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Doctor On Demand Blog

It’s cold and flu season, and you may start to feel that tickle in your throat and a cascade of sneezes coming on. Before you head to the medicine aisle and search for relief of your symptoms, it’s important to understand how common over-the-counter (OTC) medicines work. Understanding this can help you navigate the cold and flu aisle and make the right selection, since all OTC medications are not created equal.

How do common over-the-counter medications work?

  • Decongestants — Decongestants can come in a pill or spray form and can help relieve some of your cold and flu symptoms. They work by helping to reduce swelling in the passageway of your nose by shrinking down blood vessels. This in turn helps open up your passageway, improving the flow of air and allowing you to breath better.
  • Cough medications– There are 2 types of cough medications that you can buy over the counter, expectorants and suppressants. A cough expectorant will help loosen the congestion in your chest and throat so that you can cough up the mucus more easily. An example of a cough expectorant is guaifenesin which is the active ingredient in Mucinex and Robitussin. A cough suppressant works by telling the brain to “ignore” your cough reflex. Dextromethorphan, the active ingredient in Delsym, is an example of a common cough suppressant that you can buy over the counter. At the same time, it’s important to keep in mind that coughing is a natural mechanism to keep mucus out of your lungs. You would never want to turn that off completely, but reducing the reflex can make the cough less disruptive and make you more comfortable.
  • Fever reducers — Acetaminophen and ibuprofen (NSAIDS) are common fever reducers but also work to reduce aches and pains. The medicines work with your brain and nervous system to help keep you from feeling pain and providing temporary relief.
  • Antihistamines — These medicines work by blocking the action of histamine, which is a substance produced in the body’s natural defense. It is related to an allergic reaction and has an effect of drying out your nasal passageways. This helps decrease the amount of mucus produced when your passageways get inflamed.

What are some common misconceptions of OTC medications?

One of the biggest misconceptions is that over-the-counter medications will cure your cold. While these medications can decrease the severity of your symptoms, they cannot cure the cold or flu. They can however help in making you feel more comfortable or allow you to get better rest when you’re sick.

Another misconception I’ve seen is that you cannot take more than one medication at one time. Many medicines work in different ways and interact with your body differently. Depending on what you’re taking, there’s no harm in taking multiple medications at once, as long as you’re not taking more than one that has the same medicine in it. For example, you cannot take two medications together that both have acetaminophen in it. Most importantly, it’s always a good idea to ask your pharmacist about the medications you’re taking to ensure you’re not double dosing yourself and making sure you’re getting the right treatment for your symptoms.

Are there any OTC medications you should avoid?

While zinc in general can be helpful in shortening the duration of your symptoms, the nasal formulations of zinc should be avoided. Zinc nasal sprays have been linked to the permanent loss of smell.

What to do if your OTC medicines are not helping?

Most cold and flu symptoms will get better with time and care, but if you feel like you’re getting worse, you may want to consult a doctor. If you think you may have the flu, over-the-counter medications may not be enough to get you feeling better, and an antiviral medicine may be required.