Baby It’s Cold Outside (Or is it all in your head?)

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Baby It’s Cold Outside (Or is it all in your head?)

It’s that time of year again, when everyone enjoys family gatherings and holiday parties. A time for sharing and enjoying all ways to spread the holiday cheer…AND the germs that go along with that. By now I’m sure you’ve heard that you should get your flu shot to ward off these germs (and hopefully you have!) but what happens when you come down with a regular cold or some other virus? You’ll likely take some OTC products to treat the coughing, stuffy or runny nose, itchy eyes, headache, and all the rest. So, it’s time to head to the pharmacy and stock up on some medicine.

Once you are standing in the cough and cold aisle of the pharmacy, however, it can be quite overwhelming. There is shelf upon shelf of different colored boxes and bottles of liquid. Most have big bold print on the front stating what sort of illness each will treat. Phrases such as “cough and cold,” “cold and flu,” “cold and sinus” are just some examples of what can be found on these packages. But you have to look much closer to be able to find the actual active ingredients to treat the symptoms you are experiencing at the time.

However, most people just one or two symptoms (like cough and sore throat) but grab a box of medication labelled “cough and cold.” What they don’t realize is that those tablets often contain a nasal decongestant as well, which may be totally unnecessary. These “extra” medications may interfere with vitamins, foods, other OTC products, or worse, prescription medications. The last thing you need when you are already sick is to disrupt your prescribed medication therapy! It is important to take the time to read the list of active ingredients on the back to see what you are really getting in each cold product. (see below for some vocabulary)

Once you start to look at the specific ingredients in these products, you will realize there is quite a number of similar, if not identical, products out there. What’s the difference? Usually the price. Here is one example: Aleve-D Sinus & Cold and Aleve-D Sinus & Headache

Both are available behind the counter without a prescription, but what is the difference between the two?

The color of the box. That’s it. Otherwise they are identical. They both have 220mg of naproxen (a pain reliever) and 120mg of pseudoephedrine (a decongestant). One is usually a few dollars more than the other too, so without taking the time to read the ingredients you may end up paying more for something when you don’t have to. Another thing to keep in mind when looking at these combination products is what you already have in the medicine cabinet at home. In the example above, if you had a bottle of naproxen at home, it would be more cost effective to buy only the pseudoephedrine as a single product.

So, next time you or a loved one comes down with cold symptoms around the holidays, remember that not only can you save a few hard earned dollars by reading drug labels, but you can also prevent an already sick individual from taking unneeded medication.

Enjoy your family time and Happy Holidays!

Author: Lauren Kohley, Class of 2014 Pharm D. Candidate
Student of Dr. Rebecca Miller Wise,
L|E|C|O|M School of Pharmacy

Additional thoughts:

When you don’t know what an ingredient is or even what it does, you can ask the pharmacist. Also, next to the drug or active ingredient, its purpose will be listed, such as “pain reliever” or “decongestant.” But sometimes, even those words are difficult to understand, so here is a quick vocabulary lesson:

Decongestant = for stuffy noses or full sinuses – NOT for runny noses or chest congestion.
o Pseudoephedrine, phenylephrine, oxymetazoline, naphazoline

Antihistamine = for runny noses or teary eyes.
o Diphenhydramine, brompheniramine, pheniramine, chlorpheniramine, desloratadine, loratadine, cetirizine , fexofenadine

Expectorant = to loosen chest congestion, making it easier to cough out the mucus.
o Guaifenesin (only available product in the US)

Suppressant* = to reduce coughing.
o Dextromethorphan, menthol, camphor, eucalyptus oil

Antipyretic = for fever
o Acetaminophen, ibuprofen, naproxen, aspirin

Analgesic = for aches and pains
o Acetaminophen, ibuprofen, naproxen, aspirin

*Note of caution: using a suppressant will keep any mucus present in the chest, rather than allowing your body to expectorate it out. That means you are also keeping germs so your symptoms will not resolve as quickly. Most colds will naturally resolve in 7-14 days, but overuse of suppressants can make them last up to a month!

My recommendation is to only use suppressants when you absolutely have to – like to get some sleep at night. So it is imperative that you read all the active ingredients in a product before you use it). Otherwise, if you have chest congestion, use expectorants so loosen the mucus and allow your body to expel it.

Also, try to never swallow mucus (from sinuses or coughing) for the same reason – it needs to leave your body, so expel it into a tissue, flush the tissue, and then wash and sanitize your hands. If you must throw used tissues into a trash can, try to cover them with paper or otherwise block them from spreading the germs to others. One great method is to use a plastic grocery bag that you can twist closed each time you deposit a used tissue.

Be Well, Be Wise,


Dr. Rebecca Wise

Wise Words…. is a general medical information column from Dr Rebecca Wise. Dr. Wise has a master’s degree in education as well as her doctorate in pharmacy. She is an assistant professor and ambulatory care specialist at a Medication Therapy Management (MTM) clinic in Erie, PA.

Soon to be released is Dr Becky’s new website which will address women’s issues, watch for it:

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