Respiratory
Medicines for Croup
A common viral illness in young children causing a barking "seal-like" cough and noisy breathing — usually mild, and helped by a single dose of a steroid to settle the airway swelling.
Education and reference only. This explains which medicines are used and why, in plain language — it deliberately contains no doses and is not a substitute for advice from your doctor or pharmacist. Always discuss your own treatment with a qualified clinician, and check the BNF and the product labelling for prescribing detail.
Quick answer
What is Croup?
Croup is a common viral infection of the upper airway in young children, most often affecting those between about six months and three years of age. A cold-like illness, with a runny nose and mild fever, gives way to the hallmark features: a harsh, barking cough that is often described as "seal-like", a hoarse voice or cry, and a harsh, rasping noise when breathing in, called stridor.
- How it is treated: Most children with croup have a mild illness that settles on its own, and the main aim is to ease the airway swelling and keep the child comfortable.
- Self-care: Comforting and reassuring your child is one of the most helpful things you can do, because being upset or crying makes the airway swelling and the noisy breathing worse — holding them upright on your lap and staying calm yourself can ease the symptoms.
- When to seek help: Contact a GP or out-of-hours service if your child has croup symptoms, especially for the first time, so they can be assessed and a steroid given if needed, or if the symptoms are not improving.
What it is
Croup is a common viral infection of the upper airway in young children, most often affecting those between about six months and three years of age. A cold-like illness, with a runny nose and mild fever, gives way to the hallmark features: a harsh, barking cough that is often described as "seal-like", a hoarse voice or cry, and a harsh, rasping noise when breathing in, called stridor. Symptoms typically come on or worsen at night and can be alarming to hear, but in most children croup is mild and settles by itself over a few days. The barking cough and noisy breathing happen because the virus causes swelling around the voice box and windpipe, narrowing a young child's already small airway. Crying and distress can make the swelling and noise worse, so keeping the child calm genuinely helps. A small number of children have more severe symptoms that narrow the airway enough to cause real breathing difficulty, and these need urgent medical attention.
How it is treated
Most children with croup have a mild illness that settles on its own, and the main aim is to ease the airway swelling and keep the child comfortable. The mainstay of treatment is a single dose of an oral corticosteroid — most often dexamethasone — which reduces the swelling around the voice box and windpipe, easing the barking cough and noisy breathing and lowering the chance of the illness worsening. A single dose is usually enough, and it can help even in milder cases. Keeping the child calm is an important part of care in its own right, because crying and distress make the airway narrowing and stridor worse. Children with more severe croup — for example, those with stridor when at rest or signs of struggling to breathe — are assessed urgently and may be given a steroid and other treatments, such as a breathing treatment delivered as a fine mist, in hospital, with oxygen if needed.
For this condition, these medicines
Medicine classes used for Croup
Each links to a full, dose-free guide — what it is, how it works, who can and cannot use it, side effects, interactions and FAQs.
Symptom checker
Symptoms that can point to Croup
Croup can be one cause of these symptoms. Each guide explains the other possible causes and the red-flag warning signs that mean you should get urgent help:
Beyond medication
Lifestyle and self-care
Comforting and reassuring your child is one of the most helpful things you can do, because being upset or crying makes the airway swelling and the noisy breathing worse — holding them upright on your lap and staying calm yourself can ease the symptoms. Keep them well hydrated with small, frequent drinks, and you can give the usual child-friendly pain and fever relief if they are uncomfortable or feverish. Sit with your child during the night, when croup tends to be at its worst, so you can watch their breathing. Steam and humidified air are sometimes tried but are not proven to help, and hot steam carries a scald risk, so it is not recommended. Avoid smoky environments, which can irritate the airway further.
When to get help
When to see a doctor
Contact a GP or out-of-hours service if your child has croup symptoms, especially for the first time, so they can be assessed and a steroid given if needed, or if the symptoms are not improving. Call 999 or go to A&E straight away if your child is making a harsh, rasping noise (stridor) when calm and at rest rather than only when upset, is struggling to breathe, is drawing in the skin around the ribs or tummy with each breath, is unusually quiet, drowsy or floppy, is drooling or cannot swallow, or if their lips or skin look blue or grey, as these signal that the airway is dangerously narrow and need emergency care.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
Answers
Croup: frequently asked questions
What medicines are used for croup?
The main treatment for croup is a single dose of an oral corticosteroid, most often dexamethasone. It reduces the swelling around the voice box and windpipe that causes the barking cough and noisy breathing, easing symptoms and lowering the chance of the illness getting worse — and it can help even in milder cases. A single dose is usually all that is needed. Antibiotics are not used, because croup is caused by a virus. Children with more severe croup may be given a steroid and, in hospital, other treatments such as a breathing treatment delivered as a fine mist, with oxygen if required.
How can I tell croup apart from a normal cough?
Croup has a distinctive barking, "seal-like" cough, usually along with a hoarse voice or cry and a harsh, rasping noise when breathing in (stridor), and it tends to come on or get worse at night. It often follows a cold-like illness with a runny nose and mild fever. An ordinary cough does not usually have this barking quality or the noisy breathing in. If your child has these features for the first time, contact a GP or out-of-hours service for advice, and call 999 if they are struggling to breathe.
Why does keeping my child calm help croup?
When a child with croup cries or becomes distressed, their breathing becomes faster and more forceful through an already swollen, narrowed airway, which makes the noisy breathing (stridor) and the effort of breathing worse. Staying calm yourself, holding your child upright and comforting them helps to settle their breathing and ease the symptoms. This is why gentle reassurance is a genuine part of looking after a child with croup, alongside any steroid treatment.
When is croup an emergency?
Call 999 or go to A&E straight away if your child is making a harsh, rasping noise when calm and at rest rather than only when upset, is struggling to breathe or drawing in the skin around the ribs or tummy with each breath, is unusually quiet, drowsy or floppy, is drooling or unable to swallow, or if their lips or skin look blue or grey. These signs mean the airway is becoming dangerously narrow and need emergency care. For milder symptoms, or croup for the first time, contact a GP or out-of-hours service for assessment.
Keep reading
Related articles
Sources
Where this is drawn from
- NICE CKS: Croup.
- BNF for Children: Croup.
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