Could Your Cold Medicines Be Dangerous?

Don’t abandon over-the-counter cold remedies – use them more wisely.

Before you reach for a cold remedy from your medicine cabinet or drugstore shelf, consider how it could affect not only your symptoms but also your health. While over-the-counter (OTC) cold medicines are generally safe when used correctly, they can be risky for certain groups of people – including young children and those with high blood pressure. Here’s a guide to avoiding side effects when you take OTC cold medicine.

No cold meds for kids

Most children come down with at least one – and usually several – colds each year. Parents who are tempted to dispense OTC cold medicines should look elsewhere for symptom relief, experts say. 

“These products don’t reduce the time the infection will last and misuse could lead to serious harm,” says Matthew M. Davis, MD, MAPP, professor of pediatrics and communicable diseases at the University of Michigan Health System. “What can be confusing, however, is that often these products are labeled prominently as ‘children’s’ medications.”

OTC cough and cold medicines are ok for older kids, but because of the risk for side effects like allergic reactions, increased heart rate, and slowed breathing, many now carry a warning to avoid their use in children under 4 years old.

Blood pressure risks

Decongestants containing pseudoephedrine relieve stuffiness by narrowing blood vessels in the nose. What’s good for the nose is bad for the heart, because narrowed blood vessels lead to higher blood pressure. When taken with blood pressure-lowering drugs called beta-blockers, pseudoephedrine also increases the risk for irregular heart rhythm.

Talk to a doctor before taking any OTC cold medicine. Look for products made specifically for people with high blood pressure, such as Coricidin HBP, which doesn’t contain decongestants. And if you do take a traditional decongestant, monitor your blood pressure often and alert your doctor to any spikes.

Also avoid products containing salt (which may be written as “sodium” or “soda” on the ingredients list), another ingredient on the blood pressure watch list. Be careful about using multi-symptom cold medicines that include nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) or naproxen (Aleve). “These medicines may raise blood pressure a little and at higher doses they can damage the kidneys,” said Willie E. Lawrence, Jr., MD, chief of cardiology at Research Medical Center in Kansas City, Mo., and American Heart Association spokesman.

Cold relief in older adults

Cold medicine side effects can be even more pronounced in older adults. As you get older, your body doesn’t clear medicines as effectively as it once did. Plus, people over 65 often take several medicines simultaneously to manage multiple conditions. Together, these factors can lead to a greater risk for drug interactions and side effects.

In particular, watch out for older-generation antihistamines such as diphenhydramine (Benadryl), which can cause drowsiness, confusion, and blurred vision, increasing your risk for falls and car accidents. Pain relievers in multi-symptom cold remedies have been linked to stomach ulcers and kidney and liver damage. NSAIDs like ibuprofen and naproxen cause your body to hold on to water, increasing blood pressure and putting you at greater risk for a heart attack or stroke. Take no more than the recommended dose, and stay away from alcohol to protect your liver and kidneys.

Cold medicine abuse

Over-the-counter cough and cold medicines are particularly dangerous when used for the wrong purpose. Ingredients like dextromethorphan, found in many cough medicines produce a high when taken in larger-than-recommended amounts. Abusing cold medicines can affect the brain much like other illicit drug abuse, leading to addiction, as well as increased blood pressure, liver damage, and eventually brain damage.

Safe cold medicine use

You don’t necessarily have to stop taking cold medicines, but do use them more wisely. Read the package instructions carefully to make sure you take no more than the recommended dose. Only use medicine that targets symptoms you have. Avoid multi-symptom products unless you really need them. And if you’re in doubt about whether to take a particular OTC cold remedy, check with your doctor.