Consider reversible causes and treat if appropriate:
Linctus : paediatric preparation (0.625% citric acid monohydrate); adult preparation (2.5% citric acid monohydrate)
1 month -12yr: paediatric preparation 5-10mL t.d.s.- q.d.s.
>12yr: adult preparation 5-10mL t.d.s.-q.d.s.
Licence: licensed for children and adults (appropriate preparation).
Solution: 10mg in 5mL
30-50% of starting dose for analgesia (see pain section)
Cough can be a manifestation of hyper-reactive airways/ asthma and a trial of nebulised salbutamol/ ipratropium may be helpful
May be helpful if bronchospasm is present
Nebulised solution: 250µg in 1mL, 500 µg in 2mL
Child less than 1 year: 62.5µg 3 to 4 times daily,
Child 1-5 years: 125-250µg 3 to 4 times daily,
Child 5-12 years: 250-500µg 3 to 4 times daily,
Child over 12 years: 500µg 3 to 4 times daily.
May be helpful if bronchospasm is present.
Child 1 month-18years: 100-200µg (1-2 puffs) for persistent symptoms up to four times a day.
Nebulised solution: (2.5mg in 2.5mL, 5mg in 2.5mL, 5mg in 1mL)
Neonate: 1.25-2.5mg up to four times daily,
Child 1 month-18years: 2.5-5 mg up to four times daily.
N.B. Salbutamol may cause a tremor and/or if over-used.
May be helpful if secretions are thick.
2.5-5mL
May induce cough reflex in some cases.
Liquid 125mg in 5mL
2-5yr: 62.5-125mg q.d.s.
6-12 yr: 250mg t.d.s.
>12 yr: 750mg t.d.s. initially, reducing to 1.5g/day in divided doses.
Use primarily in children with Cystic Fibrosis.
Granules: 100mg, 200mg sachets. Named patient basis only.
1 month - 2yr: 100-200mg t.d.s.
2-12yr: 200mg t.d.s.
12-18 yr: 200-400mg t.d.s.
Used primarily in children with Cystic Fibrosis. Licence: not licensed in children for this use.
Nebulised solution: 1,000 units in 1mL as 2.5mL vial
Not for children < 5yr.
>5yr: 2.5mL o.d., or b.d. in infective exacerbations
Used primarily in children with Cystic Fibrosis. Licence: licensed for use in children >5yr.
Excessive secretions:
See section on noisy breathing.
PCM © 2012