Educate Patients About Cough and Cold Product Ingredients

A variety of respiratory illnesses continuously circulate.¹ Patients likely have questions and concerns about OTC cough and cold products to manage their symptoms. Health care professionals can educate patients about selecting appropriate OTC cough and cold medications.

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It is important to educate patients to read the drug facts label.₂ This provides key information about ingredients contained in the products, along with the dosage instructions.² This is also important to prevent doubling up on OTC medications with the same ingredients that could lead to an overdose.

Expectorants can alleviate symptoms of a productive cough in adults and children. Guaifenesin is found in a variety of products such as Mucinex (Reckitt) and Robitussin (Haleon). Diabetic Tussin is sugar free and could be a good option for patients with diabetes.

Some expectorant products also contain the cough suppressant dextromethorphan. Products that contain dextromethorphan can help manage dry cough symptoms; examples include Delsym (Reckitt) and Robitussin DM. Dextromethorphan is found in more than 120 cough and cold products.³ Although dextromethorphan is safe when used appropriately, educating patients about its potential for abuse is important. Taking too much dextromethorphan can cause serious adverse effects such as hallucinations, dizziness, and coordination problems.³

Decongestants may help relieve congestion, and medications include oral and intranasal options. Pseudoephedrine is a common oral decongestant found behind the pharmacy counter. Because pseudoephedrine can raise blood pressure, it should be avoided in patients with hypertension that is not well controlled.⁴

In September 2023, the FDA recommended that oral phenylephrine be avoided because these products are ineffective.⁵ Although there are no safety issues with phenylephrine, it is a good idea for patients to check the drug facts label of their oral cough and cold products to make sure there is no phenylephrine. This does not affect the phenylephrine nasal spray, which is considered effective.⁵

References

1. Protect yourself and others from flu, COVID-19, and RSV. CDC. Accessed March 13, 2024. https://www.cdc.gov/respiratory-viruses/index.html

2. OTC drug facts label. FDA. Updated June 5, 2015. Accessed March 13, 2024. https://www.fda.gov/drugs/information-consumers-and-patients-drugs/otc-drug-facts-label

3. Coughs and colds: medicines or home remedies? Healthychildren.org. Updated December 2, 2022. Accessed March 13, 2024. https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/Coughs-and-Colds-Medicines-or-Home-Remedies.aspx

4. Dextromethorphan abuse. National Capital Poison Center. Accessed March 13, 2024. https://www.poison.org/articles/dextromethorphan

5. FDA clarifies results of recent advisory committee meeting on oral phenylephrine. FDA. September 14, 2023. Accessed March 13, 2024. https://www.fda.gov/drugs/drug-safety-and-availability/fda-clarifies-results-recent-advisory-committee-meeting-oral-phenylephrine