To keep people from using a common decongestant, pseudo-ephedrine, to make the illegal drug methamphetamine, federal law now
requires that cold remedies such as Sudafed and Contac be moved from shelves to behind the counter. You have to show identification
to buy them, and sign a logbook. Is it worth the hassle or should you try other options?
The drug choices
All decongestants reduce mucus production by constricting blood vessels in the nose. But some are safer or more effective
than others.
Try nasal products first. Drops and sprays, such as Neo-Synephrine and Afrin 12-Hour, work faster than oral decongestants and are less likely to cause
substantial side effects or drug interactions. But if used for more than about three days, they can cause rebound congestion,
or renewed stuffiness that’s worse than the original problem. Switch to oral decongestants if the congestion lasts longer
than a few days.
Opt for pseudoephedrine. To keep familiar brand names on the shelves, some manufacturers have substituted the decongestant phenylephrine for pseudoephedrine
in their products. But a recent review of the evidence, published in the Journal of Allergy and Clinical Immunology, concluded
that oral phenylephrine is unlikely to work. Our consultants say pseudoephedrine is clearly the better choice for most people
who need an oral decongestant. Check with your doctor before taking either ingredient if you have hypertension, heart disease,
diabetes, hyperthyoidism, or anxiety, or take other drugs.
A runny nose caused by a cold is best treated by an older antihistamine, such as chlorpheniramine (Chlor-Trimeton) or diphenhydramine
(Benadryl Allergy). But those drugs can cause drowsiness, so they’re useful mainly when you don’t need to be alert. The newer,
nondrowsy versions, such as loratadine (Claritin), won’t relieve a cold-related runny nose, although all antihistamines can
stem the drip from an allergy.
Relief without drugs
Whenever possible, try nondrug steps first for treating congestion caused by a cold:
- Elevate your head when lying down.
- Inhale steam from a hot shower, vaporizer, or kettle.
- Drink plenty of fluids, including chicken soup, which may help fight inflammation and the cold virus itself. See our chicken-soup taste tests (available to subscribers).
- Use a saline nasal rinse, sold in drugstores.
See your physician if symptoms last longer than two weeks or you have thick, colored mucus or more than a slight fever.
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Getting a chill might lead to sniffles after all
Being cold might make you more susceptible to catching a cold, an idea long dismissed as folklore. In a 2005 study, Welsh
scientists chilled half of the 180 volunteers by putting their feet in cold water for 20 minutes. Within days, 29 percent
of them caught colds vs. 9 percent of the others. In theory getting chilled may lead to colds by hampering the body’s immune
response. While the study wasn’t definitive, it adds a possible reason to stay warm in winter.
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