How to Choose Over-the-Counter Medications for Cold and Flu Symptoms

You’re sick. And your body is slammed with aches, fever, chills, sneezing, coughing. Feeling normal might take a while, but an over-the-counter medication can help relieve symptoms.

But what should you take? With rows and rows of similar-looking boxes and bottles on the shelves, it’s easy to feel overwhelmed. These OTC medications’ main purpose is to alleviate your symptoms as your body fights off the illness.

Jessie Graney, PharmD, pharmacy supervisor at Avera Pharmacy – Louise Avenue offers tips on choosing which OTC item might work best for you. This advice is intended for adults, so talk to your family medicine provider or pharmacist to learn about over-the-counter options for children.

Types of Over-the-Counter Medications

When you’re looking at the countless options in the store, slow down, take a deep breath — you can make an informed choice.

Here’s a quick glance of the types of medication you’ll find on the shelf:

• Analgesic – relieves pain or fever
• Antihistamine – relieves runny nose and sneezing
• Decongestant – relieves nasal stuffiness and sinus pressure
• Antitussive/expectorant – relieves coughing

“Read the label like you would a food label,” said Graney. “The label will include active ingredients, and these ingredients can be matched to what is effective in treating specific symptoms.”

Is it Possible to Overdose?

It’s OK to take multiple single-ingredient medications when you’re sick. However, Graney highly recommends identifying the most aggravating symptom and then choosing one OTC option with that one ingredient for relief.

“Less is more,” said Graney. “You don’t want to overdo it on medications when you’re ill. More ingredients increase the risk of overdosing, duplicating or having an interaction with a prescription you take to manage a chronic condition. Also, symptoms can be interconnected. For instance, if you treat your nasal drainage, your sore throat feels better and you stop coughing, so you don’t need additional medications for relief.”

Multi-Symptom OTC Medications

From the shelves, Graney endorses caution when choosing multi-symptom OTC options. These medications have multiple ingredients, aiming to alleviate multiple symptoms. This would be great — but what if you don’t have one of the symptoms?

“If you don’t have a symptom that’s listed on the box, choose a different product,” said Graney. “It might be less convenient, but it is better than taking a multi-symptom product that gives you medicine you don’t need.”

Things to Consider When Taking Over-the-Counter Medications

Analgesic

• Do not exceed the recommended dose. Be especially cautious of double-dosing as multi-symptom medications often contain analgesics.
• If you have liver and kidney issues, reduce dose and consult your primary care provider.
• Consider taking with food to avoid stomach irritation.

Antihistamine

• Sedating antihistamines are stronger and work faster than non-sedating for cold and flu symptoms, but can cause drowsiness. In addition to those listed in the chart, doxylamine is a sedating antihistamine found in multi-symptom cold medicines (e.g. Nyquil).
• Non-sedating are often more effective for daily, long-term use for allergy symptoms. These ingredients include cetirizine, loratadine, fexofenadine, levocetirizine and desloratadine.

Decongestant

• Do not use a decongestant nasal spray option for more than three consecutive days; after this your nasal blood vessels become dependent upon it to contract, making the congestion worse.
• Decongestants are a stimulant, so you may have trouble sleeping.
• Oral decongestants can increase heart rate and blood pressure, and affect those with prostate issues, glaucoma and thyroid issues.
• Pseudoephedrine (Sudafed) moved to sales “behind the counter” of pharmacies in 2006 in an effort to curb methamphetamine production. Purchasers can buy a limited quantity per transaction by showing their ID at the pharmacy.
• Phenylephrine, the ingredient in oral decongestant drug SudafedPE, recently was deemed ineffective by the Food and Drug Administration Advisory Panel. Products with phenylephrine will continue to be sold until the FDA makes a final decision on the drug. The ruling did not include nasal spray formulations of phenylephrine.

Antitussive/Expectorant

• Antitussives help with that tickly, dry cough that seems to never go away.
• Expectorants help break up phlegm when you experience “wet coughing.” However, drinking plenty of water can be just as effective.
• Products are sleep neutral, so you can use them day or night.

Natural Ways to Ease Cold and Flu Symptoms

The average cold or flu doesn’t require prescription drug treatment; symptoms will subside and you’ll feel better. However, taking OTC medicine — either in pill or liquid form — can be a safe way to feel like we’re doing something to help ourselves heal.

Use these tips to feel better (even if you do use OTC options):

• Rest (call in to work/school to prevent spread of germs)
• Drink water
• Use a humidifier
• Suck on lozenges
• Carefully use a saline nasal rinse (Neti-Pot)

And even before getting sick, it’s always important to practice good hand hygiene as well as get your annual flu shot.

Have Questions?

If you have questions about what you should take, talk to your primary care provider or call an Avera retail pharmacist.