December 16, 2010
Awareness: Of Medicines and Mismeasurements
By NICHOLAS BAKALAR

Giving the correct dose of an over-the-counter pediatric medicine is critical, but the package labeling and dosing information can be virtually incomprehensible. And an overdose can be deadly.

Over the year that ended on Nov. 1, 2009, researchers examined the directions and measuring devices in 200 nonprescription pediatric liquid medicines — drugs for allergy, cough and cold, pain or gastrointestinal problems, and medicines in combination products.

Writing online on Nov. 30 in The Journal of the American Medical Association, the researchers report that 52 of the medicines had no measuring device in the package, and that 146 of the other 148 had inconsistencies between the dosing directions and the devices, including missing or superfluous markings, unfamiliar units of measurement (for example, drams or cubic centimeters), or undefined or nonstandard abbreviations.

In November 2009, the Food and Drug Administration published voluntary guidelines for the labeling of dosing directions and measuring devices for over-the-counter liquid medicines. “The plan is that we can expect to see changes by next winter,” said Dr. H. Shonna Yin, the lead author.

But Dr. Yin, an assistant professor of pediatrics at New York University, is not finished. “When we do the study again,” she said, “we’ll see if voluntary guidelines work, or if we need something stronger.” In the meantime, she said, parents should pay careful attention to both directions on packages and the labeling on measuring devices. “A tablespoon,” she warned, “is three times as large as a teaspoon.”

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