How to choose the right cold medication

One of the most confusing events pertaining to healthcare occurs while trying to determine which over the counter (OTC) cold remedy to purchase at the drug store. This article will attempt to clarify this task in order to save you money, time and most importantly a potential medical complication. I will review the names of the most common medications found in these cold remedies and recommend you keep the attached chart for easy reference the next time you go to the pharmacy or supermarket to buy something for your runny nose.

There are essentially four types of medications found in hundreds of cold remedies to relieve the following symptoms: headache/body aches/sorethroat/fever; runny nose/nasal congestion; watery or itchy eyes/sneezing; and cough. The type of medication that you need depends on the symptoms you wish to alleviate. Remember that all medications, whether they are purchased OTC or by prescription, have side effects. Your goal should be to alleviate your symptoms enough to function and get the rest you need with the least amount of medication and therefore, the least amount of side effects and expense.

There are three types of OTC pain medications or analgesics which also help lower a fever: acetaminophen (Tylenol), anti-inflammatories (also called NSAIDS, for nonsteroidal anti-inflammatory drugs) ibuprofen (Motrin) and naproxen (Aleve), and aspirin (name brands including Bayer, St. Joseph?s, etc.) The location of your pain is irrelevant as analgesics work all over, whether it is a headache, back pain or sore throat. Although NSAIDS and aspirin help to decrease both inflammation and pain, acetaminophen which only decreases pain is much gentler on your stomach.

Decongestants are used to relieve a runny nose and nasal congestion. There are only two common oral medications, pseudoephedrine (Sudafed, usually found with the letter D attached to the brand name) and phenylephrine (usually found with the letter PE attached to the brand name). All decongestants can make the following conditions worse; high blood pressure (hypertension), glaucoma, an enlarged prostate, anxiety, and insomnia. If you are taking an MAO inhibitor, do not use any decongestants. The absence of decongestants in cold medicine is usually designated by the letters HBP (safe if you have high blood pressure). Nasal decongestant sprays contain oxymetazole (Afrin) or phenylephrine. Care should be used with these since they can be addictive if used for more than three consecutive days.

Antihistamines (as opposed to decongestants) treat the symptoms of allergies (watery or itchy eyes/sneezing) and can cause similar concerns as decongestants although much less likely. They are divided into the older sedating types and the newer more expensive non-sedating types. The sedating types are sold as brompheniramine, chlorpheniramine, diphenhydramine (Benadryl), doxylamine and pheniramine. The non-sedating types are loratadine (Alavert and Claritin) and cetirizine (Zyrtec).

A cough that is productive may be bothersome, but should not be suppressed unless it is causing you harm by preventing sleep or causing significant discomfort. The process of your body producing mucus and coughing is a cleansing that your immune system uses to help rid yourself of an illness. Should you require something to loosen mucus (a mucolytic or expectorant); guaifenesin (Mucinex, Robitussin) is what you want. If suppression is needed then dextromethorphan (DM) is helpful. These are often found together (Mucinex DM, Robitussin DM,).

Be careful when reading the front packaging of OTC cold medications as it can be very misleading. The only significant difference between 4, 6, 12 and 24 hour preparations of medications is the convenience of how often it needs to be taken. It is unlikely for a 24 hour medication to last much more than 18 hours. Many medications come in various forms such as capsules, caplets, gelcaps, tablets and liquid. Once again, it is a personal preference. For people sensitive to adult doses, liquids provide more flexibility in dosing smaller amounts. People with kidney and liver problems should sometimes also have their dosages adjusted. Occasionally, ibuprofen and acetaminophen can be taken together, every six hours, for high fevers or severe pain. During my survey of cold medications at Publix Greenwise, I found Theraflu Severe Cold Formula meant simply adding acetaminophen (Tylenol) and removing the dextomethorphan (DM) whereas Tylenol Sinus Severe Cold Formula added guaifenesin. None of this makes sense. I encourage you to read the actual ingredients in the preparation along with the amount that is found in each and use only the ingredients that you need. It is usually best to try to purchase the ingredients separately and use the dosing recommendations on the box as a guideline. These OTC cold medications can usually be found in generic equivalents and makes it a whole lot easier than looking for the complex formulation that has your particular symptoms that you wish to relieve. When taking antibiotics or herbal remedies as treatment, adding these OTC cold medications is usually fine.

Lastly, remember that the great majority of colds are viral and usually go away within seven to ten days. The following symptoms though would be more concerning; fever above 100.4°F (38°C), thick colored sputum that lasts more than two days or shortness of breath. If you have underlying lung problems such as asthma or COPD or a compromised immune system, you should consider seeking medical treatment sooner.

I hope this article helps to alleviate the confusion and complicated process of selecting a cold medication the next time you find yourself on the cold medicine aisle.

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