Cold and cough combination medicines are usually used to provide relief for people suffering from the cough that often accompanies common ailments, including hay fever, influenza, and colds. These medicines are not effective in the treatment of the more chronic form of cough that often results from smoking, as a symptom of emphysema or asthma, or where the cough produces large quantities of phlegm or mucus.
Cold and cough combination medicines usually contain multiple active ingredients. For instance, some products are made up of a decongestant, an analgesic, and an antihistamine, as well as a drug to tackle the cough. When self-medicating, you must choose a medicine that best matches your symptoms. You should also look for a brand that contains those drugs that will best treat your symptoms. For the avoidance of doubt, ask your pharmacist for guidance.
Each different medicine will be made up of components that can cause different side effects and varied contraindications. You must, therefore, check the packaging to see what ingredients the product contains, before you start using it. There are a variety of components often found in cold and cough combination medicines:
Antihistamines prevent or relieve the symptoms that typically accompany allergies and hay fever. They may also be effective in tackling common cold symptoms, including sneezing and a runny nose. Antihistamines work by inhibiting the production of a naturally produced chemical known as histamine. Antihistamines that are used in these medicines typically include:
Decongestants are designed to cause the blood vessels in the nasal passages to become narrowed, effectively clearly congestion. This can also exacerbate hypertension in people who suffer from this malady. Decongestants that are commonly included in cold and cough combination medicines include:
Antitussives are used in cold and cough combination medicines to help relieve the symptoms of coughing. Antitussive drugs work on the area of the brain that triggers the cough response, dulling the response and thus preventing the feeling of the need to cough. Some antitussives contain narcotics, and there is a danger of addiction if the drugs are taken to excess or for long periods. Stopping the treatment abruptly may cause physical withdrawal symptoms.
Antitussives that contain narcotics include:
Expectorants have the effect of loosening any phlegm or mucus that has collected in your chest. Guaifenesin is the used in cold and cough combination medicines as an expectorant. Other expectorant ingredients include:
However, these ingredients are not generally very effective, and the best way of shifting mucus is to consume lots of fluids.
These drugs provide relief for the pain and aches that can be caused by influenza and common colds. Analgesics commonly included in cold and cough combination medicines include:
Kidney or urinary bladder cancer or kidney damage can develop if too much salicylate and acetaminophen is used together.
Anticholinergics are used to dry-up a runny nose and discourage the production of mucus in the lungs. Commonly used anticholinergics include homatropine.
Many cold and cough combination medicines can be purchased from your pharmacist or drug store without a prescription. However, it is not advisable to give these medicines an infant or to children of less than the age of four years. To do so could be dangerous or even life-threatening.
Cold and cough combination medicines come in many different forms, including:
In the US, cold and cough combination medicines are sold under the following brand names:
In Canada, cold and cough combination medicines are available under the following brand names:
Cold and cough combination medications are generally safe to use in adults and teenagers. However, along with the affects you require, they may cause a few unwanted side effects. This is more likely if the medicines are taken too excess or for longer than is recommended on the packet.
It is possible to overdose on narcotic antitussives that contain dihydrocodeine, hydrocodone, codeine, or hydromorphone. If you or anyone in your household experiences any of the following symptoms, you could seek emergency medical help immediately:
Cold and cough combination remedies that contain acetaminophen can cause the following side effects in some patients:
Cold and cough combination remedies that contain salicylate can cause the following side effects in some patients:
Cold and cough combination remedies that contain decongestants can cause the following side effects in some patients:
If the following effects occur after taking any form of cold and cough combination medicine, seek medical advice immediately:
Cold and cough combination remedies that contain antihistamine or anticholinergics can cause the following side effects in some patients:
Cold and cough combination remedies that contain iodide can cause the following side effects in some patients:
Cold and cough combination remedies that contain acetaminophen can cause the following side effects in some patients:
Some side effects will resolve themselves after a short time and do not generally need further medical intervention. Not all of the side effects mentioned above and further in this guide will affect everyone using cold and cough combination medication. If you do notice any adverse effects when you begin taking your chosen medicine, it is advisable to check with your pharmacist or GP as there may be another product that will suit you better.
In rare cases, patients using certain types of cold and cough combo medications can suffer from a very severe and potentially dangerous allergic reaction called anaphylaxis. The symptoms of anaphylaxis usually manifest themselves within a few minutes of the person taking the drug. If a person goes into 'anaphylactic shock', they may begin to complain of a tingling sensation in their mouth or on their tongue. They may have difficulty breathing or swallowing. In extreme cases, the person may become unconscious or begin to have seizures. If someone in your care suffers anaphylactic shock, you must summon emergency medical help immediately by calling 911.
If you are taking the medicine in order to loosen phlegm or mucus from your chest, you should have a drink of water following every dose of the product, unless you are told to do otherwise by your GP.
You should take your chosen medicine as per the instructions on the product label or as per your GP's directions. Do not take more of the medicine than you are supposed to, or you could risk suffering from more side effects.
Non-prescription medicines for colds and coughs are not suitable for babies and very young children and could actually be life-threatening.
The range of these types of medications can be mind-boggling. It is very important that you understand exactly what you are taking. If you choose the wrong kind of medicine, it might not be effective, and it could even make your condition worse. Always ask your pharmacist for help if you're not sure which product to buy.
Extended release tablet or capsule:
Extended release oral solution/suspension:
Antihistamine and/or salicylate or aspirin
If your medicine contains aspirin and smells odd (like vinegar), do not use it. The smell could indicate that the medication has 'gone off'. If you are not sure whether your medicine is safe to use, ask your pharmacist or GP.
If you forget to take your medicine, try to take the dose as quickly as you can. If it is nearly time for the scheduled dose, miss it out and revert to your usual dosing regimen. Do not take twice the dose.
You should not usually need to take cold and cough combination medicines for more than a week before you begin to see an improvement in your condition. However, if your cough proves to be very stubborn and will not shift or you begin to cough up thick yellow or greenish material, you should consult your GP for more advice.
If you begin to notice pain in your back when you inhale deeply, or if you experience a 'crackling, sensation when you breathe in, you may be developing a chest infection, which could be a serious complication. Seek medical attention as a matter or urgency.
There are some types of medicine that you should never use at the same time, as to do so may cause an interaction to occur. However, your GP may suggest that you do use more than one drug at the same time, regardless of potential interactions. If you are taking any of the cold and cough combination remedies listed below, you must tell your GP in the event that you are prescribed any other form of medication.
In the case of the following products, your treating physician might elect to withdraw one of the medicines or change the dose:
It certain cases, it may cause an interaction if you eat certain foodstuffs, drink alcohol, or use tobacco when you are taking certain cold and cough combination medicines. Be sure to have a talk to your GP about how your lifestyle choices could affect your use of the medicine.
You try to moderate or cut out altogether your intake of grapefruit juice, ethanol, and tobacco when using cold and cough combination medication. Alternatively, your GP may give you instructions on how to safely use these items together with your medicine.
If you have ever had an allergic or other strange response to any form of cold or cough remedy, or to any other type of drug, you must tell your pharmacist or GP before you start taking the medicine. You should also mention unusual reactions that you may have experienced to food colors, animal derivatives, food preservatives, vitamins, and herbal drugs.
You should not give any form of cold or cough medicine to very young children without consulting your GP or pharmacist first. Some of these drugs are far too potent for children and the effects could be life-threatening:
Elderly people are often more sensitive to cold and cough combination medicines:
Using cold and cough combination medicines does not usually cause a problem for unborn or newborn babies. However, you should not use these medicines for long periods of time or at high doses, as this could cause problems.
Some of the components of cold and cough combinations can pass through into breast milk and thus into a nursing infant. Acetaminophen, caffeine, and alcohol do pass into breast milk, but do not usually cause problems for nursing babies as the amounts are relatively small.
Antihistamine does pass into breast milk, and even small amounts can cause side effects, including irritability and overexcitement in the nursing infant. This drug can also mean a greatly reduced flow of milk in some people, so the baby may not receive the nutrition it needs, resulting in poor growth rates.
The narcotic substances that are contained in some cold and cough preparations generally include codeine. Codeine is synthesized by the body to form morphine, at different rates in different people. If a woman who is breastfeeding metabolizes morphine particularly quickly, there is a risk that a nursing infant could ingest an overdose of morphine. This will cause serious side effects in the child, potentially killing it. If you are breastfeeding, discuss the safe use of cold and cough combination medicines before you begin using them. It may be safer for your baby not to use this kind of medication, unless you are prepared to use an alternative feeding method while you are taking the medicine.
Pseudoephedrine, salicylates, and ephedrine do pass into breast milk and can cause nasty effects in nursing infants, especially in premature or newborn babies. Iodides can cause a nursing baby to develop underactive thyroid.
Some pre-existing or historical health conditions can affect how your body reacts to cold and cough medications. You must tell your doctor or pharmacist if you have any existing health problems, before you start using non-prescription cough and cold combination medicines.
Medicines that contain acetaminophen can cause in an increased likelihood of liver problems, especially if taken by someone who is an alcoholic. This is because some of the liquid form medications contain relatively large quantities of alcohol.
The following conditions can be made worse by taking a medicine that contains salicylate or aspirin:
Medications containing dihydrocodeine, codeine, hydromorphone, or hydrocodone can worsen all of the following conditions:
In children who suffer from cystic fibrosis, the side effects that can be caused by iodinated glycerol are much more likely to occur.
Some decongestant medicines may present a greater danger of blood vessel or heart disease to diabetes mellitus sufferers.
Medicines that contain salicylate or aspirin can cause a serious allergic reaction in people who have chronic lung diseases, asthma, or emphysema. This reaction makes breathing more problematic.
Some cough and cold combination medicines that contain antihistamines or anticholinergics can exacerbate problems such as enlarged prostate, difficult urination, and urinary tract blockage.
Patients suffering from glaucoma may find that medicines containing antihistamines or anticholinergics can cause an increase in the pressure in the inner eye, potentially making this condition worse.
Some medicines with a decongestant content can cause the heart rate and blood pressure to increase. Caffeine can have a similar effect. For these reasons, blood vessel conditions, hypertension, and heart diseases can be made worse by these types of cold and cough combinations.
Patients who suffer from kidney problems should use this medication with caution, because these conditions can cause a build-up of medicine in the body, raising the chance of side effects.
Patients who have liver conditions should use cold and cough combination drugs with care. This is because liver disease may slow down the removal of the drug from the body, potentially causing an overdose to occur. In people who have severe liver problems, medication that contains aspirin can cause an increased risk of bleeding.
Cold and cough medicines that have aspirin, narcotic antitussive, salicylates, and iodides should really not be used by people who have overactive thyroid diseases. This is because the medication could cause the heart to beat even faster, and it could also make these conditions worse.
All cold and cough combination medications should be kept out of the reach of children and pets. Some cough syrups contain sugar and flavorings that could make them appealing to children. Many of the drugs that come in capsule or tablet form can look like candy, and even the powders can be mistaken for sherbet. Much of the content of these medicines is highly toxic to pets, especially cats and can cause fatal side effects. If you think that your pet has eaten any of your cough and cold medicine, contact your emergency vet immediately.
Cold and cough medicines are not suitable for freezing and should not be kept in the fridge. Keep your medicines in an airtight container at room temperature. Place your drugs in a dark cupboard, out of direct sunlight and away from sources of heat and moisture.
When you are better and you no longer need the medicine, do not keep it. If you discover that your medicine is out of date, you should return it to the pharmacy and ask for a replacement.
It is important to dispose of any unused or out of date medication responsibly. Do not tip syrup down the sink or flush it away down the toilet. Wrap unused medicines in a sealed bag and place them in your trash where they cannot easily be got at by children or animals.
Cold and cough combination drugs are designed to give relief to people who are suffering the effects of the common cold, influenza, and hay fever where a cough is one of the symptoms. Although these products can be very effective in helping to control the annoying cough that often accompanies these complaints, they are no use for a cough that generates large amounts of phlegm or mucus, or to treat the symptoms of emphysema or asthma.
Combination cough and cold medications can contain several different active elements, including, antihistamine, analgesics, expectorant, antitussive, anticholinergic, and decongestant. Not surprisingly, there are a wide range of potential side effects that can occur, depending on the nature of the product you have chosen to use. There is also a long list of drugs that it is not prudent to use in tandem with many of these over the counter cold and cough remedies, because of the interactions that might occur. There are many health conditions that can be adversely affected or made worse by using certain of the group of cold and cough drugs.
Medicines that are designed to treat coughs come in many different forms, including syrup, tablets, capsules, powders for making into a solution, and lozenges. In addition, there are a great many different brands of cold and cough medicines, and the choice can be somewhat confusing if you are already taking medication for another condition. For these reasons, it is extremely important that you ask your pharmacist or GP for guidance when choosing it comes to choosing a suitable product.
Many of the components of combination cold and cough medicines can potentially cause harm to a fetus or newborn baby, and can also pass into breast milk. Pregnant women and nursing mothers should ask the advice of their midwife or GP before taking any non-prescription medications such as these.
It is not advised to use over the counter cold and cough combination drugs for young children, as many of the preparations are very potent and could potentially be very harmful. If you have concerns that your child is not recovering from a cold or cough, you should ask your doctor's advice, rather than going down the self-treatment route.