Common Children's Medicines and How GPs Prescribe Them

Why the pharmacy you choose matters more than you think

Most families pick up prescriptions wherever is closest, but the pharmacy you settle on becomes part of your child's care. A community pharmacy that keeps a consistent patient history — repeats, allergies, interactions, who else in the household is on what — saves time and prevents mistakes. In Wellington, a place like Karori pharmacy or the dispensary at Merivale Medical in Christchurch tends to know its regular families by name, which is worth more than a few dollars off.

Pharmacies attached to larger centres, such as the pharmacy at Auckland City Hospital, run on a different rhythm. They are geared to discharge prescriptions and specialist clinics rather than the slow build-up of a family's medicine history, so they are useful for a one-off supply but less ideal as your everyday dispensary. The practical rule: use the same pharmacy for repeats where you can, and bring your child's full medicine list even when you are only collecting one item.

Costs vary. Many children's prescriptions are heavily subsidised, and from the 2024 budget the $5 co-payment was removed for most funded medicines, so a standard script is often free or close to it. Unfunded items — some melatonin products among them — are where the bill appears, and it pays to ask the pharmacist for the funded alternative before you agree to the private price.

Melatonin: funded, unfunded and the two-week rule

Melatonin is one of the most asked-about children's medicines in New Zealand, usually for a child who cannot settle at night. The imported, funded brand is Circadin, a slow-release 2mg tablet that is licensed for adults and used off-label for children. For a younger child who cannot swallow a tablet, you may be offered a compounded liquid or an unfunded product, and that is where a pharmacy used to compounding — rather than a script counter — matters.

What a GP will usually try first

Most GPs will not prescribe melatonin as the first move. Sleep hygiene, a consistent bedtime, screen limits and ruling out iron deficiency or sleep apnoea come first, and with good reason: melatonin is a hormone, not a sedative, and it does not fix a chaotic routine. When it is prescribed, it is often a short trial of a few weeks with a review, not an open-ended repeat.

Parents should also know melatonin is not a free pass on safety. Drowsiness the next morning, headache and vivid dreams are the common side effects, and a child who is unwell or on other medicines — especially anything sedating — needs the pharmacist's eye before starting. Keep the container locked away; child melatonin gummies are easy to over-consume and are a familiar call to the poisons centre.

ADHD in children: the assessment pathway in New Zealand

ADHD in children is diagnosed by a paediatrician or a child and adolescent mental health team, not by a pharmacy or a quick GP visit. The GP's job is to gather the evidence: school reports, teacher questionnaires, a developmental history and a ruling-out of other causes. Waitlists are real, and in many regions the public wait for a developmental paediatric appointment runs to many months. Some families go private to shorten it, at a cost that commonly sits in the hundreds of dollars for the initial assessment.

Where medication is part of the plan, the funded options are methylphenidate (such as Rubifen or Concerta) and, for some children, lisdexamfetamine, with the exact criteria set by Pharmac and often requiring specialist sign-off. This is a controlled-drug category with tight rules on repeats and quantity. A pharmacy that handles controlled drugs regularly will flag the practical points: no early repeats, photo ID for collection, and a clear plan if the family is travelling.

One common confusion is dose timing versus half-life. A parent may ask why a short-acting stimulant wears off by mid-afternoon — that is the half-life at work, the same principle that explains why a child is groggy after a sedating antihistamine or why diazepam's long half-life makes it unsuitable for routine use in children. Understanding the concept helps you ask better questions about timing, school days and weekends.

Getting the supply right before school terms and holidays

New Zealand's summer break is long and the December pharmacy hours are shorter than parents expect. Controlled medicines cannot simply be stockpiled, so plan the last repeat of the year in early December and confirm the pharmacy's holiday closing dates. If your child is on a regular medicine and you are heading away, ask for a reasonable travel supply with documentation rather than turning up on the day.

Keep a simple written list — medicine name, dose, time, prescriber and pharmacy — in your phone and in the school bag. A mini-scenario familiar to many families: a child starts a new medicine on a Friday, has a reaction over the weekend, and the after-hours service needs the exact product and dose. The list answers that in seconds.

Finally, do not self-prescribe from the internet. Lung detox products, imported sleep aids and unverified supplements are widely sold online, and none are a substitute for a funded medicine assessed by your GP. Ask the pharmacist at your regular dispensary before you buy anything for a child, and let them do what they are trained to do: check the details others miss.