Medication Treatments for the Common Cold

Medications will not make a cold go away sooner; however they can provide some relief for symptoms. Talk to your doctor before giving medicine (other than something for fever) to a child under three years of age.

Warnings regarding cough and cold products

Many of the products used to treat colds have the same or similar ingredients. Overdoses and even deaths have resulted when infants and children accidentally received two products with the same or similar ingredients. For example: Product A's label states it is for colds. Product B is for fever and pain. Both of these products may contain acetaminophen and should not be given together.

Overdoses and serious side effects can result when:

• a product for an adult is given to a child (dosages are sometimes miscalculated)
• a product for a child 2-12 is given to a child under 2 years of age
• the correct dosage is not selected based on age and weight (talk to a pharmacist if your child is large or small for their age to find out the correct dosage)
• two products with the same or similar ingredients are taken at the same time or too close together (Examples of similar ingredients include: (acetaminophen and ibuprofen), (chlorpheniramine and dimenhydrinate), (pseudoephedrine and phenylephrine)

Ingredients for Cold Symptoms

• Pain relievers (analgesics)
• Antipyretics (lower fever)
• Cough suppressants (antitussives)
• Expectorants (thin mucous)
• Antihistamines (decrease mucous)
• Decongestants (-tighten blood vessels to decrease congestion)

Pain relievers and Antipyretics (acetaminophen, aspirin, ibuprofen, ketoprofen and naproxen)

The same medicines used in over the counter (OTC) products to relieve headaches and pain also lower fever. Recent studies have shown an increase in asthma in children treated with acetaminophen. It is unclear whether asthma is caused by the acetaminophen, or whether children prone to asthma get sick more often and this is why an increase in acetaminophen is seen.

• Aspirin should not be used in children 18 years of age and under because it may increase the risk of Reye's syndrome, a potentially fatal illness involving damage to the liver, brain and other organs.
• Aspirin, ibuprofen, ketoprofen and naproxen can worsen asthma and peptic ulcer symptoms.
• Experts recommend that only high fevers in children be treated.

Cough Suppressants (codeine, dextromethorphan)

Cough suppressants, commonly called antitussives, work to suppress the area in the brain that is responsible for the urge to cough. Most cough suppressants require a prescription because of their potential for abuse, addiction and other possible side effect. Cough suppressants are sometimes used for dry hacking coughs; however they should not be used when mucous (phlegm) is present. When mucous is present the cough helps to keep the airways clear.

• Cough suppressants should not be used in children under two years of age
• Cough suppressants should not be used without the advice of a physician in children 2-6 years of age. The effectiveness in children is questionable and has been inadequately studied.

Expectorants (guaifenasin)

Expectorants are sometimes used to thin the mucous associated with a cough, so it can be coughed up more easily. Their effectiveness is questionable and they sometimes cause nausea. Drinking plenty of fluids is another way to help thin the mucous.

Antihistamines (Brompheniramine, Chlorpheniramine, Dimenhydrinate, Diphenhydramine, and Doxylamine)

Antihistamines reduce the production of mucous secretions, which in turn reduces sneezing and cough caused by post-nasal-drip (mucous running from the nose down the back of the throat). First generation antihistamines (the earlier ones on the market) do this most effectively. These are also the antihistamines that cause drowsiness. The newer antihistamines that do not cause drowsiness are less likely to reduce coughs due to colds.

Side effects of first generation antihistamines

• Drowsiness (daytime problem and nighttime benefit)
• Dry mouth, nose and throat
• Constipation
• Increase urination problems in men with enlarged prostate

Precautions

• Do not give to children under 2 years old
• Do not give to children 2-6 years old except on the advice of a doctor
• Do not take if you have glaucoma
• Do not drive or operate dangerous machinery while you are experiencing drowsiness from these medications.
• Talk to your doctor if you have asthma, emphysema, chronic bronchitis, other lung diseases, diabetes, seizures or heart disease before taking these medications.
• Drowsiness caused by alcohol or other medications will be increased with these medications.

Decongestants

Decongestants (pseudoephedrine and phenylephrine-taken by mouth) and (oxymetazilone, phenylephrine and xylometazoline hydrochloride-found in nose sprays and drops)

Decongestants are used to reduce nasal congestion and relieve sinus pressure. They do this by narrowing the blood vessels in the nasal cavity.

• Decongestant nose drops or sprays should not be used in children under 6 years old.
• Decongestant nose drops or sprays should not be used for more than three days because longer use can lead to 'rebound congestion' which means the product itself can worsen the condition or cause it to recur.

Side effects of decongestants The most common side effects of decongestants include:

• Restlessness
• Fast pounding heart
• Feelings of nervousness
• Difficulty sleeping
• High blood pressure

Precautions

• Talk to your physician if you have heart disease, high blood pressure, blood vessel disease, glaucoma, and diabetes, enlarged prostate or overactive thyroid before taking decongestants since they may make the condition worse.
• Do not give to children under 2 years of age
• Do not give extended release decongestants to children 2-12 years old.
• These medications can cause a number of drug interactions. Talk to your pharmacist or health care provider if you are taking any prescription medications before taking decongestants. Examples of medications that may cause serious side effects when taken with decongestants include:
  • Beta blockers (i.e. acebutalol, atenolol, betaxolol, bisoprolol, cartelol, labetalol, metoprolol, nadolol, oxprenolol, penbutolol, pindolol, propranolol, timolol, etc)
  • Cocaine
  • Monoamine Oxidase Inhibitors (MAOIs)-isocarboxazid (ie-Marpan), phelelzine (ie-Nardil), procarbazine (ie-Matulane), selegiline (ie-Eldepryl), tranylcypromaine-(ie-Parnate)

10 Tips on the safe use of medications for a cold

• Talk to your doctor before using medications in a child 3 years old and under.
• Read all labels carefully.
• Look at each ingredient and what it is for.
• Carefully choose the dosage for the appropriate age and weight of your child.
• If your child is overweight or underweight ask a pharmacist or other health care provider to help you choose the appropriate dose
• Check the appropriate interval (i.e. time between doses-every 4 hours or every 8 hours)
• Read all warnings carefully. (They tell you what diseases the product should not be used in)
• Before giving two products, compare the ingredients and ask your pharmacist if they are safe together.
• If the patient is on any other medication (prescription or over the counter) ask your pharmacist or health care provider if it is safe to take the two medicines together.
• Do not use medications intended for adults in children, or medications intended for children 2-12 in children under 2 years of age.