Cold and Cough Season Basics

Cold and Cough season is here and we get a lot of questions about what products to use. So I just want to take a minute to end confusion at the Pharmacy and go over what to use with what type of sickness. I put this in a bullet point format so you can easily use it as a reference. Lastly, remember to please consult your UIC Pharmacist, we’re always ready to help with any questions you may have!

First off Nonprescription (OTC) medications are available to treat cold symptoms, but there are differences between them:

Over-the-counter Medicines

• Choose your remedy by determining which symptoms you want to treat

• Stuffy nose – use a decongestant (e.g. Sudafed or Afrin)
• Runny nose/watery eyes – use an antihistamine (e.g. Claritin)
• Headache/aches and pains – use an analgesic (e.g. Tylenol)
• Dry hacking cough – use an antitussive (e.g. dextromethorphan)
• Multiple symptoms – use a combination product but be sure the product treats only the symptoms you have

• Pediatric Use: FDA has banned the use of cold and cough products in infants and children less than 2 years of age because serious side effects can occur

• FDA is currently evaluating the use of these products in children 2-11 years of age; manufacturers have voluntarily agreed to cold and cough products with the warning “do not use in children under 4”

• A recent study in the medical journal, “Chest” describes a single case report and animal studies using Vicks VapoRub. The case reports describes a grandparent using VapoRub on a child less than 2 and under the nose, neither of which is appropriate use of the medication. This highlights the importance of reading the label and following the directions on all over the counter medicines. VapoRub is safe when used as directed.

Next I’ll take each medicine described above (decongestant, antihistamine, etc….) and break them down further.

Decongestants

• Oral and topical products are available
• Topical decongestants work the fastest and include products like Afrin but you can’t use them for more than 3 days
• Oral decongestants include pseudoephedrine and phenylephrine products; pseudoephedrine products are found behind the pharmacy counter; it is worth asking for them as the duration of action is longer and the products can be more effective

Antihistamines

• There are many antihistamines available but non-sedating product are generally your best choice

• If you take a sedating antihistamine like Benadyl, be sure to carefully read labels for precautions such as ‘marked drowsiness may occur’ and ‘be careful when driving a motor vehicle’ and heed those warnings

Analgesics

• There are several choices for pain relief available. Just about everybody can use Tylenol. If you don’t have problems with ulcers or bleeding, Motrin or Aleve are other choices for pain relief.

Antitussives

• Antitussives like dextromethorphan which is in Vicks 44 or Delsym can help stop dry, hacking, nonproductive coughs

• You can also use diphenhydramine but it will cause drowsiness.

Combination Products

• Products like Dimetapp, Actifed and others contain more than one active ingredient. Be sure you are not taking anything else containing those ingredients or class of ingredients and that you have all of the symptoms listed on the label.

In order to get the most from your nonprescription cold medicines

• Read the label, be sure you are not taking multiple products (Rx or OTC) containing the same ingredient (for example, some cold products and some products for insomnia contain the exact same active ingredients (diphenhydramine and/or acetaminophen); by taking them together, you are double dosing and can have side effects)
  

• Follow the directions
  

• If you have questions, ask your pharmacist

Hope this helps you maneuver through Cold and Cough season!

Jan Engle, Pharm.D., FAPhA

Professor and Head, Department of Pharmacy Practice

Executive Associate Dean

UIC College of Pharmacy

Past President, American Pharmacists Association