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Common Questions About Cold and Flu Relief

Store shelves bulge with cold and flu remedies -- all of which are designed to fight symptoms or shorten your illness. But how do you decide which over-the-counter drug is right for you? Here are some questions to ask the pharmacist.


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#1 Should I take a decongestant or an antihistamine?

Whether or not you take a decongestant or antihistamine depends on your cold or flu symptoms. If you have nasal or sinus congestion, then a decongestant can be helpful. If you have drainage -- either a runny nose or postnasal drip or itchy watery eyes -- then an antihistamine may be helpful.

Keep in mind that over-the-counter antihistamines often make people drowsy and can make mucus secretions thicker, which can be a problem for people with asthma. Decongestants may make you jittery or keep you awake. Keep in mind that both these medications may interact with other drugs you may be taking for conditions such as heart disease, and they may worsen some conditions. Discuss with your doctor or pharmacist which cold medication may be best for you.

#2 Is it safe to take a decongestant if I have high blood pressure?

Decongestants can increase blood pressure and heart rate, and increase the risk of heart attacks and strokes. Pseudoephedrine is the primary oral decongestant available. In general, if your blood pressure is well controlled with medications, then a decongestant shouldn't be a problem -- as long as you monitor your blood pressure. This may not be true with certain types of blood pressure medications. Check with your doctor or pharmacist about what may be best for you.

#3 How often should I use nasal spray if I have a cold or flu?

Nasal decongestants work fast to open breathing passages in those with a cold or flu. But if you use them for more than three days in a row, you may suffer a "rebound effect" and end up much more congested than you were at the start. It is also difficult to get off the medications, so avoid them or use sparingly. Some doctors suggest using a saline spray instead of a medicated spray. Saline spray works more slowly, but has no rebound effect.


#4 Should I take cough medicine?

An occasional cough may clear the lung of pollutants and excess phlegm. A persistent cough should be diagnosed and treated specifically. On the shelf, you'll find numerous cough medicines with various combinations of decongestants, antihistamines, analgesics/antipyretics, cough suppressants, and expectorants. Ask your pharmacist which combination, if any, would be right for you.

#5 What should I take for fever and aches?

Fever helps your body fight off infection by suppressing the growth of bacteria and viruses and activating the immune system. However, doctors no longer recommend suppressing fever for most people, except perhaps for the very young, the very old, and those with certain medical conditions such as heart disease or lung disease. If you are uncomfortable, it's fine to take medications. Young people (including those in their early 20s) should avoid aspirin. Acetaminophen (Tylenol and others) or other medicines like ibuprofen (Advil and others) are your best choices. Each has their own risks, so check with your doctor or pharmacist as to which may be best for you. Be careful not to overdose; these drugs are often mixed in with other cough and cold and flu remedies you may be taking. Your pharmacist can help you make the right choice and avoid any overlap.

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