Choosing the Right Cough and Cold Medicine

Every winter I see the same scene: someone staring at the cough and cold products asking, “Which one works, and is it safe for me or my kids?” Start by asking three questions: 1. What are my symptoms? A stuffy or runny nose, a or rinses are safe for all ages and can be used as often as dry or a phlegmy wet cough? Do I have fever, body aches, needed. or a sore throat? 2. Do I have medical conditions, like high blood pres-sure, heart disease, liver or kidney problems, or am I pregnant? 3. What medications am I taking? Your answers will guide which ingredients are safe for you, and which ones to avoid. The problem with all-in-one cold meds All-in-one cold products try to treat everything at once, so you may take medicine you do not need. If you only have a dry cough and a stuffy nose, you do not need a product with acetaminophen for pain and fever. Caution: acetaminophen is in many pain relievers and cold products and taking more than one can push you over the safe daily limit. Ignore the marketing on the front of the box. Read the medicinal ingredients and match them to your actual symptoms. Fever and aches For fever and aches, acetaminophen is usually the first choice. It is safe for most adults, children and during pregnancy when used at the correct dose. People with liver disease or high alcohol use should stay at the lower end of the dose range. Ibuprofen is useful when there is more inflammation, such as sinus pressure, but is not suitable for people with stomach ulcers, kidney disease or some heart conditions, and should be avoided in late pregnancy. Never give aspirin to children because of the risk of Reye syndrome. Sore throat For a mild sore throat, warm tea with honey and lemon can soothe irritation. Lozenges and throat sprays with menthol or a local anesthetic give short term relief, but for safety reasons, lozenges are only recommended for older children and adults. Cough No medicine can switch a cough off instantly, but over the counter options can make it less bothersome. For a dry, hacking cough, dextromethorphan is the most common suppressant. Some people find it helps. It should not be used in young children, and it may interact with some antidepressants, so ask your pharmacist. For a wet, phlegmy cough, the goal is to move mucus out, not shut the cough down. Drinking plenty of fluids is one of the best ways to thin mucus. Expectorants such as guaifenesin may help loosen phlegm, but the benefit is modest. Avoid a cough suppressant with a very productive cough unless your pharmacist recommends it. Children need a different approach In Canada, cough and cold medicines other than acetaminophen or ibuprofen are not recommended for children under six. They do not work well and can cause side effects. For younger children, focus on comfort: fluids, rest, saline nose drops or spray, and a cool mist humidifier. For children over one year, a small spoon of honey at bedtime can calm a cough. Never give honey to a baby under one because of the risk of botulism. When to see a doctor Most colds improve on their own. See a doctor if you or your child has difficulty breathing, chest pain, a fever lasting more than three days, severe ear or sinus pain, a very sore throat, symptoms that last longer than ten days, or suddenly get much worse. Coloured mucus alone does not mean you need anti-biotics. Many viral colds cause yellow or green mucus. Antibiotics are for true bacterial infections and using them when they are not needed increases resistance. There are no perfect cough and cold products for every-one. The safest approach is to match your symptoms to the ingredients and avoid unnecessary combinations. Ask your pharmacist if you are not sure what is right for you.