Health Canada says children and adolescents under age 18 should not use cough and cold products that contain opioids.
A safety review by the federal department found there is limited evidence to support the effectiveness of the potent narcotics in cough and cold products in children and teens.
The review found no strong evidence linking such products with opioid-use disorders in young Canadians, but it did determine their early use may be a factor in problematic substance use later in life.
Three prescription opioids are authorized to treat cough symptoms in Canada: codeine, hydrocodone and normethadone. Codeine is also available without a prescription in low-dose formulations to treat coughs and colds.
Health Canada advises parents to ask their health-care practitioner about alternatives to cough and cold products containing opioids for children and adolescents.
The use of these opioid-containing products has been declining among patients under age 18 in the last five years, with prescriptions for that age group now making up just four per cent of the total dispensed to Canadians.