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Over The Counter Cough/Cold & Flu products – what you need to know!



Over the Counter products fact & figures


Cold/flu is a leading cause of lost work days and school absenteeism. In fact, the common cold results in an economic loss of $16.7 billion for presenteeism (going to work while sick), while half that amount - $8 billion - is attributed to absenteeism.

1/3 of Canadians adults have a sore throat, cold or flu in any given month

Cough/cold remedies are the second most commonly used medications in Canada

Canadians spend more than $300 million a year on OTC cold and flu treatments and prescription antibiotics, which for the most part, neither "ameliorate symptoms nor change the course of the illness."

Cold Treatment Options

Antihistamines (Benadryl, Claritin) – help with running nose/sneezing when caused by allergies, but little evidence that they work for colds. Some cause significant drowsiness (Benadryl) and surprisingly even the non-drowsy or daytime products still do cause some sedation and thus not ideal to take during the day or if you are driving. Also avoid if breastfeeding – can dry up milk supply.

Decongestants (Sudafed, Sinutab) – help relieve sinus congestion. Sprays are more effective than tablets in the short term and act quicker but nasal sprays should not be used for more than 3 days because longer use can lead to rebound congestion, increased risk of sinus infections and even damage to nasal membranes! Decongestants can raise blood pressure, intraocular (eye) pressure and cause insomnia and arrhythmias so they have to be avoided by folks with heart disease, high BP, glaucoma, prostate disease.
Pain/fever relievers (Advil, Tylenol) – help manage pain (headache/sinus) and fever. Tylenol cause be hard on the liver, ibuprofen (Advil/Motrin) can cause ringing in ears, kidney/liver problems and stomach bleeding.


Cough Treatment Options

DM syrup – widely used but little evidence that it works!

Buckleys – helps with cough and congestion but tastes horrible. Various formulas available (with DM or decongestants)

Codeine syrup (Calmylin)– much stronger and more effective than DM however codeine is a narcotic and can cause side effects (constipation, drowsiness) and it has an addictive potential. Not for kids. Formulas containing 8mg of codeine are sold behind the counter (without Rx) and stronger formulas are Rx only.

Robitussin (guaifenesin) – an expectorant – helps reduce chest congestion by thinning mucus which helps loosen it up. Drink lots of water with it because this will also help loosen chest congestion

Lozenges – can help with cough and sore/dry throat
Note…coughing is your body’s way of removing foreign substances (mucus) and clearing your lungs. Only use a suppressant if the cough is severe and preventing you from sleeping or impacting your breathing. 

Natural Over the Counter Products

To shorten duration: zinc lozenges, Echinacea – take frequently at onset of symptoms. Zinc can cause a strong metallic taste in mouth and affect appetite. Echinacea not recommended for those with ragweed allergies or those with autoimmune disease.

For prevention:  vitamin C is helpful, especially for those not getting enough from diet or those who exercise a lot or under stress; Cold-fx taken regularly can reduce risk of cold and flu and taken acutely can also shorten duration.

Taking a good quality multivitamin, such as femMED Multi+Antioxidants, ensures that your body and immune system get essential nutrients to function optimally.

Store/generic brands not equivalent (different ingredients)
Some products are promoted for immune health but lack efficacy data (Airborne, Oil of Oregano, etc)

Products Safe for Kids & Infants

There is limited research on Over The Counter drugs and children. In fact, not too long ago Health Canada required manufacturers to re-label products to indicate that they should not be given to children less than 6 years (previously it was 2 yrs) because of limited research on efficacy, reports of misuse, overdose and very rare serious side-effects. Here is what we can do for kids:

For congestion – saline nasal drops/spray; nasal aspirator; humidifier; do not use decongestants like Sudafed in kids < 6 yrs

For runny nose –antihistamines like chlorpheniramine and brompheniramine may help reduce running nose and sneezing, but they cause drowsiness and can affect kids performance in school and not recommended for those < 6 yrs.

For cough – buckwheat honey for those > 1 year; studies on DM have found that it offers no benefits for children

For prevention
Fortified foods – new foods available with added immune-supportive ingredients (Praeventia cookies, bars, Oasis Immuniforce juice and smoothies. These foods are safe for kids and adults and Health Canada allows label claims for immune support

Probiotics (BioGaia) – offer a range of benefits for immune health and digestion. There is research showing that infants in daycare given a specific probiotic (BioGaia) have fewer colds, ear infections and illness, less doctor visits and less antibiotic usage.

Wednesday, February 1, 2012