5 ms·

Phenylephrine has been the bane of people's existence for years. I have to constantly remind friends/family when they're complaining that their cold medicine di

Phenylephrine has been the bane of people's existence for years. I have to constantly remind friends/family when they're complaining that their cold medicine didn't help: "If you pulled it off the shelf yourself, it won't do anything. The kind with the active ingredient that actually works is behind the counter."

richardhod 8y ago
In general, cold medicines do not work. We cannot cure the cold viruses, only alleviate symptoms. Mostly, warmth, fluids and rest, and not spreading the cold to others is best advice, plus decongestants, which is what you're mostly being sold. Even so, people ask for antibiotics for many ailments where they are useless, and add to resistance instead.
- Silhouette 8y ago
  I had one of those experiences a while back where the conclusion is so obvious that you wonder how you hadn't worked it out many years earlier. I actually did rest and drink plenty of fluids when I had a horrible cold. I stayed in bed for most of the next 24 hours, sleeping when I could, at a comfortable room temperature and with a little ventilation. I made sure I drank several pints of water during that time, even though at first my sore throat was hurting every time I swallowed and I really didn't want to. One day later, a condition that had felt like it was going to give me at least another week of unpleasantness was already greatly improved. Not fully recovered, but much, much better, far beyond anything any cold remedy medication had ever done for me (though the real medicine did also help with decongestion and allowing enough comfort to fall asleep). It turns out that doctors have been right all along and it was just me not getting it, fooling myself into thinking that if I went to bed a bit early and had a few extra sips of water then I was following the doctors' advice.
  - kbutler 8y ago
    Post hoc ergo propter hoc. I took megadoses of vitamin C and my cold I was sure would knock me out for a week went away!
    - Silhouette 8y ago
      Post hoc ergo propter hoc. Except that taking proper rest and fluids has consistently helped me to get over anything like colds ever since, and as far as I'm aware it is the only common factor that changed other than my age.
      - kbutler 8y ago
        I'm not saying you're wrong, and I agree that the data supports "rest and fluids". But I have relatives that make similar statements about lots of health treatments that are absolutely not supported by the data, and probably just demonstrate variability and placebo effect.
- freedomben 8y ago
  Strongly disagree. For many people a cold with congestion turns into a sinus infection if not treated with decongestants. Then you actually do need the antibiotics! It's dangerous to assume that just because the "cold medicine" doesn't attack the virus that it doesn't work.
  - GrinningFool 8y ago
    > many people a cold with congestion turns into a sinus infection if not treated with decongestants. Then you actually do need the antibiotics! This isn't strictly true either. An otherwise healthy person's body will take care of most sinus infections[1] itself given a little time and care. When it turns into something longer-term, that's when antibiotics may come into play. [1] And these can be bacterial or viral
    - Nursie 8y ago
      You know I'd rather not wait to find out if that infection is going to turn nasty and longer-term. Did once - burst an eardrum and had to take a while off work.
soylentcola 8y ago
It doesn't help that many people shop by brand names and not ingredients. When my SO has cold-type symptoms, I ask her specifically what they are so I can get the right thing. Otherwise she will just ask for "Mucinex" because it worked really well that one time. This ignores the fact that like all of the *Quils, Sudafeds, Tylenol Cold-Flu-and-Explosive-Diarrheas, and Robitussins, there are multiple preparations made from various ingredients. If I need an expectorant, I want guaifenesin. Cough suppressant: dextromethorphan. Decongestant: psuedoephedrine. Pain reliever: acetaminophen or ibuprofen or whatever. It also doesn't help that it's hard to find the specific mix you need in a single preparation but it's also gotten harder to find just single ingredient store brands of some of these as well. I don't want to take something I don't need so I'd rather not just buy some name brand kitchen-sink capsule that adds various decongestants or antihistamines if I don't need them. But then the same focus on brand names and basic descriptions can lead to people buying homeopathic sugar pills because they're in the same department and list similar symptoms. If you never shop by ingredient, you won't know that a 1000x diluted extract of duck liver isn't the same as pseudoephedrine and guaifenesin.
- unclenoriega 8y ago
  As a retail pharmacist, I agree this can be an annoying problem. I try to encourage single-ingredient generic products as much as possible. And yes, "brand extension" as they call it has rendered popular names like Mucinex and Robitussin useless or even downright harmful. I think many people just look for something with "severe cold" or whatever without even considering what's in it. It's not just patients either. Some OTC products are covered by some insurance plans. I've had prescribers change from one OTC product to another that shared none of its ingredients with the first. Not sure what they were treating other than "patient wants a prescription". And don't get me started on homeopathic products. I had a man come in once with the box of a homeopathic product looking to buy more for his wife. I looked around, showed him a similar product, and asked if this was OK. He said it was as long as it worked as well. That I could guarantee! I do try to dissuade such purchases, but when the customer comes in knowing what they want, it's often a losing battle. The one time homeopathic products can be useful is when someone just has to have something to treat their two-year-old's cold.

richardhod 8y ago

In general, cold medicines do not work. We cannot cure the cold viruses, only alleviate symptoms. Mostly, warmth, fluids and rest, and not spreading the cold to others is best advice, plus decongestants, which is what you're mostly being sold. Even so, people ask for antibiotics for many ailments where they are useless, and add to resistance instead.

Silhouette 8y ago
I had one of those experiences a while back where the conclusion is so obvious that you wonder how you hadn't worked it out many years earlier. I actually did rest and drink plenty of fluids when I had a horrible cold. I stayed in bed for most of the next 24 hours, sleeping when I could, at a comfortable room temperature and with a little ventilation. I made sure I drank several pints of water during that time, even though at first my sore throat was hurting every time I swallowed and I really didn't want to. One day later, a condition that had felt like it was going to give me at least another week of unpleasantness was already greatly improved. Not fully recovered, but much, much better, far beyond anything any cold remedy medication had ever done for me (though the real medicine did also help with decongestion and allowing enough comfort to fall asleep). It turns out that doctors have been right all along and it was just me not getting it, fooling myself into thinking that if I went to bed a bit early and had a few extra sips of water then I was following the doctors' advice.
- kbutler 8y ago
  Post hoc ergo propter hoc. I took megadoses of vitamin C and my cold I was sure would knock me out for a week went away!
  - Silhouette 8y ago
    Post hoc ergo propter hoc. Except that taking proper rest and fluids has consistently helped me to get over anything like colds ever since, and as far as I'm aware it is the only common factor that changed other than my age.
    - kbutler 8y ago
      I'm not saying you're wrong, and I agree that the data supports "rest and fluids". But I have relatives that make similar statements about lots of health treatments that are absolutely not supported by the data, and probably just demonstrate variability and placebo effect.
freedomben 8y ago
Strongly disagree. For many people a cold with congestion turns into a sinus infection if not treated with decongestants. Then you actually do need the antibiotics! It's dangerous to assume that just because the "cold medicine" doesn't attack the virus that it doesn't work.
- GrinningFool 8y ago
  > many people a cold with congestion turns into a sinus infection if not treated with decongestants. Then you actually do need the antibiotics! This isn't strictly true either. An otherwise healthy person's body will take care of most sinus infections[1] itself given a little time and care. When it turns into something longer-term, that's when antibiotics may come into play. [1] And these can be bacterial or viral
  - Nursie 8y ago
    You know I'd rather not wait to find out if that infection is going to turn nasty and longer-term. Did once - burst an eardrum and had to take a while off work.

soylentcola 8y ago

It doesn't help that many people shop by brand names and not ingredients. When my SO has cold-type symptoms, I ask her specifically what they are so I can get the right thing. Otherwise she will just ask for "Mucinex" because it worked really well that one time. This ignores the fact that like all of the *Quils, Sudafeds, Tylenol Cold-Flu-and-Explosive-Diarrheas, and Robitussins, there are multiple preparations made from various ingredients. If I need an expectorant, I want guaifenesin. Cough suppressant: dextromethorphan. Decongestant: psuedoephedrine. Pain reliever: acetaminophen or ibuprofen or whatever. It also doesn't help that it's hard to find the specific mix you need in a single preparation but it's also gotten harder to find just single ingredient store brands of some of these as well. I don't want to take something I don't need so I'd rather not just buy some name brand kitchen-sink capsule that adds various decongestants or antihistamines if I don't need them. But then the same focus on brand names and basic descriptions can lead to people buying homeopathic sugar pills because they're in the same department and list similar symptoms. If you never shop by ingredient, you won't know that a 1000x diluted extract of duck liver isn't the same as pseudoephedrine and guaifenesin.

unclenoriega 8y ago
As a retail pharmacist, I agree this can be an annoying problem. I try to encourage single-ingredient generic products as much as possible. And yes, "brand extension" as they call it has rendered popular names like Mucinex and Robitussin useless or even downright harmful. I think many people just look for something with "severe cold" or whatever without even considering what's in it. It's not just patients either. Some OTC products are covered by some insurance plans. I've had prescribers change from one OTC product to another that shared none of its ingredients with the first. Not sure what they were treating other than "patient wants a prescription". And don't get me started on homeopathic products. I had a man come in once with the box of a homeopathic product looking to buy more for his wife. I looked around, showed him a similar product, and asked if this was OK. He said it was as long as it worked as well. That I could guarantee! I do try to dissuade such purchases, but when the customer comes in knowing what they want, it's often a losing battle. The one time homeopathic products can be useful is when someone just has to have something to treat their two-year-old's cold.