STOP Decolsin (Dextromethorphan) Immediately - This Medication Should Never Be Given to Children Under 1 Year
Critical Safety Alert
The FDA explicitly states that dextromethorphan should NOT be used in children under 4 years of age, and your child is under 1 year old. 1 This is not a recommendation - it is a contraindication based on documented morbidity and mortality in young children.
Why This Medication Must Be Stopped
Major medical organizations including the American Academy of Pediatrics and FDA have issued warnings against using OTC cough medications in children under 4 years due to potential toxicity, lack of proven efficacy, and documented deaths. 2, 3
Between 1969-2006, there were 123 fatalities associated with OTC cold medications in children under 6 years, with the majority occurring in infants under 1 year. 3
Dextromethorphan is no more effective than placebo for reducing nocturnal cough or sleep disturbance in children. 2
Recent case reports (2025) describe a severe neurotoxicity syndrome called DANCE (Dextromethorphan-Associated Neurotoxicity with Cerebellar Edema) in children under 5 years, causing sudden unresponsiveness and cerebellar edema. 4
Immediate Actions Required
Discontinue Decolsin syrup immediately - do not give any additional doses. 2, 3
Monitor your child closely for the next 24-48 hours for signs of toxicity:
Seek immediate medical attention if any concerning symptoms develop. 6
What You Should Use Instead
For children over 1 year: Honey is the only evidence-based treatment for cough, providing more relief than dextromethorphan, diphenhydramine, or placebo. 2, 3, 6
For infants under 12 months: NO medications should be given - only supportive care with adequate hydration and rest. 6
Ensure adequate fluid intake to maintain hydration. 6
When to Seek Medical Evaluation
If respiratory distress develops: respiratory rate >70 breaths/min in infants, grunting, or intercostal recession. 6
If cough persists beyond 2-4 weeks, re-evaluation is needed to look for specific causes. 7, 2
If fever >38.5°C persists for more than 3 days. 6
Common Pitfall You've Encountered
- Prescribing or using OTC cough medications in young children due to parental concern, despite clear evidence of harm and lack of benefit. 2, 6 The perception that "something must be done" often leads to inappropriate medication use, but in this case, doing nothing (except supportive care) is actually the safest and most appropriate approach.