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Nonprescription Medication Overdose in Children

Medically reviewed by Last updated on Sep 3, 2023.

What is a nonprescription medication overdose?

A nonprescription medication overdose occurs when more medicine is taken than is safe to take. Nonprescription medicine is also called over-the-counter (OTC) medicine. A prescription is not needed to buy OTC medicine. OTC medicine is generally safe for your child when it is taken correctly. A medicine overdose may be mild, or it may be a life-threatening emergency.

Which nonprescription medications can cause an overdose in children?

  • Acetaminophen decreases pain and fever. Acetaminophen can cause liver damage if not taken correctly. Acetaminophen can also be found along with other OTC medicines. These may include medicines that are used to treat a cough and other symptoms of a cold.
  • NSAIDs help decrease pain, swelling, and fever. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask his or her healthcare provider if NSAIDs are safe to take. Ibuprofen and aspirin are names of common NSAIDs. Do not give NSAIDs to children younger than 6 months without direction from your child's doctor.
  • Cough and cold medicines:
    • Antihistamines are used to decrease mucus that may be produced with an illness. This medicine is used to decrease a runny nose, symptoms of allergies, and to help a person sleep. Diphenhydramine is the name of a common antihistamine. Antihistamines can also be found along with other OTC medicines that are used to treat a cough and other symptoms of a cold.
    • Antitussives are also called cough suppressants. Antitussive medicine is used to decrease a strong cough that does not seem to get better.
    • Decongestants are used to clear the nose and sinuses. Sinuses are hollow spaces inside the skull that are located behind the bones of the forehead, cheeks, and eyes. Pseudoephedrine is the name of a common decongestant.
    • Expectorants loosen mucus to allow coughing. This can clear mucus from the lungs and make breathing easier. Guaifenesin is the name of a common expectorant.

What causes a nonprescription medication overdose?

  • Too much medicine is given at one time. This can occur if you do not know how much your child weighs and you give him or her the wrong dose. You can also give too much medicine if you do not carefully read medicine labels. This can also happen if you use the wrong measuring device. A kitchen spoon should not be used to give medicine. Use the cup, syringe, spoon, or dropper that is packaged with the medicine.
  • More than one type of medicine is given at the same time. Different medicines may contain the same ingredients, such as acetaminophen. An overdose may happen if you give your child more than one medicine with the same active ingredient at the same time.
  • Extended-release medicine is given to your child too often. Extended-release medicine lasts longer than regular medicine and does not need to be given as often.
  • Medicines are shared. Medicine comes in different forms. Doses for adults and children and should not be shared.

What are the signs and symptoms of a mild nonprescription medication overdose?

  • Flushed (red) skin or dry mouth
  • Stomach pain, nausea, and vomiting
  • Ringing in the ears and trouble hearing

What are the signs and symptoms of a severe or life-threatening nonprescription medication overdose?

  • A fast heartbeat
  • Vomiting, or vomit that has blood in it
  • Trouble having a bowel movement or being unable to urinate
  • Hallucinating (seeing or hearing things that are not there) or having trouble talking clearly
  • Dilated (large) pupils, hyperactivity (unable to stand or sit still), or seizures
  • Dizziness or sleepiness, trouble breathing, confusion, or unconsciousness

How is a nonprescription medication overdose diagnosed?

Healthcare providers may not be sure which medicine is causing your child's overdose. Be sure to tell them every cold or pain medicine your child is taking. Include when your child took these medicines and how much he or she took of each. Also include how long your child has been taking each medicine. Your child's provider may ask if your child has any other medical conditions, such as liver problems or diabetes. The provider may ask you how you gave your child his or her medicine and to describe his or her symptoms. Your child may need tests to help providers learn if his or her condition is serious or life-threatening.

  • Blood tests may be needed to give providers more information about your child's condition. Your child may need to have blood drawn more than once. If you do not know which medicine your child took, blood tests may be able to tell which medicine is in his or her body. For example, blood tests may be done to check for acetaminophen in your child's body. Blood tests may be used to check his or her liver.
  • Urine tests may show which medicine is in your child's body.

How is a mild nonprescription medication overdose treated?

  • Activated charcoal is a medicine that may be in the form of a powder or liquid. Healthcare providers may give activated charcoal to your child if he or she has swallowed too much medicine. Activated charcoal helps soak up the medicine that is still in your child's stomach. He or she may vomit when given activated charcoal.
  • Emetics are medicines that cause your child to vomit. Vomiting may help remove the medicine from your child's stomach, so less is absorbed by his or her body.
  • Gastric lavage is sometimes called having your stomach pumped. Healthcare providers clean out your child's stomach to get rid of as much medicine as they can.
  • A nasogastric (NG) tube may be guided from your child's nose to his or her stomach. The tube may be attached to suction to remove the medicine from your child's stomach. He or she may also be given medicine through this tube, such as activated charcoal.
  • N-acetylcysteine (NAC) stops the effect of some types of medicine, such as acetaminophen, in your child's body. NAC may prevent some of the problems caused by your child's overdose. It can be given as medicine that your child swallows or through an IV.

How is a severe or life-threatening nonprescription medication overdose treated?

  • Anticonvulsants are given to stop seizures that may be caused by a medicine overdose.
  • Sedatives may help keep your child calm and relaxed if he or she is upset or agitated (easily angered).
  • Vasopressors help constrict (narrow) the blood vessels and increase your child's blood pressure. These may be needed if the medicine overdose caused your child's blood pressure to go lower than it should.
  • A ventilator is a machine that helps your child breathe. An endotracheal (ET) tube is put into your child's mouth or nose and attached to the ventilator. He or she may need a trach if an ET tube cannot be placed. A trach is a tube put through an incision in your child's neck and into his or her windpipe.
  • A liver transplant may be needed if your child's liver is badly damaged by a medicine overdose. This is surgery to replace your child's damaged liver with a healthy donor liver.

What should I do if I think my child has had too much of a nonprescription medication?

Call the Poison Control Center immediately . The telephone number is 1-800-222-1222 . Keep this number by every telephone in your home and on your cell phone.

What are the risks of a nonprescription medication overdose?

High doses of OTC medicine may be very harmful to your child. Large amounts of acetaminophen may cause liver damage and liver failure. An overdose of cough and cold medicine may cause seizures and other life-threatening side effects. An overdose of NSAIDs may cause stomach bleeding. Alcohol is used in some OTC medicines. If your child has an overdose of OTC medicine, he or she may also have an alcohol overdose. Alcohol overdose may increase the chance of liver damage and stomach bleeding.

Call 911 for any of the following:

  • Your child is unconscious, not breathing, or having seizures.

When should I seek immediate care?

  • Your child has abdominal pain.
  • Your child has little or no urine, or he or she has a hard time having a bowel movement.
  • Your child is confused or sees or hears things that are not there.

When should I contact my child's healthcare provider?

  • Your child is flushed and is more tired than usual.
  • Your child has nausea and is vomiting.
  • Your child has swallowed an amount of medicine that may be harmful, but he or she does not have any signs or symptoms.
  • You have questions or concerns about your child's care or condition.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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