Diabetes: How to Safely Take OTC Medicines for Cold or Flu

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You’ve got a runny nose, sore throat, chest discomfort and fever. Is it a cold or the flu? The common cold and seasonal flu are both respiratory illnesses caused by viral infections. While they share many of the same symptoms, it can be difficult to distinguish a cold from the flu based on symptoms alone. In general, the flu is worse than the common cold, and symptoms are more common and intense.

“The flu has an abrupt onset with more severe symptoms while a cold has a gradual onset and milder symptoms,” says Georgia based pharmacist Sara (Mandy) Reece, PharmD, CDE, BC-ADM, FAADE. Colds generally do not result in serious health problems. However, when you have diabetes, even a minor cold can make your diabetes harder to control and lead to serious complications. That’s why it’s essential to have a  sick day plan. Ideally, you will talk with your healthcare team so they can individualize your plan of care before you get sick.

Reece who is Vice Chair and Associate Professor, Pharmacy Practice at the Georgia Campus – Philadelphia College of Osteopathic Medicine (GA-PCOM) School of Pharmacy says “Common cold symptoms include sneezing, stuffy nose, sore throat, mild to moderate chest discomfort and cough.” Over-the-counter (OTC) cold medications can be used to relieve these symptoms. When considering which combination cold and cough product to purchase Reese says “select the product with the least number of primary ingredients to treat your symptoms.” Over-the-counter cold medicines include nasal decongestants, cough suppressants, expectorants, antihistamines, and pain relievers. “Choose the right OTC medicines for your symptoms and remember more ingredients are not better,” advises Reece.

Nasal decongestants help unclog a stuffy nose. Lauren Avery, PharmD Candidate, GA-PCOM, School of Pharmacy says “Allergies and the common cold may cause the tissue lining your nose to swell. Decongestants work by shrinking swollen blood vessels and tissues which relieves congestion.” If you have high blood pressure decongestants may make your blood pressure and heart rate rise. Reece says “Avoid decongestants such as pseudoephedrine, phenylephrine, and oxymetazoline if you have hypertension.”

Cough suppressants help relieve coughs. “These medications work to suppress your cough by blocking the cough reflex. Cough suppressants work best for a dry cough,” Avery says.

Expectorants help loosen mucus and work best for a productive cough. Avery says “Expectorants work by thinning out mucus and allowing mucus to clear our airways easily.”

Antihistamines help stop a runny nose and sneezing. During an allergic reaction, our bodies release histamine which causes allergy symptoms. “Antihistamines work to prevent the common allergy symptoms such as a runny nose, sneezing, itching, etc. by decreasing the effects of histamine,” explains Avery.

Pain relievers can help ease fever, headaches, and minor aches. Avery says “Pain medications provide both pain relief from aches and pain associated with the flu as well as controlling body temperature to reduce fevers.” Examples include acetaminophen and ibuprofen. For people with diabetes Reece says acetaminophen is preferred over ibuprofen. “NSAIDs, a drug class that ibuprofen falls into, is renally excreted [via the kidney] while acetaminophen is hepatically excreted [via the liver.] Patients with diabetes are at higher risk of renal disease, therefore, limiting the use of medications that are excreted renally is important,” explains Reece.

When searching the OTC aisle for the right cold and flu medication Reece says don’t forget to ask the pharmacist for help. Just because a pharmacist works in a place that also sells magazines, snacks and nail polish doesn’t mean he or she is not a professional. A pharmacist is trained and licensed to understand, prepare, and dispense medication.

Flu symptoms include fever, muscle or body aches, fatigue, sore throat chest discomfort, cough, and headache. If you do get sick with flu symptoms, call your doctor early in the illness. Reece says a flu test can be done during the first few days to determine if you have the flu. This is important because antiviral drugs work best when started within 48 hours after symptoms start. Antiviral drugs can make your flu illness milder and make you feel better faster. They may also prevent serious health problems that can result from flu illness.

You should see a doctor if you have a cold or flu and aren’t getting any better. Signs of trouble can include a cough that disrupts sleep; a fever that won’t respond to treatment; increased shortness of breath; face pain caused by a sinus infection; high fever, chest pain, or a difference in the mucus you’re producing, after feeling better for a short time.

Remember, when you have diabetes even a minor cold can make your diabetes harder to control and lead to serious complications often resulting in hospitalization and sometimes even death. Click here to learn more about the flu.

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