By Grace C
ottage Pharmacist John Kim and Charles Debo, Albany College of Pharmacy and Health Science, Pharm.D student
as appeared in the Brattleboro Reformer’s Graceful Health series, December 4, 2015
Achoo! It’s the start of the holiday season and also the season of the common cold.
Some common symptoms of this viral infection include a runny nose, nasal congestion, sneezing and coughing. According to the Centers of Disease Control and Prevention, almost all colds are self-resolving in seven to ten days. Most adults have an average of two to three colds each year.
Although we sometimes hear claims for various formulas that promise to cure the common cold, the science indicates otherwise. Some argue that colds can be cured with antibiotics. According to the Mayo Clinic, antibiotics do not have any use against the common cold. Remember that we are working against a viral infection when dealing with a cold. Antibiotics are used for disease-causing bacteria. And, in fact, an over-reliance on antibiotics can cause a decrease of an immune response from your body when a real bacterial infection presents itself. The hard “cold” fact is that there are no cures for the common cold.
Over-the-counter (OTC) medications will not make this illness go away any faster. However, there are OTC products to help ease the symptoms.
When choosing the appropriate OTC, first and foremost it is important to always read the label and take the medications as directed. Pay close attention to directions about who may take the medication and who should not take it. Many of these products are not recommended for certain ages. Others should not be taken by a woman who is pregnant or breastfeeding without first consulting with a medical provider. Still others may have ingredients that cause allergic reactions for some people, or that can aggravate certain medical conditions. It is vital to follow these directions.
Another important point is to treat just the symptoms that present themselves in order to help minimize unwanted possible side effects. For example, if you have a runny nose but no cough, there is no reason to take an OTC that includes a cough suppressant.
There are mixed products that provide relief to a variety of mixed symptoms. Mixed OTC cold-relief products often have both suppressants and expectorants contained within the medication. In addition, they often add other products to help with nasal congestion, fever reduction, and for dealing with pain associated with some colds.
Cough suppressants come in a variety of choices, with a variety of ingredients to choose from. This list could include camphor, eucalyptus oil, or menthol in addition to medications. If your cold is accompanied by coughing, it is important to determine what type of cough you have, for example constant or sporadic, or wet (with lots of phlegm) or dry. Cough suppressants help minimize the amount of times you cough. Expectorants help loosen up chest congestion.
One of the most common used medications for coughing is the drug called dextromethorphan, often referred to on labels as DM. Dextromethorphan works on the brain to help suppress coughing and is a good drug to use by itself if you have a dry cough. It should be noted that DM is not for children ages 4 and under.
The main expectorant drug is guaifenesin, to be used only if you have chest congestion. This drug thins the mucus in the lungs, causing coughs to be more productive by removing phlegm. Guaifenesin is often coupled with dextromethorphan to produce highly effective coughs, removing a lot of phlegm, while limiting the number of times you would cough. Guaifenesin is not to be used for children under age 2. And as always read the directions for proper dosing of medications.
One product added to many mixed cough suppressants is a nasal decongestant. The main two drugs used for nasal decongestion are pseudoephedrine and phenylephrine. Both medications work on the nasal passage, decreasing associated swelling due to the cold. Pseudoephedrine, a relative of adrenalin, is available as an OTC drug but has limitations. There are limits to the amount you can buy and you are required to present a valid ID card to purchase it. In addition, it can cause restlessness. Phenylephrine does not carry the same limitations at Pseudoephedrine; however, some find it not as effective. Both medications could cause problems if you have high blood pressure, so please consult your doctor before considering taking these medications. And, as always, look for appropriate dosing and pay attention to age restrictions.
Another issue that plagues some individuals along with their colds is pain and minor fever symptoms. Three OTC medicines help with these issues: acetaminophen, ibuprofen, or naproxen. All of these medications can be used alone or may be contained within mixed-symptom products. It is important to note that these three medications, especially acetaminophen, can be included in these other mixed products. Be careful to include any pain-relief medications in these mixed products, along with any stand-along pain-relief pills, when figuring out your daily intake in order to avoid any accidental overdoses. Their use should be policed vigilantly.
While there are a myriad of OTC cold-relief products out there, remember there are things you can do at home as well to help alleviate cold symptoms. Drink plenty of fluids, especially water, to help replace fluids lost due to fever or phlegm production. Get plenty of rest to help your body’s immune system do its work. Stay away from others to help stop the chance of infecting others.
If you have any questions or concerns about which OTC is best for your circumstances, or about other aspects of caring for the common cold, please seek the advice of your doctor or your local pharmacist. They will be happy to help direct you to the best possible choice available.
Registered Pharmacist John Kim graduated from the Massachusetts College of Pharmacy & Health Sciences University in 2013. He works in both the Grace Cottage Hospital in-patient pharmacy and for the Messenger Valley Pharmacy. He is the lead pharmacist for the Grace Cottage Anti-Coagulation Clinic. Charles Debo is a student at Albany College of Pharmacy and Health Science, working towards his Doctor of Pharmacy degree. He is currently working at Grace Cottage Hospital as an intern under the supervision of John Kim.
