Here Comes Cold and Flu Season

The severity of annual cold and flu season can be very unpredictable from year to year.

Each year, millions of individuals use the various nonprescription medications marketed for the management and treatment of symptoms that are generally associated with colds and influenza. Pharmacists can be indispensable resources in aiding patients in the selection and proper use of these products. For the management of mild to moderate common cold and influenza symptoms, nonprescription products include analgesics, anesthetics, antihistamines, antipyretics, antiseptics, cough suppressants, decongestants, and expectorants, available in multi-ingredient or single-entity formulations.

Recent Clinical Studies and New Products

Findings from 2 recently published studies predicted the impact of the 2021-2022 flu season. According to the results from one, there could be 100,000 to 400,000 more influenza hospitalizations in the 2021-2022 flu season compared with a typical season. But the investigators found that the predicted increase in those hospitalizations could be avoided if the percentage of Americans vaccinated against influenza increased from the typical 50% to 75%.¹ In the second study, investigators suggested that the 2021-2022 season could see a 20% increase in cases compared with a typical season and that children younger than age 2 would be particularly at risk for influenza because they are unlikely to have any previous exposure to the virus.² The results of both studies suggested that a flu season with high activity could be avoided if vaccination rates increased by 20% to 50% compared with those in a typical year.³

On November 1, 2021, Reckitt, the manufacturer of the OTC cold, cough, and influenza product Mucinex, announced the launch of a new product line called Mucinex InstaSoothe, which includes lozenges and spray designed to numb, relieve, and soothe sore throat pain. The new products are Mucinex InstaSoothe
Sore Throat + Cough Relief Lozenges, Mucinex InstaSoothe Sore Throat + Pain Relief Spray, and Mucinex InstaSoothe Sore Throat + Soothing Comfort Lozenges.⁴

To gain a better understanding about the impact of sore throat pain on patient quality of life, Reckitt conducted a random double opt-in survey of 2005 Americans between August 26 and August 30, 2021.

The results showed that sore throat pain is 1 of the top 3 most incapacitating symptoms, alongside fever and migraine. Despite this, 55% of individuals are most likely to “power through” a sore throat, meaning that they continue completing housework, going to school, running errands, and working while dealing with difficult sore throat pain.⁴

Conclusion

Prior to recommending any OTC cold and cough products, pharmacists should always screen for a patient’s allergy and medical history and medication profile
to check for possible contraindications or interactions. Individuals with medical conditions and/or who are taking other medications should always consult with their primary health care providers before using any nonprescription medications to ascertain appropriateness. During counseling, pharmacists should remind patients to read labels prior to self-administration and to check for expiration dates and ingredients, particularly if using multiple products, to avoid therapeutic duplications or excessive dosing. Pharmacists should also remind patients to adhere to the recommended administration guidelines, dosages, and duration of use.

Additionally, remind caregivers and parents to always read all labels prior to administering medications to children and use the calibrated drug measuring devices provided with the selected OTC products when administering liquid medications to ensure proper accuracy and dosage. Caregivers and parents should only give children those OTC products manufactured specifically for the pediatric population, and when in doubt regarding the appropriateness or dose of a medication should consult their pediatricians or pharmacists.

During counseling, pharmacists should stress the importance of obtaining an annual influenza vaccination, as well as suggest various nonpharmacologic measures that may provide relief of cold and influenza symptoms. These include humidifiers, nonmedicated nasal strips, saline nasal sprays, and vaporizers. Patients should also maintain adequate hydration and rest. Encourage patients to seek medical attention from their primary health care provider if a cough lasts more than 14 days, a fever is high, a sore throat persists, symptoms linger or worsen, or there are signs of infection. Study results have shown that the implementation of various preventive measures, such as avoiding direct contact with an individual with a cold or influenza, routine handwashing, and use of hand sanitizers when soap and water are not available, is effective for decreasing or preventing the transmission of colds and influenza.

Yvette C. Terrie, BSPharm, RPh, is a consulting pharmacist and a medical writer in Haymarket, Virginia.

References

1. Rettner R. Flu season will be bad this year, research predicts. LiveScience. September 1, 2021. Accessed November 3, 2021. https://www. livescience.com/flu-season-comeback-covid-2021-2022.html

2. Lee K, Jalal H, Raviotta JM, et al. Predicting the impact of low influenza activity in 2020 on population immunity and future influenza season in the United States. medRxiv. Preprint posted online August 30, 2021. doi:10.1101/2021.08.29.21262803

3. Krauland MG, Galloway DD, Raviotta JM, Zimmerman RK, Roberts MS. Agent-based investigation of the impact of low rates of influenza on next season influenza infections. medRxiv. Preprint posted online August 26, 2021. doi:10.1101/2021.08.18.21262185

4. Painful sore throats meet their match -Mucinex introduces Mucinex InstaSoothe, a new line of lozenges and spray to help fight against sore throat pain and irritation. News release. Mucinex. November 1, 2021. Accessed November 3, 2021. https://www.prnewswire.com/ news-releases/painful-sore-throats-meet-their-match-mucinex-introduces-mucinex-instasoothe-a-new-line-of-lozenges-and-spray-to-help-fight-against-sore-throat-pain-and-irritation-301412676.html