Treatment over the counter: How to choose a safe cold and flu remedy at the drugstore

Pharmacist Shannon Neal poses for a photo at Broadway Prescription Shop in Cape Girardeau. (Glenn Landberg)

Now that cold and flu season has arrived, people often rove pharmacy aisles looking for over-the-counter (OTC) products that will offer relief from symptoms. The decision of which over-the-counter medication to take should be carefully considered, because there is always a chance of dangerous drug interactions for those who take prescription medications on a regular basis.

In addition to filling prescriptions, pharmacists are there to assist with making decisions about the best options for OTC products.

"The best way to know is always to go up to the pharmacist and ask for help," says Abe Funk, a pharmacist at John's Pharmacy in Cape Girardeau. "Explain your specific medical conditions and they should be able to direct you toward a medication that is most suitable for your needs. With cold and flu medications, there is not a 'one size fits all' approach to treatment."

Shannon Neal, a pharmacist at Broadway Prescription Shop, agrees.

"The general rule of thumb should be to talk to your pharmacist before taking any OTC medications," she says. "Seniors should definitely consider their symptoms as well as the prescription medications they are currently taking when deciding whether to take an OTC drug. People think just because a medication is OTC it is safe; however, they can be dangerous if not used properly."

Using the same pharmacy for all medications can be helpful.

"You should go to the pharmacy where you already get your prescription medications filled," Neal says. "This pharmacist will have a file of your current medications and be able to better help you understand what will be best for you. The pharmacist will be able to look at what you are already taking and advise if a certain over-the-counter product might cause a reaction or problems."

For example, some decongestants are likely to raise blood pressure, so those struggling with high blood pressure may want to avoid them.

There are a host of products that treat multiple symptoms and contain pain relievers, decongestants, antihistamine and cough suppressants together, but they may not all be necessary.

"Unless you need every ingredient in an OTC product, you should consider buying only the products you need to treat your target symptoms," Neal says. "If you don't have a headache or muscle aches, you don't need the pain reliever. You could take a decongestant and antihistamine separately. The same could be true if you don't have a cough. There's no need for a decongestant."

When shopping for groceries, people read the ingredient labels. It's important to do the same with OTC medications.

"Not only will they tell you how much and how often you should take a medication; they can warn of interactions and advise as to when you should see a doctor if your symptoms don't improve," Neal says.

Herbal and "all natural" remedies should be considered as medications, and also may interfere with the efficacy of prescription meds.

"It does not matter if it is over the counter, herbal or marketed as 'all natural,'" Funk says. "Each of these has side effects and could potentially harm the patient. They could potentially help the patient as well, and this is why professional help should be obtained to pair the treatment with the patient."

When treating cold or flu symptoms, it's important to stay hydrated, Funk adds.

"Many elderly patients do not drink enough to stay hydrated on a normal daily basis," he says. "When they get sick, it only exacerbates the dehydration, and this can lead to unwanted problems like dizziness and falls. The exception to this would be anyone with severe kidney or heart problems who have been put on a specific fluid restriction by their physician."

And not all drinks are created equal.

"It should also be noted that the fluid to intake would be water or maybe diluted Gatorade," says Funk. "Not soda, tea or coffee, all of which can actually dehydrate a person further."

When it comes to the flu, the adage "an ounce of prevention is worth a pound of cure" holds true.

"Most important for seniors this cold and flu season, get your flu vaccination," Neal says. "It's easier to prevent and illness than to treat it, so get that flu shot now if you haven't already to protect yourself."