Your Health: Picking a cold medication is simpler than it seems

Recently, I walked into one of our local pharmacies, and I was amazed to see the tremendous number of cold and flu medications filling the shelves.
The experience made me realize how confusing it must be for anyone to decide which of these medications to use. In this column, I would like to help simplify the selection process.
Almost all of these hundreds of products contain at least one of, or a combination of, the following ingredients:
• Tylenol (acetaminophen) or Advil (ibuprofen), for aches and pains
• Sudafed (pseudoephedrine), a decongestant
• Guaifenesin, an expectorant
• Dextromethorphan, a cough suppressant
• Antihistamines such as diphenhydramine or chlorpheniramine
We could probably get by with only five different bottles of cold medications on those pharmacy shelves, each containing one of the above medications. I think that taking these drugs individually rather than in combination is better so that one can tailor one’s symptoms to a specific medication and avoid taking something that might not be necessary. Always read the label on the medication package to check potential interactions with drugs you may already take and to learn the possible side-effects or warnings.
Here’s how these drugs work:
Tylenol and Advil work equally well to relieve the aches and pains of illness, as well as to help reduce a fever.
Sudafed, for those without high blood pressure, is fairly effective as a decongestant to help relieve the swelling of the nasal and sinus passages and to relieve pressure in the ears due to blocked Eustachian tubes. Sudafed has moved from over-the-counter to behind-the-counter, and it will need to be signed out for purchase through the pharmacist. It’s probably worth the effort.
Another highly effective way to decongest the nose and sinuses is to perform sinus rinsing using either a netti pot or a Neil Med container, found at most pharmacies.
Guaifenesin is an expectorant, which means it helps thin out mucus in the nose and sinuses, as well as in the lungs, which makes it easier to either blow out or cough up the mucus.
Dextromethorphan is a cough suppressant, which should help slow down one’s cough at least a little. It is not strong enough to stop a cough, and it will not interfere with the healing process.
Antihistamines are really most useful for allergies like hay fever, but they may help colds by slowing down mucus production. Perhaps they help most by their side-effect of drowsiness, thereby helping one sleep.
In summary:
•For aches and pains from a cold or flu, use Tylenol or Advil.
• For stuffy nose, sinus congestion or plugged ears, use Sudafed.
• To loosen mucus, use something with guaifenesin, such as Mucinex or Robitussin.
• To help suppress a cough, use a medication with dextromethorphan, such as Robitussin DM or Vicks 44.
• Get plenty of rest and drink lots of liquids.
• Closely follow the directions for proper dosage found on all medication labels.
These are some basic guidelines for choosing medications for relieving the symptoms of the common cold and simple flu. See your health care provider if you have a fever that lasts more than four or five days, if you have a fever that reaches more than 103 degrees, or if you have any significant concerns about your illness.
• Terry Hollenbeck, M.D., is an urgent-care physician at the Palo Alto Medical Foundation Santa Cruz in Scotts Valley. A doctor with 36 years’ experience, he invites you to view all of his previous articles at his Web site, valleydoctor.wordpress.com. Information in this column is not intended to replace advice from your own health care professional. For any medical concern, consult your own doctor.