Can I give my kid expired Tylenol? A pediatrician’s tips for the cold medicine shortage

A rush on Tylenol, Motrin, and their generic equivalents is making parents nervous. Pediatricians’ offices and hospitals are overwhelmed with a surge of flu-like viruses that are taking a heavy toll on children. And now, the few medications that can help parents manage such illnesses at home are increasingly hard to find.

The Inquirer spoke with Maria Petrini, a pediatrician at Nemours Children’s Health in Delaware, for advice on how parents can cope with the supply issues.

Can I use Tylenol if I can’t find Motrin and vice versa?

Yes, but be aware of doses and daily limits.

Both acetaminophen, the active ingredient in Tylenol, and ibuprofen, the active ingredient in Motrin, reduce fever and improve pain, Petrini said. Parents can use one or the other, or even both in cases of high fevers.

The dose of both medications is based on the child’s weight. Tylenol can be used every four hours, while Motrin only every six hours.

In some cases, when there is a high fever and the patient isn’t improving, doctors recommend giving Tylenol and adding Motrin three hours later, she said.

It is always best to speak with your child’s doctor about your treatment plans and the proper dose of medication.

What is the difference between infant and child formulation of medications?

The concentration could be different, so always check before giving your child a medication.

The concentration of acetaminophen products such as Infants’ Tylenol and Children’s Tylenol is the same (160mg/5ml), a measure put in place following tragedies that occurred when parents mixed up the two.

The same is not true for ibuprofen products such as Motrin. Although the medication is the same, the concentration for infants’ ibuprofen is often higher than the concentration of children’s formulations. Always check the medication package for proper dosing.

What if I can only buy adult capsules or tablets?

You can split tablets but don’t try to divide the content of capsules. And triple check your math.

Tablets cut in half can be crushed into applesauce or juice. Pill cutters sold at pharmacies can help. But this technique is useful only if half of the tablet is the right dosage for your child.

“The most important part is to make sure that the dosage is appropriate,” she said.

Capsules are usually filled with a powder or gel. Petrini said that parents shouldn’t try to divide the content inside the capsule because they risk dosing incorrectly.

“It’s impossible to separate that in an accurate way,” she said.

If the dose of a full capsule is appropriate for your child, usually it would be OK to dump the contents of the capsule into something your child would take. But be extra certain about the dose and check with your pediatrician.

Can I use expired over-the-counter cold medications?

It’s not advised.

Most cold medications don’t go bad the way dairy or meat products do, but expired medication loses its potency and may not work.

Petrini recommends that parents check the expiration date of all the medications in the house once a year. Giving an expired over-the-counter cold medication is not recommended, but in a pinch, it can be effective.

When her patients call her to ask about using an expired cold medicine, Petrini asks them how long ago it expired. She’s willing to let them try it if the medication expired within the last couple of months. She recommends avoiding older medications because it’s less likely they’ll do any good.

As with dosing, make these decisions in consultation with your pediatrician.

What else can parents do at home to improve the cold symptoms of their child?

More than some parents might expect.

Petrini often doesn’t recommend cold medicine if the child’s fever is low and the child is not too uncomfortable. Instead, she suggests these home remedies:

• Rest.
• Plenty of fluids, including electrolyte water such as Gatorade or Pedialyte, which can be diluted to the child’s taste.
• Saline nasal drops or spray for congestion.
• A steam bath can also help with congestion, particularly with smaller kids who don’t know how to blow their nose.
• Nose suction.
• Humidifier.
• Honey can help to soothe the throat. Honey can be dangerous for children under a year old, who may contract infant botulism, a potentially life-threatening illness caused by a bacteria sometimes found in honey.
• A lukewarm bath. Letting the child be in there as the water gets colder can help with fevers.

One of the most important things parents can do right now is to be proactive, Petrini said. There are safe and effective vaccines for two of the main viruses that are getting children sick: flu and COVID. The vaccines are not going to prevent illness all together, but they increase the chances of getting a mild case.

“Make sure that vaccines are completed and updated for everybody in the house,” she said.

2022 The Philadelphia Inquirer, LLC.

Distributed by Tribune Content Agency, LLC.

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