Analgesics | Antitussives | Expectorants | Oral Decongestants

Colds are caused by viruses; in fact, there are over 200 different viruses that cause colds. There are no medicines to cure colds. Antibiotics are only effective against bacteria, not viruses. However, there are a variety of products that may somewhat reduce cold symptoms. Many of these can be bought without a prescription. The main types of over-the-counter (OTC) cold medicines are reviewed here:

These medicines may help reduce your symptoms. However, see your doctor if you have any of the following:

  • High fever (temperature above 102ºF [39ºC]) , skin rash, or continuing headache
  • Symptoms lasting more than 10 days or getting worse instead of better
  • Shortness of breath
  • Feeling faint
  • Confusion or feeling disoriented
  • Earache or drainage from your ear
  • Severe pain in your face or forehead
  • Swollen glands in the neck or jaw

People with moderate to severe pulmonary or cardiac disease, such as asthma, chronic bronchitis, emphysema, angina, and hypertension, should consult with their doctor early in the course of their symptoms and before taking any medicine. Children should also be seen earlier in the course of their illness, especially if they are very young.

Analgesics

Analgesics relieve aches and pains and reduce fever.

Generic NameBrand Names
acetaminophenAceta, Actamin, Aminofen, Apacet, Aspirin Free Anacin, Aspirin-Free Excedrin, Banesin, Bayer Select, Dapa, Datril, Feverall, Genapap, Genebs, Liquiprin, Neopap, Oraphen-PD, Panadol, Phenaphen, Redutemp, Snaplets-FR, St. Joseph Aspirin-Free Fever Reducer, Suppap, Tapanol, Tempra, Tylenol, Valorin
aspirinAcuprin, Anacin, Ascriptin, Aspergum, Aspirin Regimen Bayer, Aspir-Low, Aspirtab, Bayer, Bufferin, Buffex, Buffinol, Cope, Easprin, Ecotrin, Empirin, Gensan, Halfprin, Healthprin, Magnaprin, Sloprin, St. Joseph Adult chewable Aspirin, ZORprin
ibuprofenAdvil, Dolgesic, Excedrin IB, Genpril, Haltran, Ibifon, Ibren, Ibu, Ibuprin, Ibuprohm, Medipren, Midol IB, Motrin, Nuprin, Pamprin-IB, Q-Profen, Rufen, Trendar
ketoprofenActron, Orudis, Oruvail
naproxenAleve, Anaprox, Naprelan, Naprosyn

Aspirin and non-steroidal anti-inflammatory drugs or NSAIDS (ibuprofen, ketoprofen, naproxen) inhibit the formation of certain prostaglandins. These are substances in the body that are involved in various processes including pain and body temperature. Acetaminophen probably works in a similar way, but it lacks the anti-inflammatory effects of NSAIDS.

Take analgesics with food and a glass of water to decrease the chance of stomach upset. Delayed-release and extended-release tablets have a special coating that makes them easier on the stomach.

Accidental Overdosage—Many OTC medicines as well as prescription painkillers contain acetaminophen (Tylenol). Although acetaminophen is quite safe when used as directed, when taken in excess it can cause liver damage. Make sure to read the labels and do not “double up” on acetaminophen.

Children and Teens—Aspirin is not recommended for children and teens with a current or recent viral infection. Check with your doctor before giving aspirin to a child or teen. Children can be given acetaminophen or ibuprofen.

Pregnancy—Acetaminophen is usually considered the safest pain and fever reducer to use during pregnancy. Do not take aspirin during pregnancy unless your doctor has ordered it.

Alcohol—If you will be taking more than an occasional one or two doses of acetaminophen, do not drink alcohol. Doing so may increase the chance of liver damage, especially if you drink large amounts of alcoholic beverages regularly, if you take more acetaminophen than is recommended on the package label, or if you take it regularly for a long time.

Certain Conditions—If you have any of the following conditions, check with your doctor before taking an analgesic:

Possible side effects of analgesics include:

Antitussives

Antitussive medicines (also called cough suppressants) are used to control coughing; however, there is limited evidence that they work.

The main nonprescription antitussive is dextromethorphan. Products made from this drug include:

  • Benylin
  • Cough-X
  • Creo-Terpin
  • Delsym
  • Diabe-TUSS DM
  • Hold DM
  • Pertussin
  • Robitussin
  • Sucrets Cough Suppressant
  • Trocal
  • Vicks Cough Relief

Dextromethorphan is thought to relieve cough by acting directly on the cough center in the brain to depress the cough reflex.

Antitussives should not be used for persistent or chronic cough that occurs with smoking, asthma, chronic bronchitis, or emphysema, or for cough accompanied by excessive mucus or phlegm.

Follow the dosage instructions on the product label or given by your doctor closely. In some cases, dextromethorphan can be habit forming.

If you have any of the following conditions, check with your doctor before taking an antitussive:

  • Asthma
  • Diabetes
  • Liver disease
  • Chronic bronchitis
  • Emphysema
  • Slowed breathing
  • Phenylketonuria
  • Pregnant

  • Nausea or other gastrointestinal upset
  • Slight drowsiness
  • Dizziness
  • Nervousness or restlessness

Expectorants

Expectorants are used to clear phlegm from the lungs. Phlegm is an abnormal production of mucus. However, there is limited evidence that they work.

The main non-prescription expectorant is guaifenesin. Products made from this drug include:

  • Anti-Tuss
  • Breonesin
  • Diabetic Tussin EX
  • Fenesin
  • Gee-Gee
  • Genatuss
  • GG-CEN
  • Glycotuss
  • Glytuss
  • Guiatuss
  • Halotussin
  • Humibid
  • Hytuss
  • Naldecon Senior EX
  • Organidin NR
  • Pneumomist
  • Robitussin
  • Scot-tussin Expectorant
  • Sinumist-SR
  • Touro EX
  • Uni-tussin

Guaifenesin is though to increase respiratory tract fluid, which in turn should reduce the thickness of phlegm in the lungs and enable it to be cleared more easily.

Drink plenty of water while taking guaifenesin to help loosen phlegm in the lungs.

If you are pregnant or breastfeeding, check with your doctor before taking an oral decongestant.

  • Nausea and/or vomiting
  • Diarrhea
  • Dizziness
  • Headaches
  • Rash

Oral Decongestants

These drugs help to reduce congestion.

A common decongestant that is available over the counter is pseudoephedrine. Products that contain this ingredient include:

  • Cenafed
  • Chlor-Trimeton Non-Drowsy Decongestant
  • Decofed
  • Dimetapp
  • Drixoral
  • Efidac/24
  • Genaphed
  • Myfedrine
  • PediaCare Infants' Oral Decongestant Drops
  • Pseudo 60's
  • Sudafed
  • Triaminic

Oral decongestants treat cold symptoms (but not the cold itself) by narrowing the blood vessels in the nasal passages.

Follow the dosage instructions on the product label or given by your doctor closely.

If you have any of the following conditions, check with your doctor before taking an oral decongestant:

  • Nervousness
  • Excitability
  • Restlessness
  • Racing heart
  • Tremulousness
  • Dizziness
  • Weakness
  • Trouble sleeping

To avoid sleeping difficulties, take the last dose of decongestant several hours before bedtime.

With every medicine, there are important precautions to consider. These include allergies, interactions with other drugs and medical conditions, and safety during pregnancy, lactation, and other stages of life.