Safely Treat Your Cold
What cold medicine is right for me?
Winter is the time of year when you may find yourself browsing the medicine aisle in your local pharmacy searching for a preparation to treat cough and nasal decongestion associated with the common cold. You may be entering the flu season and wondering what you can do to avoid the flu or treat its symptoms. Learn more about the flu and by clicking here
Many cold preparations contain the warning that they should not be used if you are taking Parkinson’s medicine. What should your do?
There are general precautions to help you safely treat your cold without medicine interactions.
First, it is important to know what is included in cold preparations before selecting and buying a product for your cold. Because of potential side effects or medicine interactions, it’s a good idea to check with your doctor or pharmacist before taking a cold medicine. Over-the-counter cold preparations often contain a mixture of ingredients for specific needs. There are non-drowsy formulas, formulas to help you sleep, long-acting formulas, and formulas for coughs and the flu.
The most common ingredients are
- Cough suppressant
- Fever or pain relievers.
An antihistamine or allergy medicine reduces itching, inflammation, and allergy symptoms such as runny nose and watery eyes. A common antihistamine is diphenhydramine (found in Benadryl). Common side effects of some antihistamines, especially diphenhydramine, are sedation, cognitive changes, constipation, and dizziness.
Diphenhydramine can cause confusion and excessive daytime sleepiness, both of which worsen imbalance, affect driving, and increase falls.
Antihistamines can increase the sedation affect of drugs such as benzodiazepines- used for anxiety or as muscle relaxants-and increase the effect of blood-pressure drugs. Long-acting formulas offer longer cold relief, but a nighttime dose is more apt to cause early morning grogginess. Newer antihistamines such as loratadine (found in Claritin), cetirizine (found in Zyrtec) cause less sedation and therefore may be better tolerated. Some sleeping preparations such as Tylenol PM and Advil PM take advantage of the sedating effect of Benedryl and add this to the pain ingredients of acetaminophen (Tylenol) or ibuprofen (Advil).
A decongestant constricts or narrows blood vessels in the nasal lining, reducing inflammation and swelling to help open up your nasal passages to aid breathing. Common decongestants include phenylephrine and pseudoephedrine. Side effects include dizziness, heart palpitations, and agitation. Decongestants can increase the effect of stimulants such as caffeine, increasing anxiety, insomnia, agitation, and tremor. Decongestants are now determined to be safe with Parkinson’s medicines that are selective MAO-B inhibitors, such as selegiline (found in Eldepryl and Zelapar) or rasagiline (found in Azilect). However caution is still advised and talk with your doctor if you are on these medicines.
A common over-the-counter cough suppressant is dextromethorphan. This medicine should not be taken with MAO-B inhibitors such as Eldepryl or Azilect as the combination can cause serotonin syndrome with agitation, sweating, tremor, muscle jerks, diarrhea, fever, and heart palpitations.
Pain and Fever Relief
Common fever and pain relievers used in cold preparations to relieve achy muscles, headache, and fever include acetaminophen (found in Tylenol) and ibuprofen (found in Motrin.) These medicines do not interact with Parkinson’s medicines, but be careful not to take more than your doctor recommends as too much can be toxic! Prescription cough medicines often include a narcotic such as codeine and can cause sedation, confusion, and dizziness.
Because there are so many brand names to choose from, and since the ingredients in any one pill can be difficult to determine, be sure to follow the 'Practical tips when buying over the counter medicines' when you are purchasing cold medications.
Author: Monique Giroux, MD Medical Director Northwest Parkinson’s Foundation
Copyright 2011 Northwest Parkinson's Foundation Wellness Center