Is your cold and flu medicine right for you?
With the rise and fall of rains and hot days that we are currently experiencing, the incidences of people getting sick with a runny/blocked nose, a condition known as the common cold also increase.
Symptoms commonly associated with the common cold include coughing possibly due to postnasal drip, nasal congestion, low-grade fever, and/or fatigue that would present 1-2 days after exposure to rhinovirus.
While colds can resolve on their own, many of us would often refer to our nearest pharmacy to get some over-the-counter medications as it helps to alleviate our overall symptoms and speeds up our recovery period. That said, you must have come across some pharmacists who, after understanding your symptoms, would give you an option to pick if you would prefer a sedating or non-sedating cold medicine. Do you know their key differences? Let's find out!
-
Antihistamines:
They generally work by blocking histamine (a chemical that your body makes in response to an allergen) that causes us to sneeze, itch, have water eyes and/or runny nose. While antihistamines won't cure the cold itself, they can help better manage these symptoms that may be exacerbated by histamine release during a cold. To date, there are 3 generations of antihistamines that have been used to relieve cold symptoms:
First-generation antihistamines
These antihistamines are the ones your pharmacists are referring to when they ask if you’d prefer a sedating cold medicine. They are often beneficial for when the cold symptoms are too severe that it disturb your sleep and thus are typically taken at night. For safety reasons, first-generation antihistamines are not recommended to be taken during daytime at work or when driving. Due to their shorter duration of action, first-generation antihistamines can be taken up to 3 times a day after food for the best therapeutic outcome.
-
Examples: chlorpheniramine (Piriton), diphenhydramine (Benadryl)
Second & Third generation antihistamines
Being a newer generation than the first, they are less sedating as they almost do not cross the blood-brain barrier. Since they’re more advanced and have a longer duration of action, second-generation antihistamines are only taken once a day after food.
Examples:
- Second gen - Loratadine (Clarityne), Desloratadine (Aerius), Cetrizine (Zyrtec), Levocetirizine (Xyzal)
- Third gen - Fexofenadine (Telfast), Bilastine (Bilaxten)
-
Decongestants:
Decongestants are especially useful if your cold is accompanied with nasal congestion as it provides relief by narrowing blood vessels in the nasal passages, which relieves the feeling of pressure and improves airflow through the nose. As oral OTC products, decongestants are normally combined with an antihistamine (ie: Loratadine + Pseudoephedrine) to address multiple symptoms. However, decongestants may not be appropriate for everyone, especially those with pre-existing hypertension as they may raise blood pressure
-
Examples: pseudoephedrine + loratadine (Clarinase), oxymetazoline (Oxynase)
-
Saline nasal spray:
Alternatively, a saline nasal spray would be your best bud if all the above have been tried and your nose is still blocked. It essentially helps to relieve nasal congestion by moistening and loosening mucus in the nasal passages hence facilitating breathing and may reduce stuffiness associated with colds.
Examples: Sterimar, Aqua Maris
Supplements that may help:
Since a common cold is often self-limiting, supplements that offer immune support can be taken together to further reduce the severity of symptoms and ensure a smoother recovery. Here are some commonly used supplements for colds:
- Zinc
Found in foods like beef, oysters, and eggs, zinc is a mineral that plays many important roles in the body, including immune support. As a mineral that is considered an essential nutrient for our normal physiological processes, studies have shown zinc to have proviral properties as it can inhibit the replication of cold viruses. Thus, taking zinc supplements can reduce the lengths of colds when taken within 24 hours after symptoms start. However, it's important to note that high doses of zinc can cause side effects like nausea and altered taste. - Elderberry
Promoted as Sambucol in the market, Elderberry is commonly used to treat symptoms related to colds. With its antioxidant and immune-modulating properties, elderberries are safe to be taken daily and even friendly for kids age 2 and above. - Echinacea
Probably the most common herbal supplement associated with the prevention and treatment of colds. Promoted as an immune-system stimulant, some studies suggested that echinacea help reduce severity and duration of cold symptoms, especially when taken at early onset of cold. - Vitamin D
Sometimes also referred to as the sunshine vitamin, taking adequate amounts of vitamin D may help lessen the severity of infections and possibly even prevent them. Emerging studies have shown that vitamin D protects against many respiratory tract infections as it aids in the function of immune cells that protect our body against pathogens. - Vitamin C
Being known for its long standing immune-boosting properties, regular supplementation of vitamin C has been said to decrease the duration of a cold.
Additional Ways to Support Immune Health
Taking supplements may help keep your immune health in check but by incorporating these helpful tips may provide additional supportive measures:
- Practice good hand-washing habits and techniques, such as washing your hands for at least 20 seconds after touching surfaces, before preparing food and eating, as well as before touching your face, eyes, nose, or mouth
- Stay hydrated at all times
- Always sneeze into your elbows or with a handkerchief to avoid passing the germs around
- Get adequate rest
- Exercise regularly
- Humidify air
- Avoid smoking and secondhand smoke
All in All
Just like any respiratory tract infections, common colds can usually heal on their own but the symptoms may be a nuisance. Therefore, the treatment options mentioned above are mainly to relieve your symptoms and potentially shorten your recovery period. It is also worth noting that these OTC medications are not approved for children aged 2 and below as their safety profiles are yet to be properly established. Parents can opt to use nasal aspiration or boost their babies' immune system when cold strikes.
This article is written by Janelle Leong, Bpharm(Hons) (DOC2US),
reviewed by Dr. Joshua Jude Solomon, MBBS (DOC2US)
References
-
https://www.verywellhealth.com/over-the-counter-cold-and-flu-medications-770618#toc-antihistamines
-
https://www.webmd.com/cold-and-flu/decongestants-antihistamines-cold
-
https://www.uspharmacist.com/article/the-common-cold-a-review-of-otc-options#:~:text=First%2Dgeneration%20antihistamines%20have%20been,such%20as%20decongestants%20and%20analgesics.
