How to Understand Countless Confusing Cold Medicines
There are two ways to choose your favorite cold medicine when you go to the store. One is to remember the brand name you used last year; the other is to scan the fine print to find the right mix of active ingredients . The second approach may seem like a hassle, but it is much more effective.
When your head seems to be stuffed with cotton, remembering that you swear by Robitussin isn’t enough to tell you which Robitussin is – it’s like going to a shoe store and asking for a pair of Nikes, any Nike. Some medicines that look the same have very different ingredients, and some that look like completely different products are identical on the inside. And I don’t mean just generics versus brand names. Look at it:
These two products look like completely different medicines for different diseases, but they have the same dosage of the same ingredients . You might be tempted to just pick one and remember the name, but with Mucinex it’s not that easy: there are several Fast-Max products and several Sinus-Max products , each with a different composition, and I found that the Active Ingredients listed on their web -site are sometimes different from what is stated in the products in the store.
Here’s another riddle. Can you guess the difference between a multisymptomatic cold with maximum strength of Robitussin and a severe multisymptomatic Robitussin cough, cold and flu ? The latter contains acetaminophen, which means it is equivalent to taking another drug plus Tylenol. Otherwise, they are identical. (Even though one is labeled “maximum strength” and the other is not, their dosages are the same.)
Brands complicate this task by posting symptom tests and comparison tools on their websites to guide you through the product maze, but there is a better solution.
Instead of memorizing food names, think of each syrup or tablet as a set of tools : does it contain the tools you need to get it going? This approach also avoids ingredients you don’t want, as some have side effects or risks that you can avoid.
There are only a handful of ingredients in the many boxes and bottles in the aisle of cold medicines. Knowing these ingredients makes you a smart shopper, your very own OTC symptom relief alchemist. Today we’ll look at some of the more common ingredients in cold medicines, but you can use the same toolbox approach when shopping for other medicines.
Cough medicine
Drug: Dextromethorphan Usually referred to as: A cough suppressant. Purpose : Interferes with the transmission of brain signals that cause coughing, although it may not be very effective . Important to know: The effects of dextromethorphan on the brain make it a dissociative hallucinogen. (Yes, some people recreationally overdose on cold medications . Don’t try to do this at home.) Doses of cold medications are low enough that you don’t start seeing pink elephants, but they can make you feel strange or nervous. If you are concerned about this, try a product without this ingredient.
Drug: Guaifenesin Usually referred to as: Expectorant . Purpose : Causes increased wateriness of mucus in the lungs. This means you have more mucus, but it will be easier to cough up (“cough up”). Important to know: Like dextromethorphan, guaifenesin may not work very well ; results are mixed, so give it a try and see.
Decongestants
Drug: Pseudoephedrine Usually referred to as: Decongestant for the nose. Purpose : Constricts the blood vessels in the nose , so less mucus is produced. Important to know: Although this drug is sold without a prescription and does not require a prescription in most states, federal law requires it to be stored behind the counter (or in a locked cabinet). This is because it can be used to make methamphetamine, so some additional rules apply to it. You will need to show a photo ID and you cannot purchase more than 9 grams per month. This also means that if you know you need a medicine containing pseudoephedrine, go shopping when the pharmacy is open. Side effects can include feeling nervous and trouble sleeping.
Drug:Phenylephrine Usuallyreferred to as: Nasal decongestant. Purpose :Constricts the blood vessels in the nose (same idea as pseudoephedrine). Important to know: drugs that used to contain pseudoephedrine have mostly been redesigned: versions available on store shelves now contain phenylephrine. instead, which works in a similar way and has similar side effects. However, it isless effective than pseudoephedrine , so consider switching to an over-the-counter drug if it doesn’t work for you.
Sleepy Creators
Drug: Diphenhydramine Usually referred to as: Antihistamine. Purpose : Interacts with histamine receptors to induce drowsiness and reduce allergy symptoms (this is difficult). Important to know: This medicine has two very different purposes. In Benadryl, it is an antihistamine that fights allergy symptoms; in ZzzQuil it is a sleeping pill. Same drug, different branding. It is found in nighttime cold medications to “help you sleep,” although it can be powerful and sometimes longer than you expect, so use it with caution if you know you will have to get up early.
Drug: Doxylamine Usually referred to as: Antihistamine. Purpose : Same as diphenhydramine, induces drowsiness and reduces allergy symptoms. Important to know: very similar to diphenhydramine, although some people find that one works better for them than the other.
Pain relievers
Drug: Acetaminophen Usually referred to as: Pain reliever. Purpose : Reduces pain and lowers temperature. Important to know: Acetaminophen can cause liver damage in overdose. get too much. Labels should now warn about this, including a warning not to take acetaminophen if you drink alcohol.
Drug: Naproxen Usually referred to as: Pain reliever. Purpose : Reduces pain, inflammation and fever. Important to know: Naproxen does not have the same toxicity as acetaminophen, but is used for similar purposes. It lasts longer in the body than ibuprofen, which is why you’ll find it in long-acting medications.
Drug: Ibuprofen Usually referred to as: Pain reliever. Purpose : Reduces pain, inflammation and fever. Important to know: This medication is less commonly found in cold medicines, but it is good to know about it. It is very similar to naproxen, but has a shorter duration. We cover the difference between this and other pain relievers here .
More things to know
A few caveats apply to all cold medicines and label reading in general:
- Beware of giving these medicines to children. Even those labeled as “baby” are not recommended for children under 4: they may not work and carry additional risks . If you really think your child needs something, it’s worth calling the doctor first.
- If you are taking more than one medication, check the labels carefully to make sure you are not taking twice as much (especially paracetamol).
- While you are doing this, read the entire label , including warnings about how the medicine interacts with other medicines or health conditions that may apply to you.
Buying cold medicine by ingredient is actually like choosing the tools for the job. When you know which ones you need and which ones you don’t, you can choose exactly what suits you.
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Illustration by Sam Woolley.