- 12 FAQs: Cold and Flu Medications
- Can you take Mucinex and Sudafed
- Mucinex and Sudafed 12-Hour Drug Interactions
- How does Mucinex and Sudafed work in the body
- Can You Take Mucinex And Sudafed Together?
- Mayo Clinic Q and A: Decongestants sometimes cause more harm than good
12 FAQs: Cold and Flu Medications
- Can I use medications after they expire?
- What medications can I take for a cold?
- What can I take for a sore throat?
- What is the best remedy for earaches?
- What can I take for a cold when pregnant?
- What cough medication can I take while pregnant?
- What can I take for cold and flu while breastfeeding?
- What symptoms does Delsym treat?
- Can I take Mucinex DM and Sudafed at the same time?
- What can I take for a cold if I have bad reactions to Benadryl?
- What can I take for fever if I have arthritis?
- Which allergy medicine is best for cough?
Q: Can I take over-the-counter cold medicine past its expiration date?
A: Ideally, you should not take cold medicines or other medications past their expiration dates because the potency of the medication decreases over time, making it ineffective. Some medications can even turn into dangerous compounds when they degrade, so it is best not to take them after they’ve expired.
Q: What over-the-counter medications can I take for a cold?
A: Finding the cold medicine that will work best for you depends on the symptoms you are experiencing. Generally, it’s a good idea to use medicines aimed at your specific symptoms, rather than an “all-in-one” cold medicine. This can help avoid side effects from medicines that you may not need. It can also let you use different products to suit your lifestyle needs.
Symptoms of nasal or sinus congestion typically respond best to decongestants that can help open up airways and restore normal breathing. However, decongestants (such as pseudoephedrine) can cause jitteriness that many people don’t like and that can be dangerous for people with medical conditions, such as high blood pressure or heart disease. Talk to your doctor before using a decongestant if you have a chronic medical condition. Antihistamines (such as diphenhydramine or doxylamine) are more useful for cold symptoms such as runny nose, sneezing, and watery eyes. But, antihistamines often cause drowsiness which can be a problem during the day.
Over-the-counter pain relievers are available to treat the aches and pains that can come along with colds. Cough medicines can help relieve any cough symptoms you may have. Dry, non-productive (no mucus) coughs will benefit from a cough suppressant (dextromethorphan), while a productive, wet cough is best treated with an expectorant (guaifenesin). Nasal sprays are another option for treating cold symptoms and work quickly to clear nasal passageways. Medicated nasal sprays should not be used for more than three days because of the risk of a rebound effect, which can lead to more congestion. Saline nasal sprays can also help clear nasal congestion. Although they work slower, there is no risk of a rebound effect with saline sprays.
As you can see, there is no one perfect cold remedy. They all have advantages and disadvantages. You may need to try a few different remedies to find the one that is right for you. You may also find that you can use one remedy at night, but you need a different one to get you through the day.
Q: Is there an over-the-counter medication that I can buy at a local drug store for a sore throat?
A: A sore throat, also called pharyngitis, is a painful inflammation of the pharynx – the back portion of the throat that includes the back third of the tongue, the soft palate (roof of the mouth), and the tonsils (fleshy tissue that are part of the throat’s immune defenses). The most common cause of sore throat is infection from bacteria or a virus. A bacterial infection should be diagnosed by your health care provider and treated with antibiotics.
Because antibiotics don’t work against viruses, viral pharyngitis usually is handled by treating the symptoms so that you feel more comfortable until your body’s immune system defeats the infection. These measures can include taking ibuprofen (Advil, Motrin), acetaminophen (Tylenol), or aspirin (adults only) to relieve throat pain; gargling with warm, salty water to ease throat pain; drinking warm liquids (tea or broth) or cool liquids or eating gelatin desserts or flavored ices to soothe the throat; using a cool mist vaporizer to relieve throat dryness; and using nonprescription throat lozenges (with or without zinc) or anesthetic throat sprays.
Always read and follow the complete directions and warnings on over-the-counter medications and discuss their use with your health care provider before taking them. Patients with certain medical conditions may not be able to take certain over-the-counter pain relievers. Contact your health care provider for sore throats lasting longer than one week. You can find more information at http://www.everydayhealth.com/health-information/sore-throat-pharyngitis-what-is-it.aspx.
Q: I’m looking for a home remedy for earaches and ear infections. Do you know of any?
A: Ear pain can have various causes, including a cold, an infection, or possibly both. Treatment of ear pain is based on the cause. If you’re experiencing ear pain, it’s important to contact your health care provider. Based on a description of your symptoms and physical examination of the ear, your doctor can determine the cause and the best treatment option.
Q: What drugs are good to take when you are pregnant for a cold, rash, head/body aches, etc.?
A: Whenever possible, avoid using pharmaceuticals during pregnancy. Alternate therapy such as humidifier, saline nasal spray, or Breathe Right Strips should be used first. Generally, it is not safe to use over-the-counter medications unless supervised by a physician. If a pharmaceutical agent is needed, avoid using it during the first trimester.
Risk levels are categorized as A, B, C, D, and X. Category A is the safest and X is absolute contraindication. For the treatment of pain, headache, and fever, acetaminophen is the safest and has a Category B labeling. Avoid ibuprofen in the third trimester because it is a Category D. As an antihistamine for allergies, rash, and runny nose, doxylamine is in Category A, but it has some side effects, such as drowsiness, dry mouth, and urinary hesitation. Antihistamines with fewer side effects and classified as Category B are cetirizine (Zyrtec) and loratidine (Claritin). To treat cough, Robitussin DM, which contains dextromethorphan and guaifenesin, has Category C labeling. Decongestants such as pseudoephedrine and phenylephrine are also in Category C.
The physician and the patient must consider the risk versus the benefit when considering the use of these medications. Category C means animal studies show some adverse effects on the fetus, but no human data is available. You can find more information at http://www.everydayhealth.com/drugs.
Q: I am eight months pregnant and have a dry, severe cough. Is there a safe antitussive medication I can take?
A: Two of the most common medications that are available in over the counter cough suppressants are guaifenesin and dextromethorphan. Both of these medications are classified as pregnancy category C, which means that there may be some risk if taking when pregnant. Therefore, you may want to talk to your physician or OB/GYN to determine which treatment is appropriate and safe for you. Also, since you describe your cough as severe, you may want to be evaluated by your physician to determine if you have an infection or other medical condition that is causing your cough.
When choosing a medication, there are various patient specific factors that need to be considered. These factors include other medications you may be taking, other medical conditions you may have, any drug allergies you have and any other pertinent medical information. Due to the complexity of this decision making process, your physician is best able to make specific medication recommendations. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Jen Marsico, RPh
Q: What can I take for colds and flu while breastfeeding that will not harm my son?
A: There are few studies on the use of medications while breastfeeding. However, it is known that if a drug passes into breast milk, it does so at about 1/10th the concentration of it in the mother. Many over-the-counter cold and flu preparations contain drugs that are often given to infants and children, such as acetaminophen, ibuprofen, diphenhydramine, and guaifenesin. It is generally recommended to only use the products you need for the symptoms that you have instead of using a combination product that may contain unnecessary ingredients for your symptoms. Also, avoid products with a high alcohol content. Based on your individual symptoms and current medical and prescription history, your doctor or pharmacist can help recommend an appropriate product.
Q: What other symptoms does Delsym treat? Can you tell me if it helps head colds and sore throats?
A: Delsym (dextromethorphan) is a cough suppressant that dulls the cough reflex to help reduce coughing. It is used to treat a dry cough caused by seasonal allergies, the common cold, upper respiratory tract infections, sinusitis, bronchitis, or sore throat. Cough suppressants should not be used for productive or wet coughs that are bringing up mucus. Delsym will not treat other symptoms of a cold or sore throat.
Cold symptoms can be relieved with medications targeted at the specific symptoms. Antihistamines, such as diphenhydramine or chlorpheniramine, are used to treat cold symptoms including itchy or watery eyes, sneezing, and runny or itchy nose. Nasal congestion can be treated with decongestants, such as pseudoephedrine or phenylephrine. There are a variety of remedies for soothing a sore throat, including throat lozenges, throat sprays, drinking hot beverages, using humidifiers, and warm salt water gargles. Consult your doctor for any cold symptoms, including cough, that last more than 10 days. Always read and follow the complete directions and warnings on over-the-counter medicines and discuss their use with your doctor before taking them. For more specific information, consult with your doctor or local pharmacist for guidance based on your health status and current medications, particularly before taking any action. Sarah Lewis, PharmD
Q: Can I take Mucinex DM and Sudafed at the same time?
A: Mucinex DM contains guaifenesin and dextromethorphan. Guaifenesin is an expectorant which helps to thin mucous and make it easier to cough it up and out of the airways. Dextromethorphan is a cough suppressant which works to block the cough reflex. These drugs are generally well tolerated; occasional side effects include drowsiness, dizziness, and upset stomach. Sudafed contains pseudoephedrine, a decongestant. Sudafed works to reduce swelling in the nose by constricting blood vessels, making it is easier for you to breath. The common side effects of these medications are nervousness, dizziness, and an inability to sleep. Heart palpitations and high blood pressure are also possible. Sudafed is generally used during the day, because it can affect sleep. There are no interactions between these two over the counter products and they can be safely taken together.
However, if you choose a combination product, check all ingredients to make sure there is no overlap of the same ingredients. For example, there is also a Mucinex D product available that contains guaifenesin and pseudoephedrine. The use of Sudafed with Mucinex D would results in too much pseudoephedrine and an increased risk of dangerous side effects. If you have questions or need assistance picking a specific product, please consult your local pharmacist or other healthcare provider. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Michelle McDermott, PharmD
Q: What can a person take for a cold if they have very bad reactions to Benadryl? Most cold medicines have this product in them.
A: There are many different formulations of cold products, and one should be selected based on symptoms. Cold medications are generally made up of different combinations of a pain reliever/fever reducer, nasal decongestant, cough suppressant, expectorant, and antihistamine. It is recommended that you check the packaging for a list of ingredients on a product that will provide relief for your symptoms. Choose one that does not list Benadryl (diphenhydramine) as an ingredient. Typically, the daytime products will not contain Benadryl, since one side effect of Benadryl is drowsiness. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Megan Uehara, PharmD
Q: What are reliable drugs for fever and arthritis?
A: Fever is defined as an increase in the temperature of the body outside of the normal range. There are variances in people and their body temperature, but generally a fever is defined as a temperature greater than 99 degrees Fahrenheit in the morning or greater than 100 degrees Fahrenheit at anytime of the day. The treatment for fever includes staying well hydrated with water or fruit juices. Staying hydrated helps to prevent dehydration and helps to cool down the body. It is also recommended to eat foods that are easy to digest and that are light. Getting plenty of rest can also be beneficial.
There is some controversy on whether a fever should be treated if it is not severe. Medications sold over the counter that are used for the treatment of fever include: Tylenol (acetaminophen), Motrin (ibuprofen) and aspirin. If you choose to use one of these products, make sure to read and follow the directions on the label carefully. As with any medication, fever-reducing drugs have possible side effects, risks, and warnings associated with their use. For example, aspirin should not be used in patients that are less than 16 years of age due to the risk of developing Reye’s syndrome. The recommendation is to talk to your physician or pharmacist to determine what fever reducing medication is appropriate for you. When selecting a specific medication to treat a medical condition, there are many variables involved with this decision such as the patient’s condition, other medical conditions the patient has, other medications the patient is taking, any drug allergies the patient has, etc. Your health care provider has access to your personal medical information and is best able to make that decision.
Q: Which allergy medicine is best for cough?
A: Allergies tend to produce nasal congestion and a runny nose. Coughs as a result of allergies are generally caused by the nasal mucous running down the back of the throat and irritating the throat. Thus, the first treatment option is generally to address the nasal issues. Allergies are usually treated with antihistamines because they work to prevent part of the allergic response that causes itching, sneezing, runny nose, and watery eyes.
There are two types of antihistamines. First-generation (older) antihistamines include brompheniramine, chlorpheniramine, dimenhydrinate, diphenhydramine, and doxylamine. These drugs can make you feel sleepy and make it difficult for you to think clearly. They can also cause dry mouth and abdominal pain. Second-generation (newer) antihistamines include loratadine and cetirizine, and they are much less likely to cause side effects, including drowsiness.
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Can you take Mucinex and Sudafed
Mucinex and Sudafed 12-Hour Drug Interactions
Mucinex is a Brand name for a medication containing guaifenesin as an active ingredient that is used as expectorant for relieving the symptoms of cough and mucus in the chest due to flu, colds or hay fever.
This drug reduces congestion in chest and makes coughs more productive by thinning mucus in the lungs and making it less sticky and easier to cough up.
For regular (short-acting) oral dosage forms usual doses are 100-400mg 3-4 times a day, and for extended-release dosage forms usual doses are 600 to 1200 mg two times a day. Mucinex works best when it is taken with plenty of water.
Other Brand names for preparations containing guaifenesin are: Bidex 400, Organidin NR, Antitussin, Guaifenex, Robitussin, Allfen, Altarussin and Amibid LA.
Sudafed is a Brand name for a medication containing pseudoephedrine as an active ingredient that is used as a decongestant for shrinking dilated blood vessels that can cause congestion in the nasal, sinus or ear (Eustachian tube) passages.
Sudafed is used for the temporary relief of stuffy nose and sinus pain/pressure caused by common cold, flu or other breathing illnesses such as allergies, hay fever or bronchitis.
For immediate release dosage forms, usual doses are: 30 to 60 mg orally every 4 to 6 hours, for sustained release dosage forms usual doses are 120 mg orally on every 12 hours and for the sustained release suspension usual doses are 45 to 100 mg orally every 12 hours.
There are many products on the market containing pseudoephedrine such as: Nasofed, Chlor Trimeton Nasal Decongestant, Contac Cold, Drixoral Decongestant Non-Drowsy, Elixsure Decongestant, Entex, Genaphed, Kid Kare Drops, Seudotabs, Silfedrine, Sudodrin, SudoGest, SudoGest 12 Hour, Suphedrin, Triaminic Softchews Allergy Congestion, Unifed.
How does Mucinex and Sudafed work in the body
Guaifenesin acts by reducing the viscosity and increasing the volume of secretions in the trachea and bronchi. By reducing the adhesiveness and viscosity of secretions, guaifenesin increases the mucociliary mechanism efficacy in removing secretions which has been accumulated in the upper and lower airways.
Studies have also shown that guaifenesin has muscle relaxant and anticonvulsant properties due to antagonism effects on NMDA receptors.
Pseudoephedrine is sympathomimetic amine with direct action on the adrenergic receptor system. The vasoconstriction is produced after α-adrenergic receptors activation that are located on the muscles lining of the walls of blood vessels.
The constricted blood vessels allow less fluid to leave the blood vessels and enter the nose, throat and sinuses, so results are: decreased inflammation of nasal membranes and decreased mucus production.
In bronchi, due to β2-adrenergic receptors activation, this substance can produce relaxation of smooth muscle, causing bronchial dilation and decreasing congestion and breathing difficulties.
Can patients take Mucinex and Sudafed together
Patients can take Mucinex and Sudafed together and there are many companies that produce these drugs as a combination into one pill (Ambifed-G, Despec-SR, Entex T, ExeFen-IR, Maxifed, Mucinex D, Mucinex D Max Strength, Poly-Vent IR, Respaire-30, Robitussin Severe Congestion, Sinutab Non Drying etc…).
Sudafed is a very good decongestant and Mucinex can help mucus to break up in nose sinuses or lungs, so if they are taken together, both can make higher efficacy in removing secretions which has been accumulated in the upper and lower airways.
However, patients should always look at the PIL (Patient Information Leaflet) and talk with their doctors first, before they combine these two medications.
Some of the Mucinex products already contain pseudoephedrine in the combination with guaifenesin like Mucinex D, or Mucinex D Max Strength and the same goes for Sudafed product such as Sudafed Non Drying Sinus. By mixing these products together patients may get too much of the same drugs and there is a high probability of side effects to occur.
Patients with heart or blood pressure issues should always talk with their doctors first before they take these drugs together! In these patients, pseudoephedrine’s sympathomimetic effects on the heart and blood vessels can make their symptoms far worse.
Patient should look for medical help if they experience some of the following symptoms: fast, irregular, pounding heartbeat, mental or mood changes like anxiety, confusion, restlessness, shaking, difficulty urinating, as well as swelling, and difficulty breathing.
The table below shows the incidence of side effects after Mucinex and Sudafed administration in recommendable doses. This Incidence can be significantly increased if these drugs are taken together.
|Frequency Not Defined||Tremor, Restlessness, Insomnia, Nausea, Vomiting, Nervousness, Atrial fibrillation, Hypertension, Myocardial infarction, Ventricular premature beats, Ischemic colitis, Rash, Itching, Hives.|
Special precautions and warnings during Mucinex and Sudafed administration:
- Patients shouldn’t use these medicines if they have used MAO inhibitors drugs such as furazolidone (Furoxone), phenelzine (Nardil), isocarboxazid (Marplan), selegiline (Eldepryl, Emsam, Zelapar), rasagiline (Azilect), or tranylcypromine (Parnate) in the last 14 days. Drug interactions can occur, leading to serious side effects.
- Patients should ask their doctor or pharmacist before using these products if they have: high blood pressure, some heart disease, diabetes or a thyroid disorder.
- Pregnant patients shouldn’t use these medications without medical advice. It is not known whether these drugs will harm an unborn baby. These medicines should not be used if mother is breast-feeding a baby.
- Sudafed may make patients dizzy. They should not drive, use machinery, or do any activity that requires alertness.
- Patients should also limit alcoholic beverages while using these drugs.
- Older patients can be more sensitive to the side effects after Sudafed administration, especially for: fast/irregular heartbeat, problems urinating, dizziness, confusion or trouble sleeping.
Children may be more sensitive to the restlessness side effect.
- Before taking products that contain pseudoephedrine, patients should tell their doctor or pharmacist if they are allergic them or if they have any other allergies. Also they should tell doctor if they ever had negative reactions to other sympathomimetics (for example ephedrine or phenylephrine). Inactive ingredients that can be found in these products can also cause allergic reactions or other problems.
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Tags: guaifenesin and pseudoephedrine
Can You Take Mucinex And Sudafed Together?
Mucinex (guaifenesin), a commonly used over the counter expectorant, can be safely taken in combination with Sudafed (pseudoephedrine), a nasal decongestant. There is no listed or reported interaction between the two medications. In fact, there are a variety of over the counter products that combine both ingredients into a single product for ease of administration.
Taking Mucinex With Sudafed
Mucinex (guaifenesin) is classified as an expectorant and mucolytic. It loosens and thins phlegm and bronchial secretions, which in turn helps to ease expectoration. The less viscous secretions, due to Mucinex use, helps to increase the efficiency of our “mucociliary clearance mechanism”, changing a dry, unproductive cough to a more productive one.
Sudafed (pseudoephedrine) is classified as a sympathomimetic nasal decongestant. It works by causing vasoconstriction, shrinking swollen nasal passages which helps to increase nasal airflow and reduce nasal congestion.
As mentioned above, Mucinex and Sudafed can be taken together and both are available in combination in a single product. Taking both Sudafed and Mucinex at the same time can often help to alleviate symptoms more than either product alone. In many cases, Sudafed can increases sinus drainage, potentially worsening chest congestion and post nasal drip. Combining Sudafed and Mucinex can help to reduce nasal congestion while also helping to relieve post nasal drip and chest congestion.
Examples of products that contain both Mucinex and Sudafed are:
- Mucinex-D 12 Hour
- Mucinex-D 24 Hour
- Sunmark Mucus Relief D
- Chest Congesion Relief D
You can feel safe using both Mucinex and Sudafed together, or using a single product that combines the two.
Dr. Brian Staiger Pharm.D
Dr. Brian Staiger is a licensed pharmacist in New York State and the founder of PharmacistAnswers.com. He graduated from the University At Buffalo with a Doctor of Pharmacy degree in 2010. He has been featured in numerous publications including the Huffington Post as well as a variety of health and pharmacy-related blogs. Please feel free to reach out to him directly if you have any inquiries or want to connect! He’s answered thousands of medication and pharmacy-related questions and he’s ready to answer yours! [email protected] Office: 716-389-3076
Mayo Clinic Q and A: Decongestants sometimes cause more harm than good
DEAR MAYO CLINIC: I’ve heard that nonprescription decongestants can have significant side effects. Is this true?
ANSWER: While many people rely on nasal decongestants to help ease symptoms of a cold or flu, these medications can sometimes cause more harm than good, especially if taken repeatedly. Examples of commonly used decongestants include phenylephrine and pseudoephedrine. Often, these ingredients are included in multi-symptom cold and flu preparations, such as Maximum Strength Mucinex D, Robitussin Multi-Symptom Cold, and Tylenol Sinus Congestion & Pain.
Taking a decongestant can temporarily ease congestion, but it can also create a slight increase in your blood pressure. If you already have high blood pressure, especially if it’s not controlled, this may be a concern. Decongestants also can interfere with the effectiveness of certain blood pressure medications. If you’re on blood pressure medication, check with your doctor or pharmacist before taking a nasal decongestant.
Extended-release decongestants may be less likely to raise blood pressure than the immediate-release kind but can still cause problems. People who have conditions such as diabetes, benign prostatic hyperplasia (BPH), ischemic heart problems, thyroid disorders, glaucoma and seizures generally should avoid using nasal decongestants.
In addition, using nonprescription decongestant nasal sprays (Afrin, Dristan, others) for more than three or four days can cause even worse nasal congestion once the decongestant wears off (rebound rhinitis). All too often, people think their colds are getting worse, so they increase their use of nasal spray, leading to a downward spiral of medication use and worsening congestion. Other occasional side effects of nasal sprays may include nosebleeds, agitation and insomnia.
Thankfully, symptoms usually last no more than a week and a half. If you have continued congestion, it may be time to visit your doctor to explore treatment options that may be more effective. (adapted from Mayo Clinic Health Letter) — Lisa Buss Preszler, Pharm.D., R.Ph., Mayo Clinic Pharmacy, Mayo Clinic, Rochester, Minn.