Your OTC cold & flu meds may not be working

SIOUX FALLS, S.D. (KELO) — Cold and flu season is nearly upon us. Many around us have already falling victim to a variety of seasonal symptoms, and chances are you’ve stood in a pharmacy aisle, staring at a line of cough, cold and flu relief medications, asking yourself “which one should I get?”

Depending on the time of day, the answer to that question could be just down the aisle, at the pharmacy counter.

“Just go talk to one of the pharmacy staff members,” says Jeff Barnable, pharmacy resident with SDSU and Lewis Drug.

There are a lot of products out there, and it can be confusing to try and sort your way through them. “A lot of those products have multiple drugs in them,” said Courtney Feist, clinical pharmacist with Lewis Drug. “It’s important for patients to really read the labels so they know what they’re taking.”

This idea was supported by Sanford Children’s vice president medical officer, Joe Segeleon, who also pointed out how these labels can help you avoid adverse interactions with any other medications you may be on. “Usually it’s the package insert that’s going to tell you what medications not to take with it,” he said. “If there’s a concern, you can always call your medical provider.”

If you’re experiencing multiple symptoms, you may be tempted to grab a multi-symptom cold and flu-type medication, but this may not always be the best move.

Barnable brought up the example of Robitussin, which has the active ingredients Dextromethorphan and Guaifenesin.

“Realistically, there’s not a lot of great data on how well either one of them really works,” Barnable said. “Guaifenesin — the idea behind that one is it kinda thins out the mucus, allows you to cough things up a little bit better. However, you put that in combination with Dextromethorphan — which is supposed to stop you from coughing — the medicine’s kind of competing with itself.”

If you’re trying to cough up some of that mucus, says Barnable, try simply drinking plenty of water.

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Robitussin isn’t the only product with potential issues, however. If you’ve been taking a do-it-all type cold and flu symptom relief medication, you may want to reconsider your options, according to Feist.

“A lot of those combo — like, Tylenol Cold and Flu products — have a drug called phenylephrine in them,” Feist explained. “It’s a decongestant that we’ve know for years really isn’t that effective — it was put on the market before we really started regulating drugs over-the-counter for efficacy (how well they work).”

Feist went on to explain that the FDA recently looked at the drug, phenylephrine, and determined that it really isn’t very effective in an oral form. “It’s probably going to be years before anything is done to remove it from the shelves,” she added.

“At this point in time, I would probably stay away from [phenylephrine],” Segeleon agreed.

Phenylephrine is found in a wide variety of products.

Rather than relying on a multi-symptom medication that may contain a drug that will not work for you, Feist says that pharmacists often like to pick individual ingredients to treat specific symptoms.

Barnable, agreeing with Feist, noted that this presented a perfect opportunity to consult with a pharmacist. “You can list out your symptoms,” he said. “Even brand names like Robitussin for instance; if you go look, there’s five or six different types of Robitussin, and they all have different medications in them.”

Sometimes one drug may be all it takes, said Barnable. “[If] I’ve got a runny nose, I’ve got a sore throat and a cough — a lot of times you can fix all three of them with just like a simple nasal spray, because part of that sore throat and cough are potentially just caused by drainage from the runny nose.”

Looking at over-the-counter (OTC) medications, Segeleon also recommended looking at them from a perspective of age.

“Because there are so many adults that are also on other medications, [you should] be a little bit cautious with the combination of products just to make sure that if you do choose [a combination product] that you make sure they’re compatible with any medications you may have,” Segeleon said.

When it comes to children, things are a bit more complicated, said Segeleon. “For fever management, we all know about acetaminophen or Tylenol products and Ibuprofen,” he said. “Both of those are acceptable.”

Segeleon says he would stay away from any Aspirin containing products for fever management for children, however.

As for OTC cold and cough medications for children, Segeleon says he follows the advice of the American Academy of Pediatrics.

“What that means in a general form is that over-the-counter medications in children less than six are not really deemed effective, and the side-effects might not be worth it,” Segeleon said. “In those pre-school children — it’s really not recommended you use over-the-counter medication.”

Feist also commented on this.

“Most cough and cold products really are limited in [ages] six and under,” Feist said. “There’s some natural products like Zarbee’s that have various homeopathic or more natural products and probably don’t have a ton of data supporting their use of safety.”

For toddlers and younger, Segeleon highlighted products like nasal suction bulbs to help keep passages clear. Hydration and rest is also key.

For some small children, you can use small amounts of honey to soothe a cough, but Feist warns this is only for children older than one year of age.

While Segeleon says that in most cases, children 12 and older can be treated as adults when it comes to medicine, the age range of around 6-12 presents a bit of a grey area, particularly when it comes to decongestants.

“Most decongestants you could use in that [6-12] age group; just read the package insert,” Segeleon said.

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By and large, the advice of our experts is to speak with a medical professional. However, they did provide us with their advice when it comes to what types of products you’ll want to have on hand going into cold and flu season.

“I think for sure a saline nasal spray and a humidifier — an antihistamine or allergy medicine like Claritin or Zyrtec,” rattled off Feist. “Potentially some kind of decongestant — then I typically have cough drops.”

“Tylenol and Ibuprofen are always good to have,” Barnable added.

“I think a lot of it depends on the age of the person you’re talking about,” said Segeleon. “I think having acetaminophen in your medicine cabinet’s a pretty good idea — I think if you have a small child it’s good to have a rehydration solution like a Pedialyte for example.”

As for what you should have for cold and flu symptom relief as a whole, Segeleon says it’s really a matter of what you prefer. “It’s really a matter of what cold preparation has worked for you before.”

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