espiratory tract infections are common in children. Evidence for the efficacy of over-the-counter cough and cold medications in young children is limited, 1,2 but they can lead to severe adverse events, including death. 3 In Australia, the Therapeutic Goods Administration (TGA) introduced compulsory labelling changes for non-prescription cough and cold products in 2012 (but not herbal products), 4 with further changes in 2020 for first generation (sedating) antihistaminecontaining products 5 (further details: Supporting Information).

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Aim To describe time trends in opioid exposures in children under 5 years, and to describe patient demographics, the medicines involved, the reasons for exposure and disposition. Methods A retrospective analysis of paediatric (<5 years of age) opioid exposure calls to the New South Wales Poisons Information Centre (NSWPIC, Australia's largest poison centre), 2004–2019. Joinpoint regression analysis was used to examine temporal trends. Results There were 4807 cases of paediatric opioid exposure during the 16 year study period, with an average of 300 exposures per year. Exposures increased, 2004–2007, with an annual percentage change (APC) of 14.6% (95% CI = 4.3 to 26.0%), then decreased, 2007–2016, APC −3.4% (95% CI = −5.3 to −1.3%). A steeper decrease was observed after 2016, APC −14.1% (95% CI = −21.8 to −5.6%). The overall APC was −2.3% (95% CI = −4.7 to 0.2%), 2004–2019. Accidental exposures accounted for 86% of calls (4137). The majority of calls were from family members regarding exposures that happened at home, highlighting the need for safety initiatives. The preparations most frequently involved were paracetamol/opioid combination products (primarily codeine), 53% (2566) and ibuprofen/opioid combinations 14% (650). Twenty‐two percent of cases were referred to a hospital (1062), and a further 15% (719) of calls originated from hospital staff. Conclusion Opioid exposures in young Australian children continue to occur; however, the rate has declined since 2007. Safe storage and parent education initiatives could further reduce the burden of paediatric opioid poisoning in Australia.

ObjectiveTo describe the temporal relationships in attention-deficit hyperactivity disorder (ADHD) medication poisoning exposures in children; describe patient demographics, medications involved, poisoning exposure reasons and disposition.DesignA population-based, retrospective cohort study of calls to Australia’s largest Poisons Information Centre. Poisoning exposure counts and dispensing-adjusted rates were modelled with Poisson, quasi-Poisson and negative binomial regression where appropriate.SettingCalls to the New South Wales Poisons Information Centre and dispensings on the Pharmaceutical Benefits Scheme.PatientsChildren under the age of 5 years.ResultsThere were 1175 poisoning exposures to ADHD psychostimulants, 2004–2019; averaging 73 per year. Accidental poisonings accounted for 94% of cases. Methylphenidate was most frequently implicated (63%). Thirty-four per cent of cases were referred to hospital and a further 21% of calls were made by hospital staff. Poisoning exposure counts for all ADHD psychostimulants increased by 2.7% (95% CI=0.42% to 4.9%) per year; however, this differed by agent. Methylphenidate poisoning exposures increased by 5.2% per year (95% CI=4.3% to 6.1%), lisdexamfetamine increased by 62% per year (95% CI=48% to 76%), while dexamphetamine poisoning exposures decreased by 5.5% per year (95% CI=−9.5% to −1.4%). These trends are reflected in the number of dispensings; however, dispensings increased at a faster rate than exposures. When poisoning exposures were expressed as dispensing-adjusted rates, there was a 16% decrease (95% CI=−20% to −13%) per year.ConclusionsADHD medication use has increased, associated with an increased number of paediatric poisoning exposures. However, poisoning exposures per dispensed prescription has decreased. The majority of cases required hospitalisation, indicating the need for further poisoning prevention strategies.