Picking the Right Cold Medicine – Part 1

You or a loved one has a cold—almost inevitable in the wintertime. I’ll bet you’ve gone to the drugstore before and stared at the staggering number of medications which all claim to cure your cold. Will the “runny nose, sneezing, congested chest” version work better? Or the “cough, stuffy, runny nose” combination? Worry no more. I’m going to break all of it down and make it simple in this series of articles.

The first thing to do is to make a list of your symptoms. This will tell you what to look for. When you get to the pharmacy, forget all of the marketing copy on the front of the boxes, which can be confusing. Instead, pick the boxes which list your symptoms, then flip them over and look for the active ingredients. These are all you really care about. There are actually only a few common active ingredients that companies basically sell in various types of packaging and doses to confuse the consumer.

Pick products which contain the active ingredients that will help your symptoms. Compare similar products to see which one has larger amounts of each active ingredient per dose as it will likely be more effective. Avoid products that have extra active ingredients that you don’t need, such as caffeine, fever reducers, allergy treatments, or sleep aids. Medications are NOT necessarily harmless so you should try to take the minimum possible.

In this article, we’ll cover medications for coughs, and we’ll talk about other symptoms next time. Coughs can be either productive (“wet” or “phlegm-y”) or non-productive (“dry”). A productive cough means your body is trying to get rid of the germs and mucus in your lungs and airways. The faster you can clear it out, the faster your body recovers. If the phlegm is too thick to cough up easily, then you may need an expectorant. Expectorants help thin out the phlegm so that it is easier to cough it out. One of the most common expectorants found in over-the-counter medications is guaifenesin. Be sure to follow the directions in the box and drink plenty of water to help the expectorant do its job.

On the other hand, if you have a non-productive dry cough, then there is no need for an expectorant because there is no phlegm to get out. The most common cough suppressant currently found in over-the-counter medicines is dextromethorphan, commonly labeled “DM.”

Be careful of products that include both guaifenesin and dextromethorphan because you generally don’t want to use them together at the same time. The last thing you want for a productive cough is to take a suppressant that prevents you from clearing the phlegm out. This will give the germs more time to fester and allow the phlegm to thicken, making it even harder to cough up. All of this essentially prolongs your miserable cold.

If guaifenesin and dextromethorphan do not provide enough relief, then you may need a stronger cough medicine prescribed by your doctor. There are several prescription-only options with the opioid-type medications (e.g. codeine) being quite effective but with potentially dangerous side effects, such as slowed breathing, constipation, and urinary retention.

As usual, before starting a new medicine, be sure to check for contraindications and interactions with your current medications. If your symptoms persist or fail to improve, you should consult your physician. In the next article, I’ll cover some over-the-counter medications indicated for other cold symptoms such as runny noses, nasal congestion, and fevers.