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The Informed Parent

Differentiating Over-the-Counter Cold Remedies

by Shanna R. Cox, M.D., F.A.A.P.
Published on Nov. 15, 2004

As we enter into another season of seemingly never-ending cough, congestion, and runny nose, the pharmaceutical industry prepares itself to have a business boom. Our patients struggle through literally aisles and aisles of generic and name brand cold and flu remedies. In order to market their products most effectively most of these companies have focused in on a specific complaint or “buzz word” that attracts their customer. In reality the ingredients of these products are remarkably similar. Therefore, it pays to know what these core medicines are in order to best treat the symptoms of your child, and not be fooled by a marketing facade.

Perhaps one of the most common core ingredients and brands in the local drugstore is Tylenol. The generic name for Tylenol is acetaminophen, which is found in the majority of cough/cold products in different quantities or more scientifically milligrams. Tylenol is primarily a fever reducing or pain-relieving drug. The Tylenol brand also markets other products that usually contain the drug Tylenol combined with other common remedies. However, of note is that there are other brand products that offer the same combination but under a different name. The only difference may be in the milligrams provided.

Sudafed is another brand of a common ingredient known generically as pseudo ephedrine. This is a drying agent that may be used to help runny noses, sinus pressure or postnasal drip. It is available as a combination product or on its own. Often it is combined in cold products with Benadryl, generically known as diphenhydramine. Benadryl is an antihistamine, and therefore is generally helpful when symptoms are related to allergy. It is sedating and therefore should not be used on children who are heading off to school, as it may affect attention. It may help relieve sinus pressure and act as a decongestant.

Advil is another brand name that is associated with both a specific product, generically known as ibuprofen, and a line of combination products that oftentimes include the above mentioned drugs. Ibuprofen acts as a fever reducer, a pain reducer, and an anti-inflammatory drug. Therefore, it may be helpful with acute muscle injuries, teething, migraine headache, or the general aches and pains of a viral syndrome.

A common cough suppressant used in many preparations is generically known as dextromethorphan. Multiple brand names will include this ingredient such as Delsym, Robitussin, and Triaminic. Similarly the Tylenol and Advil brands marketed for cough or flu will include this ingredient. With this list of ingredients handy, you can more accurately purchase your over-the-counter remedies with the realization that the majority of the products off the shelf have the exact same ingredient profile with minor differences usually in the quantity of a particular ingredient included. It also helps to realize that your child may not need one of the many combination products marketed if you can target their symptoms with only one or two of the above-mentioned medicines. This knowledge can also be financially beneficial in that all of these products with generic names are usually available under a store brand, such as Kirkland, and are usually less expensive than their brand name equivalents. In taking a walk down your local pharmacy aisle, pick up two or three products and compare the active ingredients. You will find, remarkably, they are oftentimes the same grouping of medications, only packaged in a different box!

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