Nonprescription Medicines and Products

Cold and Allergy Remedies

In general, whether you take medicines for your cold or not, you'll get better in about a week. Rest and liquids are the best treatment for a cold. Antibiotics will not help. But nonprescription medications help relieve some cold symptoms, such as nasal congestion and cough.

Allergy symptoms, especially runny nose, often respond to antihistamines. Antihistamines are also found in many cold medicines, often together with a decongestant. But the value of antihistamines in treating cold symptoms is under debate.

Decongestants

Decongestants make breathing easier by shrinking swollen mucous membranes in the nose, allowing air to pass through. They also help relieve runny nose and postnasal drip, which can cause a sore throat.

Decongestants can be taken orally or used as nose drops or sprays. Oral decongestants (pills) are probably more effective and provide longer relief, but they cause more side effects. Pseudoephedrine (the active ingredient in products such as Sudafed) is an oral decongestant. In some states, medicines containing pseudoephedrine (such as Sudafed) are kept behind the pharmacist's counter or require a prescription. You may need to ask the pharmacist for it or have a prescription from your doctor to buy the medicine.

Sprays and drops provide rapid but temporary relief. Nasal sprays containing phenylephrine (such as Neo-Synephrine) are effective. Sprays and drops are less likely to interact with other drugs than oral decongestants are. Saline nose drops are not decongestants but may help keep nasal tissues moist so the tissues can filter air.

Decongestant precautions

• Do not give cold medicines or oral decongestants to a child younger than 2 unless your child’s doctor has told you to. If your child’s doctor tells you to give a medicine, be sure to follow what he or she tells you to do. Nonprescription cold medicines have not been proved effective for preschool children.
• Do not use medicated nasal sprays or drops more than 3 times a day or for more than 3 days in a row. Continued use will cause a "rebound effect," in which your mucous membranes swell up more than before you used the spray.
• Drink extra fluids when taking cold medicines.
• Decongestants can cause problems for people who have certain health problems, such as heart disease, high blood pressure, glaucoma, diabetes, or an overactive thyroid. Decongestants may also interact with some drugs, such as certain antidepressants and high blood pressure medicines. Read the package carefully or ask your pharmacist or doctor to help you choose the best decongestant for you.
• If you are pregnant, check with your doctor or pharmacist before using a decongestant.

Cough preparations

Coughing is your body's way of getting foreign substances and mucus out of your respiratory tract. Coughs are often useful, and you shouldn't try to stop them. Sometimes, though, coughs are severe enough to impair breathing or prevent rest.

Water and other liquids, such as fruit juices, are probably the best cough syrups. They help soothe the throat and also moisten and thin mucus so it can be coughed up more easily.

You can make a simple and soothing cough syrup at home by mixing 1 part lemon juice with 2 parts honey. Use as often as needed. This can be given to children older than 1 year of age.

There are two kinds of cough medicines: expectorants and suppressants.

Expectorants help thin the mucus and make it easier to cough mucus up when you have a productive cough. Look for expectorants containing guaifenesin, such as Robitussin, Mucinex, and Vicks 44E.

Suppressants control or suppress the cough reflex and work best for a dry, hacking cough that keeps you awake. Look for suppressant medicines containing dextromethorphan, such as Robitussin-DM and Vicks Dry Hacking Cough. Don't suppress a productive cough too much (unless it is keeping you from getting enough rest).

Cough preparation precautions

• Cough preparations can cause problems for people with certain health problems, such as asthma, heart disease, high blood pressure, or an enlarged prostate (BPH). Cough preparations may also interact with sedatives, certain antidepressants, and other medicines. Read the package carefully or ask your pharmacist or doctor to help you choose one.
• Cough suppressants can stifle breathing. Use them with caution if you give them to someone who is very old or frail or if you have chronic respiratory problems.
• Read the label so you know what the ingredients are. Some cough preparations contain a large percentage of alcohol, and others contain codeine. There are many choices. Ask your pharmacist to advise you.
• Do not give cough and cold medicines to a child younger than 2 unless your child’s doctor has told you to. If your child’s doctor tells you to give a medicine, be sure to follow what he or she tells you to do.
• If you are pregnant, check with your doctor or pharmacist before using a cough preparation.

Antihistamines

Antihistamines dry up nasal secretions and are commonly used to treat allergy symptoms and itching.

If your runny nose is caused by allergies, an antihistamine will help. For cold symptoms, home treatment and perhaps a decongestant will probably be more helpful. It is usually best to take only single-ingredient allergy or cold preparations, instead of those containing many active ingredients.

Products such as Chlor-Trimeton (chlorpheniramine) and Benadryl (diphenhydramine) are single-ingredient antihistamine products.

Products such as Dristan, Coricidin, and Triaminic contain both a decongestant and an antihistamine.

Antihistamine precautions

• Do not give antihistamines to infants younger than 4 months of age. For children between 4 months and 1 year, ask your doctor first.
• Use of antihistamines to treat the stuffiness of a cold will often thicken the mucus, making it harder to get rid of.
• Drink extra fluids when taking antihistamines.
• Antihistamines can cause problems for some people with health problems such as asthma, glaucoma, epilepsy, or an enlarged prostate. Antihistamines may also interact with certain antidepressants, sedatives, and tranquilizers. Read the package carefully or ask your pharmacist or doctor to help you choose one that will not cause problems.
• If you are pregnant, check with your doctor or pharmacist before using an antihistamine.
• The drowsiness that antihistamines often cause usually decreases with continued use. If drowsiness continues, or if the medicine isn't helping your allergies after 1 week, call your doctor for advice.
• Antihistamines that don't cause drowsiness are available by prescription. Ask your doctor if these are appropriate for you.

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Author:	Caroline Rea, RN, BS, MS	Last Updated: May 1, 2008
Medical Review:	Patrice Burgess, MD - Family Medicine Adam Husney, MD - Family Medicine
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