Munson Health
 
Medications for Viral Upper Respiratory Infections (Colds and Influenza)

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by Polsdorfer R
 
The information provided here is meant to give you a general idea about each of the medicines listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions.
Use each of these medicines as recommended by your doctor or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.
Only influenza can be specifically treated with antiviral medicine, and those medicines should be used only in serious cases because they may have unwanted side effects. Most people with the flu do not need antiviral medicine. If you have the flu, check with your doctor to see if you need antiviral medicine. You will need it if you are in a high-risk group or if you have a severe illness (like breathing problems).
In general, uncomplicated influenza and the common cold should not be treated with antibiotics for several reasons:
  • Antibiotics, though generally safe, have side effects and are not as harmless as the common cold.
  • Antibiotics do not cure influenza or the common cold since both are caused by viruses; they only work against bacterial infections.
  • Misuse and overuse of antibiotics has caused a worldwide crisis—the emergence of resistant bacteria. Some infections are now resistant to every known antibiotic.
On the other hand, many over-the-counter (OTC) remedies are available to help minimize your symptoms. If the treatments recommended under lifestyle changes , such as a warm baths and humidified air, aren't enough, these OTC products may help you through the worst of the illness.

Over-the-counter Medications

  • Pseudoephedrine
  • Phenylephrine
  • Naphazoline
  • Oxymetazoline
  • Diphenhydramine
  • Chlorpheniramine
  • Brompheniramine
  • Loratadine
  • Acetaminophen
  • Ibuprofen
  • Guaifenesin
  • Dextromethorphan
  • Codeine

Prescription Medications

Over-the-counter Medications

With each type of OTC medicine, the active ingredients are listed. There are many brand name preparations for each of these active ingredients. Only a few brand names are listed here, but be aware that there are other brands to choose from. Read labels and look for the active ingredients when choosing a product.
The Food and Drug Administration (FDA) recommends that OTC cough and cold products should not be used to treat infants or children less than two years old and supports not using them in children less than four years old. Rare but serious side effects have been reported, including death, convulsions, rapid heart rates, and decreased levels of consciousness. OTC cough and cold products include decongestants, expectorants, antihistamines, and antitussives (cough suppressants). The FDA is still reviewing data concerning the safety of these products in children aged 2-11 years. There have been serious side effects reported in this age group as well.
  Pain Relievers and Fever Reducers
  • Acetaminophen
  • Ibuprofen
These drugs reduce both pain and fever. A combination of acetaminophen and ibuprofen may be more effective in reducing fever than acetaminophen alone. Talk to your doctor before combining medicine or giving medicine to your child. In some cases, fever reduction may not be beneficial, since fever helps fight off the infection.
Prescription pain relievers, like codeine, do not lower fever. Codeine also suppresses coughing.
Possible side effects of ibuprofen include:
  • Stomach irritation, ulceration, and bleeding
  • Allergic reactions
  • Kidney damage (very rare)
  • Liver damage (very rare)
Possible side effects of acetaminophen include:
  • Allergic reactions that damage blood cells or cause rashes
  • Taking too much can damage the liver or kidneys
 

References


Influenza antiviral medications. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm . Updated December 22, 2012. Accessed January 10, 2012.


Hulisz D. Efficacy of zinc against common cold viruses: An overview. J Am Pharm Assoc . 2004;44:594-603.


Influenza in adults. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated November 14, 2012. Accessed January 10, 2012.


Linde K, Barrett B, Wolkart K, Bauer R, Melchart D. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev . 2006;1:CD000530.


Prevention and control of influenza. MMWR . 2006;55(RR10):1-42.


Schroeder K, Fahey R. Systematic review of randomized controlled trials of over the counter cough medicines for acute cough in adults. BMJ . 2002;324:1-6.


What you should know about flu antiviral drugs. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/flu/pastseasons/1112season.htm . Updated December 22, 2012. Accessed January 10, 2012.


12/4/2007 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Lizogub VG, Riley DS, Heger M. Efficacy of a pelargonium sidoides preparation in patients with the common cold: a randomized, double blind, placebo-controlled clinical trial. Explore (NY) . 2007;3:573-584.


1/30/2008 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Public health advisory: Nonprescription cough and cold medicine use in children—FDA recommends that over-the-counter (OTC) cough and cold products not be used for infants and children under 2 years of age. US Food and Drug Administration website. Available at: http://www.fda.gov/cder/drug/advisory/cough%5Fcold%5F2008.htm . Accessed January 30, 2008.


1/30/2008 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Paul IM, Beiler J, McMonagle A, Shaffer ML, Duda L, Berlin CM Jr. Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents. Arch Pediatr Adolesc Med . 2007;161:1149-1153.


3/12/2008 DynaMed Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : 2008 safety alerts for drugs, biologics, medical devices, and dietary supplements: tamiflu (oseltamivir phosphate). US Food and Drug Administration website. Available at: http://www.fda.gov/medwatch/safety/2008/safety08.htm#Tamiflu . Accessed March 12, 2008.


10/13/2008 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Hay AD, Costelloe C, Redmond NM, et al. Paracetamol plus ibuprofen for the treatment of fever in children (PITCH): randomised controlled trial. BMJ . 2008;337:a1302.


11/9/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Shun-Shin M, Thompson M, Heneghan C, Perera R, Harnden A, Mant D. Neuraminidase inhibitors for treatment and prophylaxis of influenza in children: systematic review and meta-analysis of randomised controlled trials. BMJ. 2009;339:b3172.


11/12/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Smith S, Schroeder K, Fahey T. Over-the-counter (OTC) medications for acute cough in children and adults in ambulatory settings. Cochrane Database Syst Rev. 2010;(9):CD001831.


11/30/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : US Food and Drug Administration. Propoxyphene: withdrawal—risk of cardiac toxicity. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm234389.htm . Published November 19, 2010. Accessed November 30, 2010.

 

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