Background and Purpose: Characterization of emergency department (ED) visits for acute harms related to use of over-the-counter cough and cold medications (CCMs) by patient demographics, intent of CCM use, concurrent substance use, and clinical manifestations can help guide prevention of medication harms.Methods: Public health surveillance data from the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance project were used to estimate numbers and population rates of ED visits from 2017 to 2019.Results: Based on 1396 surveillance cases, there were an estimated 26 735 (95 Cl, 21 679-31 791) US ED visits for CCM-related harms annually, accounting for 1.3 (95 Cl, 1.2-1.5) of all ED visits for medication adverse events. Three fifths (61.4, 95 Cl, 55.6-67.2) of these visits were attributed to non-therapeutic CCM use (nonmedical use, self-harm, unsupervised pediatric exposures). Most visits by children aged <4 years (74.0, 95 Cl, 59.7-88.3) were for unsupervised CCM exposures. Proportion hospitalized was higher for visits for self-harm (76.5, 95 Cl, 68.9-84.2) than for visits for nonmedical use (30.3, 95 Cl, 21.1-39.6) and therapeutic use (8.8, 95 Cl, 5.9-11.8). Overall, estimated population rates of ED visits for CCM-related harms were higher for patients aged 12-34 years (16.5 per 100 000, 95 Cl, 13.0-20.0) compared with patients aged <12 years (5.1 per 100 000, 95 Cl, 3.6-6.5) and ≥ 35 years (4.3 per 100 000, 95 Cl, 3.4-5.1). Concurrent use of other medications, illicit drugs, or alcohol was frequent in ED visits for nonmedical use (61.3) and self-harm (75.9).Conclusions: Continued national surveillance of CCM-related harms can assess progress toward safer use.
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