Decoding the Cold and Flu Medicine Aisle
It's that time of year again, when colds and flu come to plague many of us. Symptoms of these viral infections, such as runny nose, cough, congestion, headache, and aches and pains are common, persistent, and annoying. In response, many of us will run to our health care provider for relief, and perhaps for a prescription of antibiotics, but find that we will likely leave the office empty handed. And for good reason! Antibiotics are rarely needed for cold and flu symptoms. What is needed is plenty of rest, drinking lots of fluids, and to help relieve symptoms, a cold or flu medication. There are a plethora of treatment options available at your local pharmacy or grocery store. But which product to choose, which are safe, which are effective, and which should be avoided?
For the relief of symptoms associated with coughs, there are lots of products available and most include an antitussive, an expectorant, or both. Guaifenesin is an oral expectorant. It loosens and thins phlegm and bronchial secretions and therefore, helps to ease expectoration. It is commonly used to treat cough due to colds and minor upper respiratory infections, and it is especially useful in the treatment of dry, non-productive cough. Guaifenesin is an ingredient contained in many combination over-the-counter (OTC) cough and cold products.
Dextromethorphan is an oral antitussive, or cough suppressant. It is found in many cough and cold preparations, and is useful in treating chronic, nonproductive cough. It can cause drowsiness, restlessness, and nausea. Diphenhydramine (Benadryl), while classified as an antihistamine, also has antitussive activity and is found in many cough and cold preparations. It may cause drowsiness, blurred vision, and dry mouth.
For the relief of symptoms of nasal congestion, decongestants are often used. A stuffy nose occurs when tissue and blood vessels in the sinuses become swollen with excess fluid. Decongestants constrict the blood vessels, which reduces blood flow and thus shrinks the swollen tissue. Pseudoephedrine (Sudafed), phenylephrine, and phenylpropanolamine are oral decongestants which are safe and effective for treating nasal congestion. They also are helpful for promoting eustachian tube drainage. The eustachian tube is a narrow passage that runs from the middle ear to the back of the nose. Blocked tubes can cause popping or clicking sounds as well as ear pain. They come in short-acting or long-acting preparations, either alone or in combination with other products.
Other treatments options include topical decongestants, as well as non-medications alternatives such as saline spray and humidifiers. If something has worked in the past, use it again. If you are unsure, ask for help in deciding which product may be the best for you.
One concern with decongestants is, can they be used by people with high blood pressure? Patients with controlled hypertension are generally not at risk for increased blood pressure when using decongestants at recommended doses. Nevertheless, if you have high blood pressure, check with your health provider or pharmacist before taking these medications.
Author: Tom Root, PharmD
Tom Root is the Director of Pharmacy at Vibra Hospital Sacramento. Prior to that he was Director of Pharmacy at Kindred Hospital Sacramento. He has worked as a staff pharmacist at Methodist Hospital, Mercy San Juan Hospital, and as Pharmacy Manager at Campus Pharmacy. He graduated from UCLA, received his Pharm.D. from UCSF, and did a Residency at the VA Reno, NV. He is an Adjunct Clinical Professor at California Northstate University College of Pharmacy.
Outside of his career, he is a musician, enjoys skiing, boating, reading, and traveling.