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Cold & Cough Remedies, Adult

Comforts for the common cold

Medicine cabinets are filled with capsules, tablets, gel tabs, and liquids to help get you through a cold. And there are just as many folk and herbal remedies (eat spicy food, take echinacea, sweat it out, and so on). None can claim to cure or even shorten the life of a cold, but all usually offer some relief. The high-tech stuff will help relieve a sore throat, unstuff your nose, and suppress excessive coughing. The low-tech stuff can comfort you and ease your suffering. So it's really about choosing what makes you feel the best.

By the way, there's also no sure-fire way of preventing a cold, besides isolation, since the virus that causes it is spread from contact with other people. Dancing in the rain won't give it to you; neither will chilly weather or damp apartments. And once you've caught a cold, it has to run its course.

Choose your remedies, grab the tissues, snuggle in comfortably, and get plenty of rest. It's the best you can do.


Cold vs. Flu

Colds and flus are often confused. They share many of the same symptoms, but the severity differs. Here are some tips on how to distinguish between the two.

Cold symptoms

  • Slight body pain
  • Mild to moderate chest discomfort
  • Hacking cough
  • Mild fatigue
  • Sneezing
  • Sore throat
  • Stuffed-up nose
  • Fever rarely occurs
  • Headache rarely occurs
Flu symptoms

  • Symptoms can last anywhere from five to 10 days, and can be accompanied by an earache.
  • Body pains that are often severe
  • Chest discomfort
  • Cough that is often severe
  • Extreme exhaustion that often appears early
  • Fatigue, which can last up to three weeks
  • High fever (102? to 104? F) lasting three to four days
  • Headache
  • Stuffed-up nose is not as common as in a cold
  • Sneezing is not as common as in a cold
  • Sore throat is not as common as in a cold
  • Symptoms usually last one week, and can lead to bronchitis and pneumonia.
The All Too Common Cold and Flu

  • Drink lots of fluids for their soothing effect and to prevent dehydration.
  • A sore throat may be the first sign of a cold, followed by a stuffy or runny nose.
  • The common cold is rarely accompanied by a fever, but body temperatures may rise a degree or two.
  • Decongestants are commonly used to reduce nasal congestion.
  • Antitussives, or cough suppressants, are used to inhibit coughing.
  • If your cough is productive, use an expectorant to thin mucus secretions. Do not use an antitussive.
  • The FDA recommends using single-ingredient cold medicines that work to relieve a particular symptom.
  • Time-release capsules can provide some relief from cold and cough symptoms for up to 12 hours -- great for those who don't like to pop too many pills. Do not chew or crush time-release products. This releases all the medication at once and may produce side effects.
Controversial Cures

Controversy still surrounds the effectiveness of antihistamines for cold symptoms. Currently, there is no evidence that antihistamines are of any benefit to cold sufferers.

There is no evidence that vitamin C can prevent a cold, but data suggests that vitamin C might reduce the severity and duration of a cold.

Some studies do indicate that zinc lozenges taken early enough and in adequate amounts might prevent the onset of the common cold. Dissolve them slowly in your mouth; do not chew them.

Analgesics (acetaminophen)

Reduces pain and fever but has no anti-inflammatory activity. It works by acting directly on the central nervous system and blocking pain messages.

Analgesics (NSAIDs)

NSAIDs, also known as non-steroidal anti-inflammatory drugs, are a class of drugs that reduce inflammation. They are commonly used in the treatment of arthritic pain. They work by blocking the production of prostaglandins, chemicals linked to pain sensations and inflammation in the body. NSAIDs available without a prescription include ibuprofen, ketoprofen, and naproxen.

Analgesics (salicylates)

A class of drugs which reduce fever and relieve pain. They include such drugs as aspirin, choline salicylate, magnesium salicylate tetrahydrate, and magnesium salicylate. They work by blocking the production of prostagladins -- chemicals linked to pain sensations and inflammation in the body.

Antihistamines

In an allergic reaction, body cells secrete a substance called histamine, which causes itchiness, watery eyes, and other symptoms. Antihistamines are a versatile class of drugs used to alleviate the effects of allergic reactions in the respiratory system and to treat motion sickness and insomnia. Antihistamines work by blocking histamine's effect on certain secretory cells and drying mucous membranes. Their use in cold-relief preparations is somewhat controversial. Some studies have shown that colds do not cause increased histamine release in the body, making the effect of antihistamines in relieving cold symptoms minimal. They may, however, offer some relief to the cold-sufferer due to their sedating effect and mild drying effect on the nasal passages.

Antitussives

Cough suppressants that work by directly depressing the brain's cough center, which lowers the sensitivity of cough receptors and interrupts transmission of cough impulses. They also relax the smooth muscles in the throat and bronchial passages. All of this leads to a reduced urge to cough.

Decongestants

Drugs that unstuff clogged nasal passages and improve breathing for allergy sufferers. They work by significantly constricting, or narrowing, blood vessels to decrease blood flow to the nose. This shrinks the swollen tissues and reduces secretions, allowing you to breathe more easily. Oral decongestants have a longer lag than spray decongestants before taking effect, but they last longer. While they are more likely to produce side effects, they have not been associated with rebound congestion.

Expectorants

Substances that increase sputum secretions in the respiratory tract to thin mucus and phlegm, making them easier to cough out of the lungs. Helps dry, irritating coughs to become more productive. Only one non-prescription ingredient, guaifenesin, has been approved by the FDA as an expectorant.

Analgesics (Acetaminophen)
Ingredient
Description
Acetaminophen?Safe and effective for treating minor aches and pains and fever relief. Less likely to cause stomach irritation than aspirin and NSAIDs. Consult a doctor before taking this drug if you have liver or kidney disease.
Analgesics (NSAIDs)
Ingredient
Description
Ibuprofen?Stronger than acetaminophen or aspirin in relieving pain and reducing inflammation. Fewer side effects than naproxen and ketoprofen. Should not be used by anyone with gastrointestinal or bleeding disorders.
Ketoprofen?Effective in relieving moderate pain and reducing inflammation. Stronger than acetaminophen or aspirin in relieving pain. More likely to cause gas, bloating, diarrhea, nervousness, and irritability than ibuprofen or naproxen. Should not be used by anyone under age 16 or anyone with gastrointestinal or bleeding disorders.
Naproxen?Effective in relieving moderate pain and reducing inflammation. Stronger than acetaminophen or aspirin in relieving pain. Naproxen has a longer duration of action (8 to 12 hours) than ibuprofen and ketoprofen. More likely to cause drowsiness, shortness of breath and ringing in the ears than ibuprofen and ketoprofen. Should not be used by children under age 12 or anyone with gastrointestinal or bleeding disorders.
Analgesics (Salicylates)
Ingredient
Description
Aspirin (Acetasalicylic Acid)?Present in many over-the-counter analgesics. Long-term use may be associated with greater risk of side effects such as stomach upset. Never administer to children with flu-like symptoms or fever (see Reye's syndrome).
Choline Salicylate?A salicylate salt comparable to aspirin. Less irritating to the stomach.
Magnesium Salicylate?Comparable to aspirin but less potent and less irritating to the stomach.
Sodium Salicylate?Comparable to aspirin. People on a low-sodium diet should be cautious.
Antihistamines
Ingredient
Description
Brompheniramine Considered safe and effective with very few serious side effects and a low risk of drowsiness.
Clemastine A newer approved antihistamine found in long-acting products.
Chlorcyclizine Safe, effective, and popular with few known side effects. FDA approved, but not commonly found in nonprescription products.
Chlorpheniramine Has a proven low frequency of side effects. Effective against allergic runny nose and sneezing.
Dexbrompheniramine A former prescription drug generally accepted as the most active form of brompheniramine maleate. Because of its strength, it can be taken in lower doses.
Diphenhydramine A popular and effective antihistamine, but it has a strong sedating effect
Phenindamine Fast-acting and effective but known to produce more side effects than most antihistamines, including dry mouth, overstimulation, drowsiness, and insomnia.
Pheniramine Safe and effective against hay fever and other allergies.
Pyrilamine Highly effective against hay fever but with many reported side effects, including drowsiness, listlessness, irritability, loss of appetite, and nausea. But even at high doses this drug is not likely to produce fatal toxic effects.
Thonzylamine One of the oldest and generally considered the least toxic of the antihistamines. FDA approved, but not commonly found in nonprescription products.
Triprolidine Safe and effective with a low incidence of side effects, the most common of which is drowsiness.
Antitussives
Ingredient
Description
Codeine Preparations?Extremely effective. Only certain states allow codeine to be purchased over-the-counter. May cause drowsiness and constipation. Can be habit-forming if taken in large amounts. Medical supervision is recommended before taking this drug.
Dextromethorphan?Extremely effective. Overdoses may lead to bizarre behavior, respiratory depression, and drowsiness -- among other things. Do not use if you are taking an MAO inhibitor.
Diphenhydramine?Very effective. May cause drowsiness. Also offers antihistamine properties.
Decongestants
Ingredient
Description
Phenylephrine?Fast-acting and effective. When taken orally provides significant decongestant effect, but can also raise blood pressure and increase heart rate. Safest in low doses.
Pseudoephedrine?Good marks in clinical and scientific studies of cold sufferers. Side effects are minimal and include drowsiness, headache, and insomnia. Avoid if taking MAO inhibitors.
Ephedrine (Conditionally Approved)?Safe when taken orally or via inhalation, but can cause tension, nervousness, tremor, and sleeplessness. Appears to reduce nasal congestion in high doses. No longer sold in most over-the-counter products because it can be used to produce illicit drugs.
Phenylpropanolamine (Conditionally Approved)?Studies show the effectiveness of phenylpropanolamines as nasal decongestants. However, there are concerns over potentially dangerous side effects, including increased blood pressure.
Expectorants
Ingredient
Description
Guaifenesin?Also known as glycerol guiacolate. Effective and safe as an expectorant, especially during the initial stages of a cold with cough. Do not administer to children under age 2 without a doctor's supervision.

FDA-Approved Uses

Analgesics
  • For the temporary relief of minor aches and pains associated with the common cold, flu, sore throat, headache, toothache, and muscular aches.

  • This product is a pain reliever that helps to reduce fever.

Antitussives
  • Temporarily alleviates cough due to minor throat and bronchial irritation associated with a cold.

  • Suppresses cough to help you rest.

Oral antitussives
  • Nonnarcotic; calms the cough "control center" and relieves coughing.

Decongestants
  • Temporarily relieves nasal congestion due to the common cold, hay fever and other upper respiratory allergies (allergic rhinitis), and sinusitis.
  • Helps clear nasal passages; shrinks swollen membranes. Helps decongest sinus openings and passages; temporarily relieves sinus congestion and pressure.
  • Promotes nasal and sinus drainage.
Expectorants
  • Helps loosen phlegm (sputum) and thin bronchial secretions to rid the bronchial passageways of bothersome mucus and to make coughs more productive

Which Drug to Choose
  • It's best to just use medications specific to your symptoms.
  • Don't just buy combination products with drugs to treat symptoms you do not have.
  • If you are coughing, use an antitussive.
  • If you have a fever, use an analgesic.
  • If you are producing phlegm and need to clear your throat, use an expectorant.
  • If your nose is congested, use a decongestant.
Coughing Up the Facts
  • Antitussives do reduce the urge to cough. But they should not be used for phlegm-producing coughs.
  • If you are coughing up phlegm, use an expectorant, not an antitussive.
  • Guaifenesin is the only expectorant approved to loosen phlegm, but the studies are not conclusive.
Colds Are Not Allergies
  • Antihistamines are in a variety of cough and cold products because many cough and cold symptoms are similar to allergy symptoms.
  • However, there is no conclusive evidence that antihistamines help treat the symptoms of the common cold. And several studies indicate they are of no benefit.
  • Allergy symptoms are caused by IgE and histamine. Cold symptoms are not.
  • If you feel an antihistamine might help, try chlorpheniramine. In studies, it was slightly better than a placebo.
Recommended Dosage

Expectorants
DrugAdults & Children Over Age 12Max. DailyChildren Ages 6 to 12Max. DailyChildren Under Age 6Max. Daily
Guaifenesin200 to 400 mg every 4 hrs2400 mg100 to 200 mg per day1200 mg per dayRefer to package or consult a physician
Antitussives
DrugAdults & Children Over Age 12Max. DailyChildren Ages 6 to 12Max. DailyChildren Under Age 6Max. Daily
Dextromethorphan10 to 20 mg every 4 hrs120 mg5 to 10 mg every 4 hrs60 mgRefer to package or consult a physician
Diphenhydramine25 to 50 mg every 6 to 8 hrs400 mg12.5 to 25 mg every 6 hrs300 mgRefer to package or consult a physician
Codeine10 to 20 mg every 4 to 6 hrs120 mg5 to 10 mg every 4 to 6 hrs60 mgRefer to package or consult a physician
Decongestants
DrugAdults & Children Over Age 12Max. DailyChildren Ages 6 to 12Max. DailyChildren Under Age 6Max. Daily
Phenylephrine10 mg every 4 hrs60 mg5 mg every 4 hrs30 mgConsult a physician
Pseudoephedrine Preparations60 mg every 4 hrs360 mg30 mg every 4 hrs180 mgConsult a physician
Phenylpropanolamine25 mg every 4 hrs150 mg12.5 mg every 4 hrs75 mgConsult a physician
Analgesic (Acetaminophen)
DrugAdults & Children Over Age 12Max. DailyChildren Ages 6 to 12Max DailyChildren Under Age 6Max. Daily
Acetaminophen650 mg every 4 to 6 hrs4000 mgRefer to package or consult a physicianRefer to package or consult a physician
Analgesic (NSAID)
DrugAdults & Children Over Age 12Max. DailyChildren Ages 6 to 12Max. DailyChildren Under Age 6Max. Daily
Ibuprofen200 to 400 mg every 4 to 6 hrs1200 mgRefer to package or consult a physicianRefer to package or consult a physician
Naproxen200 mg every 8 to 12 hrs, or

200 every 12 hrs if over 65
600 mg

400 mg if over 65
Not recommendedNot recommended
Ketoprofen12.5 mg every 4 to 6 hrs

A second dose may be taken after one hour if needed.
Not recommended for those age 16 and under.
75 mgNot recommendedNot recommended
Analgesic (Salicylates)
DrugAdults & Children Over Age 12Max. DailyChildren Ages 6 to 12Max. DailyChildren Under Age 6Max. Daily
Aspirin (Acetylsalicylic Acid)325 mg every 1 to 2 hrs, or

500 mg every 2 to 3 hrs

Not recommended for those age 16 and under
4000 mgNot recommendedNot recommended
Choline salicylate870 mg every 3 to 4 hrs

Not recommended for those age 16 and under
5220 mgNot recommendedNot recommended
Magnesium salicylate325 to 1000 mg 6 to 8 hrs

Not recommended for those age 16 and under
3000 mgNot recommendedNot recommended
Sodium salicylate325 to 650 mg every 4 hrs

Not recommended for those age 16 and under.
4000 mgNot recommendedNot recommended
Antihistamines
DrugAdults & Children Over Age 12Max. DailyChildren Ages 6 to 12Max. DailyChildren Under Age 6Max. Daily
Brompheniramine4 mg every 4 to 6 hrs24 mg2 mg every 4 to 6 hrs12 mgRefer to package or consult a physician
Chlorcyclizine25 mg every 6 to 8 hrs75 mg12.5 mg every 6 to 8 hrs37.5 mgRefer to package or consult a physician
Chlorpheniramine4 mg every 4 to 6 hrs24 mg2 mg every 4 to 6 times12 mgRefer to package or consult a physician
Dexbrompheniramine2 mg every 4 to 6 hrs12 mg1 mg every 4 to 6 hrs6 mgRefer to package or consult a physician
Dexchlorpheniramine2 mg every 4 to 6 hrs12 mg1 mg every 4 to 6 hrs6 mgRefer to package or consult a physician
Diphenhydramine25 to 50 mg every 6 to 8 hrs300 mg5 to 25 mg every 4 to 6 hrs150 mgRefer to package or consult a physician
Doxylamine7.5 to 12.5 mg every 4 to 6 hrs75 mg3.75 to 6.25 mg every 4 to 6 hrs37.5 mgRefer to package or consult a physician
Phenindramine25 mg every 4 to 6 hrs150 mg12.5 mg every 4 to 6 hrs75 mgRefer to package or consult a physician
Pheniramine12.5 to 25 mg every 4 to 6 hrs150 mg6.25 to 12.5 mg every 4 to 6 hrs75 mgRefer to package or consult a physician
Pyrilamine25 to 50 mg every 6 to 8 hrs200 mg12.5 to 25 mg every 6 to 8 hrs100 mgRefer to package or consult a physician
Thonzylamine50 to 100 mg every 4 to 6 hrs600 mg25 to 50 mg every 4 to 6 hrs300 mgRefer to package or consult a physician
Triprolidine2.5 mg every 4 to 6 hrs10 mg1.25 mg every 4 to 6 hrs5 mgRefer to package or consult a physician

Warnings

Analgesic (Acetaminophen)

Consult a physician before using or do not use if you have:
  • Alcoholism
  • Allergy to acetaminophen or any component in acetaminophen products
  • Kidney impairment
  • Liver impairment
Or if you:
  • Are pregnant or nursing
  • Are a senior; you may require a lower dosage
  • Plan to use more frequently or at higher than recommended doses
  • Still have a fever after three days
  • Using to treat symptoms for more than 10 days in adults
  • Using to treat symptoms for more than five days in children
Or if you are taking:
  • Chronic alcohol use: may increase the risk for acetaminophen-induced liver damage
  • Isoniazid (Nydrazid): may increase the risk for acetaminophen-induced liver damage
  • Phenobarbital (Luminal): may increase the risk for acetaminophen-induced liver damage
  • Phenytoin (Dilantin): may increase the risk for acetaminophen-induced liver damage
  • Rifampin (Rifadin): may decrease analgesic effects of acetaminophen
  • Sulfinpyrazone (Anturane): may increase the risk for acetaminophen-induced liver damage
  • Warfarin (Coumadin): use of high dose acetaminophen might further increase the risk of bleeding
Analgesic (NSAID)

Consult a physician before using or do not use if you have:
  • Allergy to NSAIDs, aspirin, or iodides
  • Anemia
  • Blood clotting disorders
  • Heart disease
  • High blood pressure
  • Kidney impairment
  • Liver impairment
  • Parkinson's disease
  • Pre-existing infection (might be masked by NSAIDs)
  • Psychiatric disorder (NSAIDs may aggravate it)
  • Ulcers or other gastrointestinal problems
Or if you :
  • Are under age 15 with a viral illness (due to the increased risk of Reye's syndrome)
  • Are pregnant or nursing
  • Are a senior, as you may require a lower dosage
  • Are bedridden or incapacitated
  • Are in sunlight for prolonged periods, as photosensitivity may occur
  • Are on a low-salt diet
  • Develop blurred vision or other eye problems during treatment, consult a physician
  • Experience headaches with drug usage that do not diminish as dose is lowered
  • Experience severe abdominal pain or cramps
  • Plan to use for an extended period of time or at a higher dose
Or if you are taking:
  • Cyclosporin (Neoral, Sandimmune): may increase the risk for kidney damage
  • Digoxin (Lanoxin): may increase digoxin levels and effect when ibuprofen is also used
  • Furosemide (Lasix): may decrease furosemide levels when ibuprofen or ketoprofen is also used
  • Lithium (Lithobid): may increase lithium levels or effect
  • Methotrexate (Folex): may increase methotrexate levels and side effect
  • Other NSAIDs: increases NSAID side effects
  • Phenytoin (Dilantin): may increase phenytoin levels or effect when ibuprofen is also used
  • Probenecid (Benemid): may increase NSAID levels and side effects
  • Salicylates, such as
    • Aspirin (Ecotrin): may decrease NSAID levels and increase NSAID side effects
    • Choline salicylate (Arthopan): may decrease NSAID levels and increase NSAID side effects
  • Warfarin (Coumadin): may increase warfarin side effects and the risk of bleeding
Analgesic (Salicylate)

Consult a physician before using or do not use if you have:
  • Allergy to aspirin or other salicylate
  • Asthma
  • Blood clotting disorders
  • Kidney impairment
  • Liver impairment
  • Nasal polyps
  • Ulcers or other gastrointestinal problems
Or if you:
  • Are a child or teenager with a viral illness; salicylates may increase the risk of developing Reye's syndrome
  • Are pregnant or nursing
  • Are a senior, as you may require a lower dosage
  • Are on a low-salt diet
  • Experience ringing in the ears; consult a physician
  • Note that the drug has a vinegar-like odor; the pill may have decomposed
  • Plan to have surgery; stop use seven days before the procedure
  • Plan to use for an extended period of time or at a higher dose
Or if you are taking:
  • Urinary acidifiers, such as:

    • Ammonium chloride: decreases salicylate removal
    • Ascorbic acid (Vitamin C): decreases salicylate removal
  • ACE inhibitors, such as:
    • Benazepril (Lotensin): may decrease benazepril effects
    • Enalapril (Vasotec): may decrease enalapril effects
  • Alcohol: increases the risk of stomach ulceration and bleeding
  • Antacids: may decrease salicylate effects
  • Beta blockers, such as:
    • Atenolol (Tenormin): may decrease atenolol effects
    • Metoprolol (Lopressor): may decrease metoprolol effects
  • Corticosteroids, such as:
    • Cortisone (Cortef): may decrease salicylate levels and/or increase the risk of stomach ulceration
    • Methylprednisone (Medrol): may decrease salicylate levels and/or increase the risk of stomach ulceration
  • Heparin (Hep-Lock): increases risk of bleeding
  • Methotrexate (Folex): may increase methotrexate levels and effect
  • Other salicylates: increases salicylate side effects
  • Valproic Acid (Depakote): may increase valproic acid effects
  • Warfarin (Coumadin): may increase warfarin side effects and the risk of bleeding
Antihistamines

Consult a physician before using or do not use if you have:
  • Allergy to any antihistamines
  • Chronic respiratory conditions
  • Enlarged prostate
  • Glaucoma
  • Urinary obstruction
Or if you:
  • Are pregnant or nursing
  • Are a senior, you may require a lower dosage
  • Are administering to a child under age 6
  • Drive or operate machinery requiring alertness, dexterity, or quick reflexes
Or if you are taking:
  • Alcohol: increases antihistamine side effects
  • CNS depressants, such as:
    • Diazepam (Valium): increases antihistamine side effects
    • Phenobarbital (Luminal): increases antihistamine side effects

  • Monoamine oxidase inhibitors (a class of antidepressants), such as:
    • Phenelzine (Nardil): increases antihistamine side effects

    • Tranylcypromine (Parnate): increases antihistamine side effects
  • Other antihistamines: increases antihistamine effects
Antitussive

Consult a physician before using or do not use if you have:
  • Asthma
  • Chronic cough due to asthma, emphysema, or smoking
  • Cough with over-production of mucus
  • High fever
  • Liver impairment
  • Persistent headache
  • Rash
  • Nausea or vomiting
Or if you:
  • Are pregnant or nursing
  • Are a senior; you may require a lower dosage
  • Drive or operate machinery requiring alertness, dexterity, or quick reflexes
  • Plan to use for an extended period of time or at a higher dose
Or if you are taking:
  • Monoamine oxidase inhibitors (a class of antidepressants), such as:

    • Phenelzine (Nardil): may cause serious central nervous system depression or excitation

    • Tranylcypromine (Parnate): may cause serious central nervous system depression or excitation
Codeine (not available in all states)

Consult a physician before using or do not use if you have:
  • Allergy to codeine
  • Diarrhea due to toxic effect of drugs or poisons
  • Impaired liver
  • Kidney complications
Or if you:
  • Are pregnant or nursing
  • Are a senior; you may require a lower dosage
  • Are administering to a child or infant
  • Are drinking caffeinated beverages while using medication
  • Drive or operate machinery requiring alertness, dexterity, or quick reflexes
  • Plan to use at high doses and for an extended period of time
Or if you are taking:
  • Alcohol: increases codeine side effects
  • CNS depressants, such as:

    • Phenothiazines: increase codeine side effects

    • Tricyclic antidepressants: increase codeine side effects
  • Narcotic analgesics, such as:
    • Morphine: increases morphine and codeine side effects
Decongestants

Consult a physician before using or do not use if you have:
  • Allergy to any decongestants
  • Diabetes
  • Enlarged prostate
  • Heart disease
  • High blood pressure
  • Thyroid disease
Or if you:
  • Are pregnant or nursing
  • Are a senior, you may require a lower dosage
  • Are administering to a child under age 6
  • Develop new or worse symptoms with the use of the medicine
  • Use a larger dose than recommended
Or if you are taking:
  • Antihypertensives, such as:

    • Enalapril (Vasotec): may decrease enalapril's antihypertensive effects
    • Nifedipine (Adalat): may decrease nifedipine's antihypertensive effects
  • Methyldopa (Aldomet): may increase decongestant effects
  • Monoamine oxidase inhibitors, (a class of antidepressants) such as:
    • Phenelzine (Nardil): may increase decongestant side effects
    • Tranylcypromine (Parnate): may increase decongestant side effects
  • Reserpine: may increase decongestant effects
  • Tricyclic antidepressants, such as:

    • Amitriptyline (Elavil): may increase decongestant effects
    • Nortriptyline (Pamelor): may increase decongestant effects
  • Phenothiazines, such as:
    • Perphenazine (Trilafon): may reduce decongestant effects
    • Trifluoperazine (Stelazine): may reduce decongestant effects
Expectorant

Consult a physician before using or do not use if you have:
  • Chronic cough due to asthma, emphysema, or smoking
  • Cough with over-production of mucus
Or if you:
  • Are a senior; you may require a lower dosage
  • Are pregnant or nursing
  • Are administering to a child or infant
  • Are concerned about ingestion of alcohol; some products contain alcohol
  • Are concerned about ingestion of sugar; some products contain sugar
  • Drive or operate machinery requiring alertness, dexterity, or quick reflexes
  • Have symptoms that last for more than seven days
Common Side Effects

Analgesic (Acetaminophen)
  • None anticipated
Analgesic (NSAIDs)
  • Dizziness
  • Fatigue
  • Heartburn
  • Nausea
  • Rash
  • Stomach cramps
Analgesic (Salicylates)
  • Abdominal discomfort
  • Heartburn
  • Indigestion
  • Nausea
Antihistamines
  • Drowsiness
  • Thickened mucus
Antitussive
  • None anticipated
Decongestant
  • Excitability
  • Headache
  • Insomnia
  • Nervousness
  • Rapid heartbeat
Expectorant
  • None anticipated
Infrequent to Rare Side Effects

Analgesic (Acetaminophen)
  • Bruising
  • Nausea
  • Rash
  • Vomiting
Analgesic (NSAIDs)
  • Confusion
  • Fluid retention
  • Headache
  • Itching
  • Nervousness
  • Ringing in ears
  • Stomach ulceration
  • Vomiting
Analgesic (Salicylates)
  • Difficulty breathing
  • Fatigue
  • Rash
  • Stomach ulceration
  • Weakness
Antihistamines
  • Diarrhea
  • Dry mouth
  • Headache
  • Nausea
  • Nervousness
  • Tiredness
  • Vomiting
Antitussive
  • Constipation
  • Dizziness
  • Drowsiness
  • Nausea
  • Slow breathing
  • Stomach cramps
Decongestant
  • Difficult urination
  • Dizziness
  • Nausea
  • Vomiting
  • Trouble breathing
  • Weakness
Expectorant
  • Abdominal discomfort
  • Drowsiness
  • Headache
  • Nausea
  • Rash
  • Vomiting
Effects of Overdose

Analgesic (Acetaminophen)
  • Kidney damage
  • Liver damage
Analgesic (NSAIDs)
  • Kidney failure
  • Seizures
  • Severe nausea
  • Vomiting
  • Ringing in ears
Analgesic (Salicylates)
  • Coma
  • Confusion
  • Headache
  • Liver damage
  • Low blood sugar
  • Rapid breathing
  • Ringing in ears
Antihistamines
  • Confusion
  • Hallucinations
  • Loss of consciousness
  • Loss of coordination
  • Seizures
  • Severe agitation
  • Severe drowsiness
Antitussive
  • Blurred vision
  • Convulsions
  • Drowsiness
  • Extreme tiredness
  • Hallucinations
  • Very slow breathing
Decongestant
  • Increased blood pressure
  • Nausea
  • Rapid and irregular heartbeat
  • Seizures
  • Severe agitation
  • Vomiting
Expectorant
  • Coma
  • Severe drowsiness
  • Very slow breathing
  • Vomiting
What to Do in Case of Overdose

  • If you suspect that you or someone you know has taken an overdose of this medication, immediately STOP USING THE MEDICATION and SEEK MEDICAL

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