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How To Choose Over The Counter Cold And Flu Medicine

Everyone can buy over-the-counter cold and flu medicine. You don’t need a prescription, plus they are widely available in pharmacies. Even convenience stores carry a few cough and cold drugs. 

Let’s review in this article what should be considered when buying an over-the-counter product for colds and flu. Use this information as a guideline, because it is best to consult with your doctor or a pharmacist before choosing a product. Babies, pregnant, lactating women, or those with some chronic conditions have fewer options because many of these drugs are not suitable for them. 

If you are overall healthy and don’t take prescription drugs 

If you don’t have chronic conditions like heart disease or diabetes and don’t take any prescription drugs, you can choose the OTC product based on your symptoms. 

  • Decongestants. If you have nasal or sinus congestion- a decongestant like pseudoephedrine or phenylephrine can provide relief of the symptoms. 
  • Antihistamine drugs on the other hand work best for runny nose, post nasal drip and itchy watery eyes.  Be aware that antihistamines make you drowsy and sleepy, while decongestants keep you awake and should not be used at bedtime.
  • For fever and body aches, acetaminophen and ibuprofen can help, although they carry some risks, as you  will see below. Aspirin can be used by older adults only. Children, teens and young adults (even  adults  in the early 20s) should avoid aspirin. 
  • If you experience a sore throat, it is important to drink plenty of fluids and  gargle with warm water and salt. Acetaminophen and medicated lozenges can also be useful.

Important information for individuals with heart diseases or  those who want to prevent heart diseases

Respiratory infections such as cold and flu normally put additional strain on the cardiovascular system, as inflammation and increased heart rate develop as part of the body’s response to the illness. Cold and flu medicine can further aggravate the problem.  According to the American Heart Association, both decongestants and non-steroidal anti-inflammatories (NSAIDs) can increase blood pressure.

Decongestants like pseudoephedrine or phenylephrine constrict blood vessels, which can aggravate heart diseases and increase high blood pressure. NSAIDs in particular can trigger cardiovascular events in both healthy people and those who have a history of heart diseases.  

Antihistamines can also be problematic. Along with decongestants and NSAIDs, antihistamines can interfere with blood pressure drugs, too. It is best to monitor closely the blood pressure and heart rate during an illness or when taking a new drug (including cold and flu medicine).

Important information for individuals with diabetes

It is best to choose an OTC product that contains one single active ingredient versus a combination formula. The more ingredients are in medicine, the more the risk to interact with diabetes medication. It is also best to check the blood glucose levels and the urine ketones more often when taking these drugs (or any new drug) and stay well hydrated. 

Some colds and flu drugs can affect blood sugar levels. For example, oral decongestants can increase blood sugar levels. It is still ok to take these drugs, but the doctor may need to adjust the diabetes medication. Saline nasal sprays are a safe, alternative option, as they don’t alter blood sugar levels.

Many cough syrups contain sugar to improve their taste. Of course, these sugary products can raise blood glucose levels. The benefits of using sugar-free (sucrose-based) medicine and foods in those with diabetes are controversial, as some researchers point out that artificial sweeteners may not be a good option for those with diabetes either. Simply choose a product without added sweeteners. 

For pain and fever, the safest options are acetaminophen, aspirin, and ibuprofen- for adults. Children and teenagers should not use aspirin due to the risk of Reye’s syndrome. Seek medical advice in case diabetes is complicated with kidney diseases and other chronic conditions before taking these pain/fever relievers. 

Special notes on ibuprofen and other  NSAIDs

In 2015, the FDA strengthened the warnings– particularly the risk of heart diseases, heart failure, and strokes associated with the use of ibuprofen, naproxen, and other NSAIDs. These drugs should not be used in higher doses or for a longer time than recommended by a doctor. Anyone with high blood pressure, heart disease, kidney disease, liver cirrhosis, stomach bleeding,  or a history of stroke should seek medical advice before using ibuprofen and NSAIDs. 

Keep in mind that these OTC drugs do not have antiviral effects, as they do not inactivate the viruses. Instead, they provide symptomatic relief -for cough, nasal congestion, or fever. 

Use them short-term, only as needed, and don’t use higher than recommended doses. 

Be very careful when using combination formulas along with single-ingredient drugs. There is an increased risk of overdosing, plus the risk to interfere with other prescription drugs you may take. Generally speaking, it is best to use single-ingredient products. 

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