your child's nose is congested, use a decongestant.
Coughing up the Facts- Antitussives do reduce the urge to cough. But they should not be used for phlegm-producing coughs.
- If your child is coughing up phlegm, use an expectorant, not an antitussive.
- Guaifenesin is the only expectorant approved to loosen phlegm. Studies are not conclusive as to its effectiveness in helping a cold.
Cold, Not Allergy- Antihistamines are in a variety of cough and cold products because many cough and cold symptoms are similar to allergy symptoms.
- However, there is no conclusive evidence that antihistamines help treat the symptoms of the common cold. Several studies indicate they are of no benefit.
- Allergy symptoms are caused by IgE and histamine. Cold symptoms are not.
- If you feel an antihistamine might help your child, try chlorpheniramine. In studies, it was slightly better than a placebo, but not much.
Recommended Dosage
| Antitussives | | Drug | Adults & Children Over Age 12 | Max. Daily | Children Ages 6 to 12 | Max. Daily | Children Under Age 6 | Max. Daily |
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| Dextromethorphan | | | 5 to 10 mg every 4 hrs | 60 mg | Refer to package or consult a physician | | Diphenhydramine | 12.5 mg every 6 hrs | 50 mg | Refer to package or consult a physician | | Codeine | | | 5 to 10 mg every 4 to 6 hrs | 60 mg | Refer to package or consult a physician | | Expectorants | | Drug | Adults & Children Over Age 12 | Max. Daily | Children Ages 6 to 12 | Max. Daily | Children Under Age 6 | Max. Daily |
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| Guaifenesin | | | 100 to 200 mg every 4 hours | 1200 mg per day | Consult a physician | | Analgesic (Acetaminophen) | | Drug | Adults & Children Over Age 12 | Max. Daily | Children Ages 6 to 12 | Max. Daily | Children Under Age 6 | Max. Daily |
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| Acetaminophen | | | Refer to package or consult a physician | | Refer to package or consult a physician | | Analgesic (NSAID) | | Drug | Adults & Children Over Age 12 | Max. Daily | Children Ages 6 to 12 | Max. Daily | Children Under Age 6 | Max. Daily |
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| Ibuprofen | | | Refer to package or consult a physician | | Refer to package or consult a physician |
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Warnings
Analgesic (acetaminophen)
Consult a physician before using or do not use if you have:- Allergy to acetaminophen or any component in acetaminophen products
- Kidney impairment
- Liver impairment
Or if you:
- Still have a fever after three days
- Use to treat symptoms for over five days in children
- Plan to use more frequently or at higher than recommended doses
Or if you are taking:
- Chronic alcohol use: may increase the risk for acetaminophen-induced liver damage
- Isoniazid (Nydrazid): may increase the risk for acetaminophen-induced liver damage
- Phenobarbital (Luminal): may increase the risk for acetaminophen-induced liver damage
- Phenytoin (Dilantin): may increase the risk for acetaminophen-induced liver damage
- Sulfinpyrazone (Anturane): may increase the risk for acetaminophen-induced liver damage
- Warfarin (Coumadin): use of high-dose acetaminophen might further increase the risk of bleeding
Analgesic (ibuprofen)
Consult a physician before using or do not use if you have:
- Allergy to NSAIDs, aspirin, or iodides
- Anemia
- Blood clotting disorders
- Heart disease
- High blood pressure
- Kidney impairment
- Liver impairment
- Preexisting infection; might be masked by NSAIDs
- Psychiatric disorder; NSAIDs may aggravate it
- Ulcers or other gastrointestinal problems
Or if you:- Are administering to someone under age 15 with a viral illness (due to the increased risk of Reye's syndrome)
- Are bedridden or incapacitated
- Are in sunlight for prolonged periods; photosensitivity may occur
- Are on a low-salt diet
- Develop blurred vision or other eye problems during treatment, consult a physician
- Experience headaches with drug usage that do not diminish as dose is lowered
- Experience severe abdominal pain or cramps
- Plan to use for an extended period of time or at a higher dose
Or if you are taking:
- Cyclosporin (Neoral, Sandimmune): may increase kidney damage
- Digoxin (Lanoxin): may increase digoxin levels and effect when ibuprofen is also used
- Furosemide (Lasix): may decrease furosemide levels
- Lithium (Lithobid): may increase lithium levels or effect
- Methotrexate (Folex): may increase methotrexate levels and side effect
- Other NSAIDs: increases ibuprofen side effects
- Phenytoin (Dilantin): may increase phenytoin levels or effect
- Probenecid (Benemid): may increase ibuprofen levels and side effects
- Salicylates, such as
- Aspirin (Ecotrin): may decrease ibuprofen levels and increase ibuprofen side effects
- Choline salicylate (Arthopan): may decrease ibuprofen levels and increase ibuprofen side effects
- Warfarin (Coumadin): may increase warfarin side effects and the risk or bleeding
Antihistamines
Consult a physician before using or do not use if you have:
- Allergy to any antihistamines
- Chronic respiratory conditions
- Enlarged prostate
- Glaucoma
- Urinary obstruction
Or if you:
- Are administering to a child under age 6
Or if you are taking:
- Alcohol: increases antihistamine side effects
- CNS depressants, such as:
- Diazepam (Valium): increases antihistamine side effects
- Phenobarbital (Luminal): increases antihistamine side effects
- Monoamine oxidase inhibitors (a class of antidepressants), such as:
- Phenelzine (Nardil): increases antihistamine side effects
- Tranylcypromine (Parnate): increases antihistamine side effects
- Other antihistamines: increases antihistamine effects
Antitussive
Consult a physician before using or do not use if you have:
- Asthma
- Are allergic to dextromethorphan or any component of antitussive products
- Liver impairment
Or if you:
- Are administering to a child or infant
- Cough blood or thick, brown-yellow mucus
- Plan to use for an extended period of time or at a higher dose
Or if you are taking:
- Monoamine oxidase inhibitors (a class of antidepressants), such as:
- Phenelzine (Nardil): may cause serious central nervous system depression or excitation
- Tranylcypromine (Parnate): may cause serious central nervous system depression or excitation
Decongestants
Consult a physician before using or do not use if you have:- Allergies to any decongestants
- Blood vessel disease
- Diabetes
- Enlarged prostate
- Heart disease
- High blood pressure
- Thyroid disease
Or if you:
- Are administering to a child under age 6
- Develop new or worse symptoms with the use of the medicine
- Use a larger dose than recommended
Or if you are taking:
- Antihypertensives, such as:
- Enalapril (Vasotec): may decrease enalapril's antihypertensive effects
- Nifedipine (Adalat/Procardia): may decrease nifedipine's antihypertensive effects
- Methyldopa (Aldomet): may increase decongestant effects
- Phenothiazines, such as:
- Perphenazine (Trilafon): may reduce decongestant effects
- Trifluoperazine (Stelazine): may reduce decongestant effects
- Reserpine: may increase decongestant effects
- Monoamine oxidase inhibitors (a class of antidepressants), such as:
- Phenelzine (Nardil): may increase decongestant side effects
- Tranylcypromine (Parnate): may increase decongestant side effects
- Tricyclic antidepressants, such as:
- Amitriptyline (Elavil): may increase decongestant effects
- Nortriptyline (Pamelor): may increase decongestant effects
Expectorant
Consult a physician before using or do not use if you have:- Chronic cough due to asthma, emphysema, or smoking
- Cough with overproduction of mucus
Or if you:
- Are concerned about ingestion of alcohol; some products contain alcohol
- Are concerned about ingestion of sugar; some products contain sugar
- Have symptoms that last for more than seven days
Common Side Effects
Analgesic (acetaminophen)
Analgesic (ibuprofen)
- Dizziness
- Fatigue
- Heartburn
- Nausea
- Rash
- Stomach cramps
Antitussive
Decongestant
- Excitability
- Headache
- Insomnia
- Nervousness
- Rapid heartbeat
Expectorant
Infrequent to Rare Side Effects
Analgesic (acetaminophen)
- Bruising
- Nausea
- Rash
- Vomiting
Analgesic (ibuprofen)
- Confusion
- Fluid retention
- Headache
- Itching
- Nervousness
- Ringing in ears
- Stomach ulceration
- Vomiting
Antitussive
- Constipation
- Dizziness
- Drowsiness
- Nausea
- Slow breathing
- Stomach cramps
Decongestant
- Difficult urination
- Dizziness
- Nausea
- Vomiting
- Trouble breathing
- Weakness
Expectorant
- Abdominal discomfort
- Drowsiness
- Headache
- Nausea
- Rash
- Vomiting
Symptoms of Overdose
Analgesic (acetaminophen)
- Kidney damage
- Liver damage
Analgesic (ibuprofen)
- Kidney failure
- Seizures
- Severe nausea
- Vomiting
- Ringing in ears
Antitussive
- Blurred vision
- Convulsions
- Drowsiness
- Extreme tiredness
- Hallucinations
- Very slow breathing
Decongestant
- Increased blood pressure
- Nausea
- Rapid and irregular heartbeat
- Seizures
- Severe agitation
- Vomiting
Expectorant
- Coma
- Severe drowsiness
- Very slow breathing
- Vomiting
What to Do in Case of Overdose
- If you suspect that you or someone you know has taken an overdose of this medication, immediately STOP USING THE MEDICATION and SEEK MEDICAL HELP.
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Websites, Organizations & Manufacturers
Sources & Further Reading
Government Sources
- 1. Food & Drug Administration. Federal Register 11/8/85.
- 2. Food & Drug Administration. Federal Register 12/9/92.
- 3. Food & Drug Administration. Federal Register 1/28/94.
- 4. Food & Drug Administration. Federal Register 4/9/96.
- 5. Food & Drug Administration. Federal Register 8/12/87.
- 6. Food & Drug Administration. Federal Register 6/3/94.
- 7. Food & Drug Administration. Federal Register 10/2/86.
- 8. Food & Drug Administration. Federal Register 10/20/93.
- 9. Food & Drug Administration. Federal Register 5/20/96.
- 10. Food & Drug Administration. Federal Register 2/28/89.
- 11. Food & Drug Administration. Federal Register 6/30/92.
- 12. Food & Drug Administration. Federal Register 9/14/92.
- 13. Food & Drug Administration. Federal Register 8/23/94.
- 14. Food & Drug Administration. Federal Register 3/8/96.
- 15. Food & Drug Administration. Federal Register 11/16/88.
- 16. Food & Drug Administration. Federal Register 12/24/91.
- 17. Food & Drug Administration. Federal Register 2/2/94.
- 18. Food & Drug Administration. Federal Register 4/19/95.
- 19. Food & Drug Administration. Federal Register 6/13/96.
- 20. Food & Drug Administration. Federal Register 11/14/97.
- 21. Food & Drug Administration.Colds and Flu: Time Only Sure Cure. FDA Consumer 2/98.
Books
- 1. Covington, TR et al. Handbook of Nonprescription Drugs, Eleventh Ed. American Pharmaceutical Assoc. Washington, DC 1996.
- 2. Kastrup EK et al. Drug Facts and Comparisons. Facts and Comparisons.
- 3. Inlander, CB and Slamans, S. The Over-the-Counter Doctor. Cader Books. New York, NY 1997.
- 4. Zimmerman, DR. Zimmerman's Complete Guide to Nonprescription Drugs, Second Ed. Gale Research, Inc. 1983.
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