It is cold and flu season and you’re standing in front of a shelf full of product and wondering what will get rid of your cold. The answer truthfully is nothing. Everything that you are looking at in that section is purely symptomatic. If you have a stuffy head and nose, we can use a decongestant of some kind. If you have a cough, we can give you a cough suppressant, and of the cough is thicker and settled into the chest a bit, then we will be able to add an expectorant to help you move it along. In what you see as the night time products there are antihistamines that will help to dry the sinuses a bit, but they will also help you to sleep. For the most part these products also contain either acetaminophen (TylenolR is the most common brand name) or ibuprofen (MotrinR or AdvilR). These are there for the general pain, discomfort and fever associated with colds and flu.
So, what are these things and what do they do?
The two main decongestants we have are pseudoephedrine and phenylephrine. You will find one of these in many cold and flu or sinus preparations. Of the two, most people find that pseudoephedrine is the more effective for getting rid of the pressure and congestion of a head cold. It is also the more likely to activate the person taking it; troubles sleeping, heart rate increases, nervous energy, that sort of thing. Pseudoephedrine or phenylephrine can potentially give you issues with other medications that you may be taking for your heart, blood pressure, hyper-thyroid conditions, diabetes, depression or glaucoma.
For cough suppression we have basically two options; dextromethorphan (the DM in products) or codeine. Dextromethorphan is as effective as codeine in the doses that are available without a prescription. Suppressing completely a cough that is productive is not a great idea. However, that irritating dry hack can often be effectively treated with DM products if using an antihistamine or a decongestant were unsuccessful on their own . Adding in the expectorant thins out the fluids that are accumulating, making them easier to move, and therefore remove when you cough.
Another group of products that we have seen some success with are a number of ‘traditional’ or herbal preparations that are available, including products like Buckley’s MixtureR, and Wampole Bronchial CoughR, StodalR and others. While there is not a lot of data to support their efficacy there is enough anecdotal evidence to say that they are very effective for a lot of people.
Antihistamines are included in the cold and flu preparations and the night time cold preparations for a couple of reasons. The first is that they do help to dry up the runny nose symptom for most people. The second reason, and probably the most beneficial for the night time preparations is that they will make you drowsy, and help you to sleep, and rest. The common ones included are chlorpheniramine, diphenhydramine, brompheniramine, and doxylamine.
What do I need to worry about with cough and cold preparations?
To reiterate, these products do not get rid of colds or flus, they simply treat the symptoms and allow you to get on with your day in a more normal manner. That means that even though you may feel fine, you are still sick, and in many cases still contagious. So if your plans include people with compromised immune systems you still need to be careful, as that mild cold to you could have serious implications for another.
One of the largest concerns with cold and flu medications is the common belief that because they are available without a prescription and in some cases not in pharmacies, that they are completely safe and have no issues with other medications. That is not true. Every one of the products that are included have the potential to interact with many prescription medications. What does that really mean? It means you need to talk to the pharmacist about them. You need to let us know what you are taking and when so we can help you choose a product that works for you.
There are some herbal and natural products that have been used for immune support for a very long time; echinacea, ginseng, allicin rich garlic just to name a few.
Dealing with a cold is a fact of life for the immune system. It is what that system does, so we need to let it do it’s job. That means that first and foremost we need to give it the support it needs. Primarily that means two things: good nutrition and rest. Grandma was right about this kind of stuff, you need to eat well, and you need to sleep. Adequate fluid intake, good easy to digest foods, and sleep.