Over the Counter Guide- Cold and Flu by Dr. Q

When a cold strikes, we look for remedies to help make us feel better. Most people will go to their local pharmacy to find over the counter medicines before thinking about going to a doctor, which is a good approach, because over the counter medicines do help with symptoms and most colds do go away without intervention. However, marketing efforts by the pharmaceutical companies can take advantage of patients by having them pay for products which don’t work or charge extra by combining cheap, effective medicines which work fine alone. At EuDoc, we help our patients navigate the healthcare system, including the often confusing world of medications. Here is a guide to some common over the counter cold and flu medicines. This is meant for general knowledge and should not be taken as medical advice. Find a good primary care physician who can help you better understand what you see on the shelves.

Acetaminophen

Very common cold and flu medicine ingredient. Works well as both a fever reducer and pain reliever for body aches common in viral illnesses.

More commonly known as: Tylenol

Beware: Can cause liver toxicity at very high doses. Long term use in high doses increases the chance of liver damage.

Ibuprofen

Another ingredient found in cold and flu medicine, though more known for pain relief in minor injuries. Has some fever reducing ability as well.

More commonly known as: Advil, Motrin

Beware: Can cause kidney and stomach problems in high doses. Can also worsen blood pressure in those with chronic hypertension.

Dextromethorphan

Cough suppressant. Well studied and proven to suppress cough in a variety of conditions. Not well proven to reduce cough in the common cold mostly because cold symptoms often resolve quickly by themselves.

More commonly known as: Any medication brand ending in DM

Beware: High doses can lead to abuse potential due to altered behavior and sensation. Most over the counter doses are far from overdose limits.

Guaifenesin

Expectorant- meaning, loosens mucus to make coughing it out easier. Despite FDA approval as a medicine that works, studies are mixed about this one with many claiming this medicine doesn’t actually do anything. 

More commonly known as: Robitussin, Mucinex

Beware: Generally no common side effects.

Phenylephrine

Blood vessel constrictor which has made its way into the cough and cold section as a cure for congestion. Oral phenylephrine has absolutely NO effect on congestion. Buying medicines with this is a waste of money.

More commonly known as: Anything ending in PE, also very commonly mixed in “cold and flu” versions of common medicines.

Beware: Doesn’t work. Don’t buy anything with this added.

Pseudoephedrine

Decongestant. Previously the main ingredient in Sudafed (from PSEUDOEPHEDrine). Still technically over the counter but requires a pharmacist to give it to you due to abuse potential.

More commonly known as: Sudafed, common medicines with a D at the end (ex Claritin-D)

Beware: Abuse potential. Also not good for those with diabetes, high blood pressure, heart disease, and certain types of glaucoma and prostate issues. 

Hope this short guide helps you become a more informed consumer the next time you go out to buy cold and flu medicine!