Liquid Medicines

Oral liquid medicines are pourable liquids that contain a mixture of the active medicine and inactive substances used to color, sweeten, flavor, and bulk up the medicine and allow it to mix in a suspension or solution. Oral liquid formulations are most suitable for certain types of medicine (e.g., antacids, cough medicines) or for people who have difficulty taking tablets or capsules, such as children and the elderly. But there is a higher risk of a dosing error since accurate dosing depends on measuring the proper volume for each dose of medicine. This can be a significant issue for people who can’t see well, those with arthritis, or when the numbers on an oral dosing syringe or medicine cup can’t be read. Some errors with the directions for taking oral liquid prescription medicines prepared in a pharmacy have been reported due to mix-ups between milliliters (mL) and teaspoons. Also, household teaspoons are not an accurate measuring device for oral liquid medicines.

Safety tips for liquid medicines

When you take or give liquid medicines, use only the cup or measuring device that comes with the medicine. If you get a liquid medicine and it doesn't come with a measuring device, ask your pharmacist to suggest what type of measuring device you should use.

Use oral syringes with mL markings. Oral syringes are considered the gold standard when accurate measurement of the medicine dose is critical. Healthcare professionals use oral syringes to accurately measure medicine doses and so should consumers especially when giving liquid medicine to children. The oral syringe should have mL markings on it and preferably no other markings (e.g., teaspoons or tsp). If your child’s medicine comes with a dosing cup, ask your pharmacist for an oral syringe for you to use instead, particularly if a small volume of the medicine is needed for each dose.

Evaluate the dropper when provided. If your child’s medicine comes with a dropper, check if the markings are easy to see and understand. If not, ask your pharmacist to provide an oral syringe to replace the dropper. Be sure to ask the pharmacist how to measure the amount of medicine needed for each dose using the oral syringe.

Make sure markings match the needed dose. Be sure the oral syringe and/or dosing cup markings match the volume of medicine that is needed to measure each dose. For example, if a dose of 0.5 mL is needed, the oral syringe or dosing cup should have markings that correspond to 0.5 mL.

Never use a household spoon. To promote dosing accuracy, both the American Academy of Pediatrics (AAP) and the US Food and Drug Administration (FDA) discourage using kitchen teaspoons or tablespoons to measure doses of liquid medicine. These utensils are not standard sizes and vary widely in volume of liquid they hold. In addition, kitchen measuring spoons used to measure recipe ingredients should NOT be used to measure liquid medicines.

Read the instructions on the label. Before leaving the pharmacy with a prescription or over-the-counter (OTC) liquid medicine, read the instructions on the label. If the directions for use include teaspoon or tablespoon measurements only, verify the mL amount of each dose with the pharmacist. Also ask the pharmacist to relabel any prescription medicine to include the mL amount of each dose.

Verify dose measurement with a pharmacist. Whether your child’s medicine is an OTC or prescription medicine, it is always best to verify with your pharmacist that you know how to measure the correct dose. Ask your pharmacist for a demonstration, and then show the pharmacist how you will measure each dose to verify accuracy. This is especially important for doses that are not measured in whole numbers (e.g., 2.5 mL, 7.5 mL).

For more safety tips and a (downloadable teaching sheet) for measuring liquid medicines safely, visit: here.