With the cold and flu season approaching, I want to repeat an article I did several years ago about what over the counter medications are available to help alleviate the miserable symptoms of the winter illnesses. Almost all of the hundreds of products available over the counter contain at least one or a combination of the following ingredients:
- Tylenol (acetaminophen) or Advil (ibuprofen) for aches and pains
- Sudafed with either pseudoephedrine or phenylephrine, a decongestant
- Guaifenesin an expectorant (thins mucus)
- 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 on potential interactions with drugs you may already be taking and to know the possible side effects or warnings.
Here’s how these drugs work. Tylenol or Advil work equally well for relieving the aches and pains of an illness as well as helping to reduce a fever. Read the directions carefully. The maximum daily dose for acetaminophen is 3000mg. per 24 hours.
Sudafed, for those who do not have high blood pressure, may be helpful to relieve the swelling of the nasal/sinus passages and to relieve the pressure in the ears due to blocked eustachian tubes. Sudafed with the main ingredient pseudoephdrine, has changed 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. Sudafed with ingredient phenylephrine can still be purchased over the counter but may be a bit less effective than the pseudoephridine.
Guaifenesin is an expectorant which means it helps to thin out mucous in the nose and sinuses, as well as in the lungs, which makes it easier to either blow out or cough up the mucous. Dextromethorphan is a cough suppressant which should help at least a little to lessen one’s cough. Honey has also been found to be effective in slowing down a cough. Neither of these remedies is strong enough to actually stop a cough and will not interfere with the healing process.
Antihistamines are really most useful for the symptoms of allergies like hay fever, but they may help colds by slowing down mucous production. Perhaps they help most by their side effect of drowsiness, thereby helping one to sleep.
Another highly effective way to decongest the nose and sinuses is to perform sinus rinsing using either a netti pot or my preferred method, a Neil Med sinus rinsing kit found at most pharmacies. I have found rinsing to be highly effective to alleviate sinus symptoms and to even treat or prevent sinus infections.
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 mucous use guaifenesin such as Mucinex or Robitussin.
- To help slow down a cough, use a medication with dextromethorphan, such as Robitussin DM or Vicks 44, or try a couple tablespoons of honey in a hot beverage.
- Get plenty of rest and drink lots of liquids.
Closely follow the directions for proper dosage found on the medication labels.
These are some basic guidelines for choosing medications for the symptomatic relief of common cold and simple flu. I have to admit the effectiveness of these drugs is somewhat limited but worth trying. Adequate rest, liquids, and time still play a major role in recovery from these miserable conditions.
See your health care provider if you have a fever for more than 4-5 days, if you have a fever of more than 103 degrees, or if you have any significant concerns about your illness.
Terry Hollenbeck, M.D., is a retired urgent-care physician at Palo Alto Medical Foundation Santa Cruz in ScottsValley. Readers can view his previous columns on his website, valleydoctor.wordpress.com, or e-mail him at
va**********@sb*******.net
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