The Common Cold: Advice for the Patient

Author: Lori C. Brown, PharmD

    We all get a cold from time to time, and we wonder how to get rid of it. The bad news: there is no cure . . . yet. The good news: you can prevent colds. If you do get a cold, however, you can treat the symptoms. The common cold is caused by 1 of more than 200 known viruses, so antibiotics are not effective treatments. Symptoms appear gradually and include congestion, sneezing, sore throat, and sometimes a cough.

Is It a Cold or the Flu?

    Once you start feeling bad, it is important to determine whether your symptoms are caused by the common cold or the flu. If you become sick quickly, have joint pain or aches, or have a high fever, chances are you have the flu, which is caused by the influenza virus. (See the Table for more information on the differences between a cold and the flu.) The best way to prevent the flu is to get a yearly flu shot. Like the common cold, there is no cure for the flu, and antibiotics are not helpful in treating the flu either. Some over-the-counter (nonprescription) products and remedies, however, can help you feel better and make dealing with the flu or a common cold a little bit easier.

An Ounce of Prevention

    Because there is no known cure for the common cold, prevention is key to keeping colds away. Most of the time, you acquire a cold virus by touching your eyes, nose, or mouth with an object that has the cold virus on it. Therefore, to help avoid catching a cold:

 The Course of a Cold

    Whether or not you take medicine for your symptoms, a cold will probably last about a week. Be sure to drink plenty of fluids to help with congestion, and get plenty of rest?up to 12 hours a night. Be considerate of others?you are contagious for the first 3 days that you have cold symptoms.

Medications and Symptom Relief

    Dozens of cold medicines are available over the counter. Some of these products contain multiple active ingredients, and others contain only 1 active ingredient. By choosing single-ingredient preparations, you can be sure to treat only the symptoms that you have. Combination products may be more convenient, but you can easily overmedicate yourself. You may feel the side effects of these unnecessary extra ingredients. Always check with your pharmacist if you have questions about over-the-counter medicines.

What Are the Ingredients in Cold Medicines?

    Expectorants (guaifenesin) loosen up the congestion in your chest, which helps you cough up the mucus. Guaifenesin comes in short-acting and extended-release formulas. Short-acting guaifenesin products are available as a syrup or pill (Robitussin). Short-acting products generally are taken every 4 hours. Mucinex is the only extended- release guaifenesin product available. It is an over-the-counter medicine and is in the form of a tablet. Do not crush, chew, or break the tablet. Expectorants are most effective when taken with plenty of water. (Note: All single-ingredient, extended-release guaifenesin tablets sold as prescription products will not be available for retail dispensing as of December 1, 2003.)

    Decongestants are used to treat nasal stuffiness and drainage. Decongestants work by temporarily shrinking blood vessels in the lining of your nose, which results in easier breathing. They also help dry up postnasal drip, so they may help a sore throat. Decongestants can be taken by mouth or as a nasal spray or drops. Pseudoephedrine (Sudafed, Cenafed, Decofed, Dorcol, Efidac 24, Pedia- Care, Sinutab) is a single-ingredient oral decongestant that works well but has the potential to cause rapid heartbeat. Oral decongestants should be avoided in children younger than 6 months. If you have heart disease, high blood pressure, an enlarged prostate, glaucoma, diabetes, or an overactive thyroid, check with your doctor or pharmacist before taking a decongestant by mouth. Other decongestants are available over the counter as nasal sprays (Afrin, Dristan, Neo-Synephrine [4 hour], Vicks, Otrivin). They are less likely to cause side effects when used correctly, so always read the package insert.

    Cough suppressants keep you from coughing. They are best suited for a dry, hacking cough, particularly when it keeps you awake at night. Dextromethorphan is found as a single ingredient in liquid and capsule forms (eg, Delsym, Hold DM, Robitussin Pediatric, Robitussin Cough Calmers, St. Joseph Cough Suppressant, Sucrets Cough Control). Cough suppressants may hold mucus in your lungs and make breathing more difficult for some people. So, if you are elderly or frail, or if you have chronic respiratory problems, ask your physician or pharmacist for advice before taking a cough suppressant.

    Pain relievers/fever reducers may help if you have a mild fever or sore throat. Acetaminophen (Tylenol) is the safest choice for most people, but it should not be used if you have liver damage or disease. Ibuprofen (Advil, Motrin) and naproxen sodium (Aleve) are nonsteroidal anti-inflammatory drugs (NSAIDs) that are effective in treating pain and swelling. NSAIDs should be taken with food. You should consult your pharmacist or physician before using NSAIDs if you have heart disease, including hypertension, or if you have a history of ulcers or stomach/intestinal bleeding. Sore throats also can be relieved by gargling with salt water (1/2 teaspoonful of salt dissolved in 8 ounces of warm water) or by sucking on lozenges or sour candy.

    Antihistamines usually are not effective for the common cold. They can thicken mucus, which makes it more difficult to break up and get rid of. Antihistamines are preferred for treating allergy symptoms, such as sneezing, itchy or watery eyes, and runny nose.

When to Call Your Doctor

    Usually, it is not necessary to see the doctor for a common cold. You should contact your physician if:

Mucinex is the first and only single-ingredient, extended-release guaifenesin product to have a new drug application approved by the Food and Drug Administration. The patented, bilayer 600-mg guaifenesin tablet provides an immediate release of 100 mg of guaifenesin for rapid onset of action and 500 mg of extended-release guaifenesin for the only approved 12-hour delivery. It helps loosen mucus and thin bronchial secretions to rid the bronchial passageways of bothersome mucus and make coughs more productive.

    Additionally, Mucinex has been approved as an over-the-counter product and is available to patients without a prescription. Mucinex is dosed as 1 or 2 tablets every 12 hours. It is sold in bottles of 20 tablets (5-10 days of therapy) or 40 tablets (10-20 days of therapy). With the approval of Mucinex, all single ingredient, extended-release guaifenesin tablets sold as prescription products will not be available for retail dispensing as of December 1, 2003.