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Cold Medicines by Karen Schroeder Kassel, MS, RD, MEd En Español (Spanish Version) Colds are caused by viruses; in fact, there are over 200 different viruses that cause colds. There are no medicines to cure colds. Antibiotics are only effective against bacteria, not viruses. However, there are a variety or products that may somewhat reduce cold symptoms. Many of these can be bought without a prescription. The main types of over-the-counter (OTC) cold medicines are reviewed here: Analgesics Antitussives Expectorants Oral decongestants These medicines may help reduce your symptoms. However, see your doctor if you have any of the following: High fever (temperature above 102ºF [39ºC]) , skin rash, or continuing headache Symptoms lasting more than 10 days or getting worse instead of better Shortness of breath Feeling faint Confusion or feeling disoriented Earache or drainage from your ear Severe pain in your face or forehead Swollen glands in the neck or jaw People with moderate to severe pulmonary or cardiac disease, such as asthma, chronic bronchitis, emphysema, angina, and hypertension, should consult with their doctor early in the course of their symptoms and before taking any medicine. Children should also be seen earlier in the course of their illness, especially if they are very young. Analgesics Analgesics relieve aches and pains and reduce fever. Brand Names Generic Name Brand Names Aceta, Actamin, Aminofen, Apacet, Aspirin Free Anacin, Aspirin-Free Excedrin, Banesin, Bayer Select, Dapa, Datril, Feverall, Genapap, Genebs, Liquiprin, Neopap, Oraphen-PD, acetaminophen Panadol, Phenaphen, Redutemp, Snaplets-FR, St. Joseph Aspirin-Free Fever Reducer, Suppap, Tapanol, Tempra, Tylenol, Valorin aspirin Acuprin, Anacin, Ascriptin, Aspergum, Aspirin Regimen Bayer, Aspir-Low, Aspirtab, Bayer, Bufferin, Buffex, Buffinol, Cope, Easprin, Ecotrin, Empirin, Gensan, Halfprin, Healthprin, Magnaprin, Sloprin, St. Joseph Adult chewable Aspirin, ZORprin ibuprofen Advil, Dolgesic, Excedrin IB, Genpril, Haltran, Ibifon, Ibren, Ibu, Ibuprin, Ibuprohm, Medipren, Midol IB, Motrin, Nuprin, Pamprin-IB, Q-Profen, Rufen, Trendar Page 1 of 6 Copyright © 2011 EBSCO Publishing. All rights reserved. ketoprofen Actron, Orudis, Oruvail naproxen Aleve, Anaprox, Naprelan, Naprosyn How These Medicines Work Aspirin and non-steroidal anti-inflammatory drugs or NSAIDS (ibuprofen, ketoprofen, naproxen) inhibit the formation of certain prostaglandins. These are substances in the body that are involved in various processes including pain and body temperature. Acetaminophen probably works in a similar way, but it lacks the anti-inflammatory effects of NSAIDS. Proper Use Take analgesics with food and a glass of water to decrease the chance of stomach upset. Delayed-release and extended-release tablets have a special coating that makes them easier on the stomach. Precautions While Using This Medicine Accidental Overdosage—Many OTC medicines as well as prescription painkillers contain acetaminophen (Tylenol). Although acetaminophen is quite safe when used as directed, when taken in excess it can cause liver damage. Make sure to read the labels and do not “double up” on acetaminophen. Children and Teens— Aspirin is not recommended for children and teens with a current or recent viral infection. Check with your doctor before giving aspirin to a child or teen. Children can be given acetaminophen or ibuprofen. Pregnancy—Acetaminophen is usually considered the safest pain and fever reducer to use during pregnancy. Do not take aspirin during pregnancy unless your doctor has ordered it. Alcohol—If you will be taking more than an occasional one or two doses of acetaminophen, do not drink alcohol. Doing so may increase the chance of liver damage, especially if you drink large amounts of alcoholic beverages regularly, if you take more acetaminophen than is recommended on the package label, or if you take it regularly for a long time. Certain Conditions—If you have any of the following conditions, check with your doctor before taking an analgesic: Alcohol abuse Kidney or liver disease Peptic ulcer Phenylketonuria (PKU) Severe allergies Bleeding disorders Pregnancy Possible Side Effects Possible side effects of analgesics include: Abdominal or stomach cramps, pain, or discomfort Heartburn or indigestion Nausea or vomiting Diarrhea Dizziness, drowsiness, or lightheadedness Tinnitus (ringing in the ears) Easy bruising Rash Page 2 of 6 Copyright © 2011 EBSCO Publishing. All rights reserved. Antitussives Antitussive medicines (also called cough suppressants) are used to control coughing. However, there is limited evidence that they work. Brand Names The main nonprescription antitussive is dextromethorphan. Products made from this drug include: Benylin Cough-X Creo-Terpin Delsym Diabe-TUSS DM Hold DM Pertussin Robitussin Sucrets Cough Suppressant Trocal Vicks Cough Relief How This Medicine Works Dextromethorphan is thought to relieve cough by acting directly on the cough center in the brain to depress the cough reflex. Proper Use Antitussives should not be used for persistent or chronic cough that occurs with smoking, asthma, chronic bronchitis, or emphysema, or for cough accompanied by excessive mucus or phlegm. Follow the dosage instructions on the product label or given by your doctor closely. In some cases, dextromethorphan can be habit forming. Precautions While Using This Medicine If you have any of the following conditions, check with your doctor before taking an antitussive: Asthma Diabetes Liver disease Chronic bronchitis Emphysema Slowed breathing Phenylketonuria Pregnant Possible Side Effects Nausea or other gastrointestinal upset Slight drowsiness Dizziness Nervousness or restlessness Expectorants Page 3 of 6 Copyright © 2011 EBSCO Publishing. All rights reserved. Expectorants are used to clear phlegm from the lungs. Phlegm is an abnormal production of mucus. However, there is limited evidence that they work. Brand Names The main non-prescription expectorant is guaifenesin. Products made from this drug include: Anti-Tuss Breonesin Diabetic Tussin EX Fenesin Gee-Gee Genatuss GG-CEN Glycotuss Glytuss Guiatuss Halotussin Humibid Hytuss Naldecon Senior EX Organidin NR Pneumomist Robitussin Scot-tussin Expectorant Sinumist-SR Touro EX Uni-tussin How This Medicine Works Guaifenesin is though to increase respiratory tract fluid, which in turn should reduce the thickness of phlegm in the lungs and enable it to be cleared more easily. Proper Use Drink plenty of water while taking guaifenesin to help loosen phlegm in the lungs. Precautions While Using This Medicine If you are pregnant or breastfeeding, check with your doctor before taking an oral decongestant. Possible Side Effects Nausea and/or vomiting Diarrhea Dizziness Headaches Rash Oral Decongestants These drugs help to reduce congestion. Brand Names Page 4 of 6 Copyright © 2011 EBSCO Publishing. All rights reserved. A common decongestant that is available over the counter is pseudoephedrine. Products that contain this ingredient include: Cenafed Chlor-Trimeton Non-Drowsy Decongestant Decofed Dimetapp Drixoral Efidac/24 Genaphed Myfedrine PediaCare Infants' Oral Decongestant Drops Pseudo 60's Sudafed Triaminic How This Medicine Works Oral decongestants treat cold symptoms (but not the cold itself) by narrowing the blood vessels in the nasal passages. Proper Use Follow the dosage instructions on the product label or given by your doctor closely. Precautions While Using This Medicine If you have any of the following conditions, check with your doctor before taking an oral decongestant: Diabetes Enlarged prostate Glaucoma Heart disease or a blood vessel disease High blood pressure Overactive thyroid Pregnancy Possible Side Effects Nervousness Excitability Restlessness Racing heart Tremulousness Dizziness Weakness Trouble sleeping To avoid sleeping difficulties, take the last dose of decongestant several hours before bedtime. With every medicine, there are important precautions to consider. These include allergies, interactions with other drugs and medical conditions, and safety during pregnancy, lactation, and other stages of life. RESOURCES: American Academy of Family Physicians http://www.aafp.org/ Page 5 of 6 Copyright © 2011 EBSCO Publishing. All rights reserved. National Institute of Allergy and Infectious Diseases http://www3.niaid.nih.gov/ CANADIAN RESOURCES: Canadian Family Physician http://www.cfpc.ca/ Canadian Institute for Health Information (CIHI) http://www.cihi.ca/ REFERECES: Acetaminophen. U.S. National LIbrary of Medicine PubMed Health website. Available at: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000521/. Updated July 8, 2011. Accessed December 6, 2011. Colds and the flu. American Academy of Family Physicians. Family Doctor.org website. Available at: http://familydocto.... Updated October 15, 2011. Accessed December 6, 2011. Dextromethorphan. U.S. National LIbrary of Medicine PubMed Health website. Available at: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000695/. Updated July 8, 2011. Accessed December 6, 2011. Guaifenesin and codeine. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/.Updated Novmeber 2, 2010. Accessed December 6, 2011. Pseudoephedrine. U.S. National LIbrary of Medicine PubMed Health website. Available at: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000731/. Updated July 8, 2011. Accessed December 6, 2011. Last reviewed December 2011 by Brian Randall, MD Last Updated: 12/6/2011 Page 6 of 6 Copyright © 2011 EBSCO Publishing. All rights reserved.