Picking the Right Cold Medicine – Part 2

In my last article, I covered how to pick cold medicines for coughs. Now, we’ll go over medications for other common cold symptoms.

Stuffy noses and sinus congestion is caused by swelling in the mucous membranes lining the nasal cavities. Besides making it harder to breathe, it can prevent drainage of excess mucous, leading to build up and painful pressure. Given enough time, germs living in this retained mucous can fester and cause sinus and ear infections.

If your symptoms are unbearable, you can consider trying a nasal decongestant. Pseudoephedrine and phenylephrine are commonly found in oral cold medicines. Both have vasoconstricting properties that shrink blood vessels and may help reduce swelling in the mucous membranes. However, they can also raise blood pressure so if you have blood pressure issues, be sure to check with your doctor first.

Research studies suggest pseudoephedrine is the more effective of the two but due to concerns of people converting it into illegal drugs, you’ll have to ask the pharmacist for it. Phenylephrine has not been shown to be more effective than placebo but if it works for you, that’s all that really matters.

You can also find nasal decongestants as topical sprays that you squirt into your nose. Oxymetazoline is a common active ingredient in these sprays. Effectiveness varies from person to person so you’ll have to try it to see if it works for you. Follow the directions and do not exceed the recommended dosage. Otherwise, you’ll have a higher chance of rebound nasal congestion when you stop using it, even after your cold is gone.

If you have a runny nose or sneeze frequently, you can try medications that contain an antihistamine. Although histamines are responsible for these symptoms when you have allergies, they have not been shown to be involved during a cold. Despite this, the older generation antihistamines used in allergy medications may help reduce symptoms in some people. If your runny nose becomes intolerable, you can consider trying an antihistamine, such as chlorpheniramine which is commonly found in OTC cold medicines.

Please keep in mind that antihistamines may make you drowsy so be careful when using them and heed the safety warnings. On the other hand, when your cold prevents you from getting enough rest at night, this side effect may be helpful. You’ll often find diphenhydramine, also known by the brand name Benadryl®, in medications marketed as night-time cold medications.

Fevers are common with bad colds and especially the flu. Since it is one of your body’s methods of fighting the germs causing your illness, you generally don’t need to treat a fever. But if the fever and accompanying chills are making you miserable, you can consider taking an antipyretic (fever reducer) such as ibuprofen or acetaminophen, the active ingredient in Tylenol®. Never give aspirin to children with fevers or suspected viral illnesses as it can potentially cause a serious and even fatal reaction known as Reye’s Syndrome.

Finally, you may have aches and pains, called myalgias, with your cold. They are generally short-lived but if they become too bothersome, you can consider taking an analgesic such as ibuprofen or acetaminophen. When taking these pain killers, make sure you follow the directions. Do not exceed the maximum daily dosage among all of medications you are taking since that can lead to serious organ damage. Also, do not drink alcohol when you are going to, or have taken, acetaminophen. This can lead to serious and even fatal liver damage.

Remember, always consult your healthcare professional if you are unsure whether a certain medication is appropriate for you.

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.