Cough and cold medications: Active ingredients, types, cautions

Cough and cold medications are commonly available over the counter, but consumers do not always know what they contain or what they can do.

It is important to be aware of what is in any over-the-counter (OTC) drug to stay safe and to get the best treatment for symptoms.

Fast facts on cough and cold medications:

Here are some key points about cough and cold medications. More detail is in the main article.

A wide array of over-the-counter medication is available for coughs and colds.

Combined treatments target more than one symptom at a time.

It is important to know which ingredients do what, to avoid making symptoms worse.

Some medications can interact or have adverse effects, so it is important to take safety precautions and read the instructions carefully.

Know your drugs

Cough and cold medicine can help relieve symptoms, but are you using the right one?
Cough and cold medicine can help relieve symptoms, but are you using the right one?

One study has suggested that fewer than 40 percent of consumers are familiar with the most common active ingredients in cough, cold, and flu remedies, and only 43 percent ask the pharmacist for help.

A cold or seasonal flu can have a wide range of symptoms, so it is important to treat the right ones. For example, a person with a runny nose and sore throat should not use medications that include an ingredient to control coughs. A cough helps remove mucus from the throat.

Consumers must make sure they choose medications that treat only the symptoms that they have and avoid taking medications they do not need. Understanding the different active ingredients and which symptoms they treat can help find the most suitable OTC treatment.

A person with a runny nose should not use a preparation that controls a cough.
Decongestants help unblock the nose and the sinuses.

Analgesics: These include acetaminophen and the non-steroidal anti-inflammatory drugs (NSAIDs) aspirin, ibuprofen, and naproxen sodium.

Decongestants: These are for nose and chest congestion. Pseudoephedrine and phenylephrine are examples.

Expectorants: These loosen or thin the mucus in the chest, making it easier to cough it up. One example is guaifenesin. Drinking extra fluids can also help.

Antihistamines: These are also used in medication for allergies, which may have similar symptoms to a cold. They include chlorpheniramine maleate, diphenhydramine, and doxylamine succinate.

Cough suppressants: These block the cough reflex, making coughing less likely. One example is dextromethorphan.

Cough suppressants should not be used if the cough is caused by smoking, emphysema, asthma, pneumonia, or chronic bronchitis, because coughing helps to clear the lungs.

Antihistamines or decongestants can also dry the throat, making the mucus thicker and harder to move, resulting in a more severe cough.

Combination medicines: These contain more than one of these ingredients, and they treat more than one symptom.

Changes to cough and cold medications

In the United States (U.S.), all OTC cold products that are not sold behind the pharmacy counter have recently been reformulated with phenylephrine. Products that are sold from behind the pharmacy counter still contain pseudoephedrine.

To buy these, the person will need to present a valid ID, and their recent purchase history will be reviewed online through MethCheck, a database. The amount of each product that a person can buy within a certain time is restricted, because of the risk of abuse of these medications.

Examples of medications sold from behind the counter are Aleve Cold and Sinus, Motrin Cold and Sinus, Sudafed, and Sudafed 12 hour.

Types of therapy

Treatments are available in a range of forms, including syrups, powders, pills, capsules, and sprays.

Consumers can often choose from brand-name medications or store-brand products. These contain the same ingredients, but store-brand products are usually cheaper.

Cough suppressants

Cough suppressants help to control a persistent cough. Expectorants make a cough more productive.

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