Medications for Cold and Flu

As fall turns to winter, cold and flu viruses become more common. Protect yourself by taking early precautions: get the annual flu vaccine, wash your hands frequently, and avoid close contact with sick individuals.

While these steps can reduce your risk, it's still possible to catch a cold or flu. Understanding the differences between the two can help you manage your symptoms.

Cold

• Gradual onset
• Common: stuffy nose, sore throat, sneezing
• Occasional: cough, body aches, fatigue, weakness
• Rare: fever, headache

Flu

• Sudden onset
• Common: fever, body aches, chills, fatigue, weakness, cough, headache
• Occasional: sneezing, stuffy nose, sore throat

Remember, while colds and flu share some symptoms, the flu is typically more severe.

Choosing the Right Product

When dealing with a sore throat, fever, or lack of sleep, many people turn to medications to alleviate their symptoms. However, with so many options available, choosing the right product can be challenging. Here are some key factors to consider:

• Cost Generic medications contain the same active ingredients as brand-name versions but are often more affordable.
• Choose the Right Form Medications come in various forms, such as oral tablets, nasal sprays, and eye drops. Selecting the appropriate form can help target symptoms more effectively and minimize side effects.
• Warnings and Ingredients Always carefully read instructions and warning labels to ensure safe and effective use. Additionally, understanding the active ingredients provides a clearer picture of the medication’s purpose. This is especially important when combining multiple products to avoid doubling up on the same medication.

In general, it is best to target your symptoms specifically, with the use of products containing only medications treating your specific needs. Taking such factors into consideration, how can you determine which medication is best? The best way to figure this out is to base your treatment on your individual symptoms.

For Aches and Pains

Aches and pains are among the most common and uncomfortable symptoms of the flu. Over-the-counter painkillers can provide significant relief. The two main options are acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs).

Acetaminophen (Tylenol)

Acetaminophen effectively alleviates mild to moderate aches, pains, and headaches associated with the flu. While generally safe, liver damage can occur at very high doses. The recommended adult dosage is 500-1000mg every 4-6 hours, with a maximum of 3000mg daily. For tablets containing 325mg, this translates to 650-975mg every 4-6 hours. Do not exceed 4000mg from all sources within 24 hours. Acetaminophen is also safe for children but requires precise dosing based on weight and age.

NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)

NSAIDs reduce both pain and inflammation, making them beneficial for flu-related inflammation. However, they can irritate the stomach, potentially causing ulcers or bleeding with long-term use. Additionally, NSAIDs have restrictions for certain individuals, necessitating consultation with a healthcare provider before use.

• Ibuprofen: 200-400mg every 4-6 hours (maximum 1200mg daily)
• Aspirin: 325-650mg every 4 hours or 975mg every 6 hours (maximum 4000mg daily)
• Naproxen: 220-440mg every 8-12 hours (maximum 660mg daily)

Aspirin is strictly prohibited for children and teenagers under 19 due to the risk of Reye's syndrome. While acetaminophen is generally better tolerated by children, both ibuprofen and acetaminophen are safe options when used as directed based on the child's weight and age.

For Fever

Fever is a common bodily response to colds and flu. Contrary to popular belief, it's not caused by the virus itself but rather by the brain as part of the body's defense mechanism. A normal body temperature is around 37°C (98.6°F), but this can vary slightly daily. A fever is typically diagnosed when your temperature consistently exceeds 38°C (100°F) orally. However, temperature readings can vary depending on the method used (rectal, ear, forehead).

Fever is usually harmless in healthy individuals and can often be managed at home. However, infants under 6 months old or fevers lasting over three days warrant medical attention. While mild fever often doesn't require treatment, medications can help alleviate discomfort.

Acetaminophen (Tylenol)

Acetaminophen is a common fever reducer. It's available alone or combined with other cold and flu medications. It is considered a very safe medication with fewer side effects than other pain relievers and a high toxicity threshold.

Ibuprofen (Advil)

Ibuprofen also reduces fever and offers additional anti-inflammatory benefits. However, it can upset the stomach and cause ulcers or bleeding with prolonged use.

While fever is often a natural part of the healing process, it's essential to monitor your symptoms and seek medical advice when necessary.

For Nasal Congestion

A stuffy or runny nose is a common cold symptom. Contrary to popular belief, congestion primarily stems from inflamed nasal lining, rather than excessive mucus. Swelling of the nasal blood vessels causes this inflammation. In addition to stuffiness, congestion often includes nasal discharge, which can drip down the throat, causing postnasal drip.

Typically, nasal congestion resolves on its own within about 7 days, unless it is caused by allergies or another source. However, many people seek relief from these symptoms during their illness.

Decongestants: Relief and Risks

Decongestants are the primary medication for congestion. They come in oral and nasal forms. Oral decongestants offer longer-lasting relief but have more side effects, while nasal sprays provide quick relief with minimal side effects but shorter duration.

Common over-the-counter decongestants include oxymetazoline, phenylephrine, and pseudoephedrine, found in products like:

• Oxymetazoline: Xlear, Afrin, Mucinex Sinus-Max, Vicks Sinex
• Phenylephrine: Neo-Synephrine
• Pseudoephedrine: Sudafed PE

While generally safe, decongestants should be avoided by individuals with high blood pressure and children under six.

Alternatives to Medication

For those unable to use decongestants, non-medicated options include saline sprays or rinses, increased fluid intake, and humidifiers or vaporizers.

How to use:

1. Insert the applicator into the product can.
2. Press the applicator firmly on the wart for up to 20 seconds.
3. Discard the applicator and wash hands.

For Wet Cough

A wet or productive cough, characterized by coughing up phlegm or mucus, is a common cold and flu symptom. It occurs when fluid from postnasal drip collects in the airways, and the body's natural response is to expel it. While helpful, a wet cough can be uncomfortable.

Beyond colds and flu, conditions like pneumonia (often with green or red phlegm and shortness of breath) and COPD (chronic cough) can also cause wet coughs.

Non-medicated options include ensuring that you stay hydrated, gargling with salt water, avoiding exposure to tobacco, and sucking on lozenges to help soothe the pain in your throat associated with a cough.

Expectorants: Thinning the Mucus

Expectorants are medications that thin the mucus in your airways, making it easier to cough up and remove. Adequate hydration complements expectorants by further thinning mucus. Guaifenesin is the main active ingredient in expectorants like Buckley's and Mucinex.

Cough Suppressants: Limited Use

Cough suppressants temporarily block the cough reflex, which can be helpful for sleep. However, they should be used sparingly with productive coughs to allow mucus clearance and prevent potential bacterial infections.

For Dry Cough

A cough is a protective reflex triggered by irritants in the airways. A dry cough, common with colds and flu, arises from throat and airway inflammation caused by the virus. While most dry coughs resolve within three weeks, persistent coughs warrant medical evaluation to rule out underlying conditions.

Dry coughs can be both irritating and disruptive. Several non-medicated remedies can help soothe the throat and reduce cough frequency: staying hydrated, consuming warm beverages, gargling with salt water, using a humidifier, and avoiding irritants like tobacco smoke.

Cough Suppressants: Quieting the Cough Reflex

Cough suppressants are medications that reduce the cough reflex in the brain. Dextromethorphan is the primary active ingredient found in many over-the-counter cough suppressants, such as Buckley's Dry Cough Extra Strength, Robitussen 12 Hour Cough, and Delsym.

While cough suppressants can provide temporary relief, they do not address the underlying cause of the cough. For persistent or severe coughs, consult a healthcare professional.

For Sore Throat

Sore throats have various causes, including cigarette smoke, allergies, vocal strain, and commonly, colds or flu. During illness, throat swelling often leads to a painful swallowing sensation. While most sore throats resolve within a few days, discomfort can be significant.

The primary way to soothe a sore throat is to keep it moist. This can be achieved by consistently drinking fluids and sucking on lozenges that dissolve slowly in your mouth to stimulate saliva production.

• Menthol Lozenges: Menthol has a soothing effect and helps stimulate saliva production. Common products include Halls Cough and Throat Relief and Fisherman’s Friend Lozenges
• Benzocaine Lozenges: Benzocaine is a local anesthetic that numbs painful areas of the mouth and throat. Common products include Cepacol Extra Strength Lozenges and Chloraseptic Max Sore Throat Lozenges

Hard candies and lozenges pose a choking hazard for young children. Popsicles and syrups offer similar benefits.

When to Seek Medical Attention

Severe sore throat, significant swelling, or the presence of blood or pus indicates a potential bacterial infection like strep throat. This requires prescription antibiotics. While antibiotics are ineffective against viral sore throats, they are crucial for treating bacterial infections.

Sleeplessness During Illness

Adequate rest is crucial for recovery from colds and flu. Unfortunately, common cold and flu symptoms often disrupt sleep, leading to increased discomfort and fatigue.

Enhancing Sleep Comfort

Several non-medicated strategies can improve sleep quality during illness. Using a humidifier, taking a warm shower before bed, and elevating your head while sleeping can alleviate congestion and discomfort.

Diphenhydramine (Benadryl, ZzzQuil)

When non-medicated methods prove insufficient, over-the-counter sleep aids can be considered. Diphenhydramine, an antihistamine commonly found in allergy medications, induces drowsiness and is often used to promote sleep. Products like Benadryl and ZzzQuil contain diphenhydramine. To maximize its sleep-inducing effects, take it 20-30 minutes before bedtime.

Diphenhydramine is not a long-term solution and may cause excessive drowsiness, especially in older adults.

For Multiple Symptoms

While targeting individual symptoms with specific medications is often ideal, combination products offer convenience for managing multiple symptoms at once. However, it’s essential to carefully read labels and understand the ingredients to avoid unintended side effects.

Combination products typically contain two to four active ingredients. Common combinations include:

• Pain relief: acetaminophen or ibuprofen
• Decongestant: pseudoephedrine, phenylephrine, or oxymetazoline
• Cough suppressant: dextromethorphan
• Expectorant: guaifenesin
• Sleep aid: diphenhydramine (often in nighttime formulas)

Popular combination products include:

• Tylenol Cold and Flu Severe
• Advil Multi-Symptom Cold and Flu
• Robitussin Cough and Chest Congestion
• Vicks NyQuil Cold and Flu

Always prioritize understanding the specific ingredients in any medication you take. Consult a healthcare professional if you have concerns or questions about combination products.

When to Use Antibiotics

Contrary to popular belief, most colds and flu are caused by viruses, not bacteria. Antibiotics, designed to fight bacterial infections, are ineffective against viruses. Unnecessary antibiotic use can lead to side effects like diarrhea, nausea, and rashes, and contribute to antibiotic resistance.

While most respiratory illnesses resolve on their own, certain signs may indicate a bacterial infection requiring antibiotics:

• Green phlegm: Persistent green mucus from the nose or throat.
• Sore throat with: Red, swollen tonsils; white patches on the tongue or throat.
• Severe earache
• Chest tightness or difficulty breathing)

If you experience these symptoms, consult a healthcare provider to determine if antibiotics are necessary.