How to Choose a Cold Remedy

you arrive at the pharmacy for a remedy for your cold or flu you may be forgiven for being confused. In many stores an entire wall is given over to these products. Where do you start? What do you need? How are they different from each other?

Most cold and flu remedies actually contain variations of the same three or four ingredients. They may be packaged differently and you may take them in different ways, and they may taste differently to each other, but they are in most respects the same as each other.

The remedies will each usually contain

1. A Pain and Fever reliever. This is usually Acetaminophen (paracetamol), and less often a NSAID. Acetaminophen (Paracetamol) is the safer option for most people as it has fewer interactions and side effects at normal doses than the non-steroidal anti-inflammatory drugs. Acetaminophen is highly dangerous in overdose, causing liver damage, and every year thousands of people accidentally over dose. Always read the packaging to make sure you are not taking more than one product containing Acetaminophen.

2. A decongestant. The decongestant is often pseudoephedrine or phenylephrine. These will both dry up nasal secretions relieving a runny or stuffy nose and stopping sneezing and any cough that is due to a post nasal drip. Pseudoephedrine has been removed from many formulations due to problems with illegal drug manufacturing. Phenylephrine is equally effective for most people. The decongestant part of a cold remedy is responsible for many of its side effects; causing dizziness, blurred vision, urinary retention and insomnia in those affected.

3. An antihistamine. A sedating antihistamine is added to many remedies, particularly nighttime ones. They have some effect in drying the nose but are not as effective as the decongestants. They are added to formulations as well as or instead of decongestants to help you sleep. The formulas using antihistamines instead of decongestants are useful for patients who are sensitive to decongestants.

4. A cough suppressant. Usually dextromethorphan, although codeine is used in some countries. This works in the brain to stop the cough reflex. It has a long list of possible interactions with other medications and medical conditions, although in practice these are not often significant.

The manufacturer having selected which ingredients will be in the treatment then packs them into a capsule, syrup, or a hot drink formula (or now a "strip" formulation from Theraflu) and markets them.

Your choice comes down to what symptoms you are wanting to treat and how much you are willing to pay for a brand name. Consider if you have a particular symptom that is troubling you, such as a very runny nose, and make sure your choice has something for that. If you have any other medical conditions or take any other drugs check with the pharmacist that your choice is suitable for you. If you have a family at home it is often a good idea to buy something that is suitable for everyone, or to get separate decongestant and pain relieving formulations to allow for flexible dosing,

Consider the convenience of your choice. Can you take it once or twice a day or do you need to carry it around with you all day. Syrups will often feel better on a sore throat, but will make a mess if you spill them in your bag, and have you got a medicine measure with you?