Making Sense of OTC Cold and Cough Medications
Unsure about the hundreds of cold and
flu preparations on the drugstore
shelves? You're not alone. Deciding among the OTC (over-the-counter) remedies for cold,
flu, or allergy symptoms can be intimidating, and a basic
understanding of the types of drugs included in these medications can help you
make an informed choice.
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Facts about cold, flu, and allergy treatments
- The three classes of pain and fever treatments available over the counter (OTC) are aspirin, acetaminophen (Tylenol), and nonsteroidal anti-inflammatory drugs (NSAIDs).
- Antibiotics have no effect on viruses, which are the cause of colds and the flu. However, bacterial infections that can follow viral infections, for example, infections of the ears and sinuses, may be treated with antibiotics.
- Nasal decongestants (for example, pseudoephedrine, oxymetazoline, etc.) narrow the blood vessels in the nose, thereby preventing fluid from leaking and the lining from swelling. These can be used for short-term relief in older children and adults.
- Analgesic/antipyretic medications are often sold in combination with other ingredient(s) to treat cold/flu/allergy symptoms.
- Antihistamines are commonly used to block the histamine effect that causes the symptoms of an allergic reaction, including swelling, congestion, irritation, and itching. "First generation" antihistamines such as diphenhydramine (Benadryl) have been in use longer, are less expensive, and are more sedating (prone to cause drowsiness) than the newer, "second generation" antihistamines (fexofenidine [Allegra], loratidine [Claritin], etc.), which have minimal sedative effects.
- OTC antihistamines frequently are combined with a nasal decongestant and sometimes also with a cough suppressant or an analgesic. Generally, antihistamine preparations are not effective for cold symptoms.
- Codeine and hydrocodone are narcotic oral cough suppressants that require a doctor's prescription. Dextromethorphan (Tussin P) is an oral cough suppressant that is available OTC.
- Guaifenesin (Robitussin, Mucinex) is an oral expectorant that is used to increase the leaking of fluid out of the lung tissue and into the airways.
- There is no conclusive evidence that mega-doses of vitamin C prevent colds or decrease the severity and duration of cold symptoms.
- Aspirin-containing medicines should never be used for children and teenagers with influenza, chickenpox, or other viral illnesses.
Introduction to cold, flu, and allergy treatments
Every year, millions of people use over-the-counter (OTC) products to relieve nasal stuffiness and congestion, sneezing, runny noses, sore throat, and cough. The common causes of these symptoms include the viruses that cause the common cold, influenza virus, allergic rhinitis (hay fever), and sinus infections (sinusitis). Viral infections can also cause headache, body aches, fatigue, and sometimes fever. Hay fever symptoms can also include itchy eyes, nose, and throat, and watery eyes.
To benefit from OTC products for cold, flu, and allergy, it is important to understand (1) the condition causing the symptoms, (2) the predominant symptom(s) one wishes to relieve, and (3) the active ingredient(s) in the product. Some OTC products contain a single active ingredient medication to relieve one symptom. Many others contain a combination of two, three, and even four active ingredient medications to treat several symptoms at once. Selecting the right product can be difficult at times.
Here we have categorized products for cold/flu/allergy according to the predominant symptoms they relieve:
Since cold and flu sufferers usually experience several symptoms, products containing medication combinations provide convenience. Therefore, you may need to take only one product as compared with two to four products. You also may need to stock fewer items in the medicine cabinet. Nevertheless, it is preferable to take products that contain only those medications you need for relieving the symptoms that are present, and you may not need products designed to relieve multiple symptoms at once. This prevents the ingestion of unnecessary medications and reduces the chances of side effects. It is also easier to adjust the dose of a single ingredient medicine to maximize relief of a predominant symptom and minimize side effects.
Medically Reviewed by a Doctor on 2/23/2016