Cough and cold medicines – adults

Cough and cold medicines do not cure your cough or cold but may help to ease your symptoms. If you have cough or cold symptoms it is important that you get tested for COVID-19. If you test positive, or think you might, ask friends or whānau to go to the pharmacy to get medicines for you rather than going in yourself.

On this page you can find the following information:

What are cold and cough medicines?

There are many cold and cough medicines available from supermarkets and pharmacies. These medicines do not cure your cold or cough but are designed to ease your symptoms. Symptoms of a cold are a runny or congested, stuffy nose, sneezing and watery eyes. Sometimes there may be a cough – either a dry, hacking cough or a wet cough with mucus or sputum.

The information on this page is for cough and cold medicines for adults. For information on children, see cough and cold medicines for children. 

Examples of cold and cough medicines 

  • Codral®
  • Coldrex®
  • Lemsip®
  • Dimetapp®
  • Robitussin®
  • Benadryl®
  • Duro-Tuss®
  • Maxiclear®
  • Sudafed PE®

Image credit: Canva

What to consider before taking cough and cold medicines

Cold and cough medicines often contain more than one ingredient.

Cold and cough medicines often contain more than one ingredient that do different things, such as clearing your nose or chest, relieving pain and discomfort or reducing the urge to cough. Choosing a suitable cough and cold medicine will depend on your symptoms, and any health conditions you may have. If you have any health conditions, always ask your pharmacist before taking cold and cough medicines. Some products may not be suitable for you. 

Ingredients commonly found in cold and cough products

Paracetamol

  • Paracetamol is found in many cold and flu products, eg, Codral®, Coldrex® and Lemsip®.
  • Paracetamol is used to relieve pain and discomfort such as headaches and muscle aches.
  • It is also used to treat fever but mild fever does not need to be treated unless it is causing discomfort.
  • When taken as directed, paracetamol works well. However, it is important not to take more than the daily recommended dose. If you take too much, all at once or over a period of days, paracetamol can damage your liver.
  • Always carefully read and follow the instructions provided on the packaging. Do not take more than the daily recommended dose of paracetamol.
  • If you do take other medicines that have paracetamol in them, be careful not to take more than the recommended dose of paracetamol each day (4 grams in 24 hours). Read more about paracetamol.

Ibuprofen

  • Ibuprofen is found in cold and flu products such as Nurofen Cold and Flu. Ibuprofen can also ease headache and muscle pain.
  • For most people taking ibuprofen is safe. However, extra care is needed if you have high blood pressure, high cholesterol, diabetes, stomach ulcers, asthma, heart or kidney problems, are age 65 or older, or smoke.
  • It can also be harmful if you take it when you are dehydrated or have been sick with nausea or vomiting.
  • Discuss with your doctor whether taking ibuprofen is suitable for you. Read more about ibuprofen.

Decongestants

  • Decongestants help to unblock a stuffy or blocked nose. They work by narrowing blood vessels in the nose, throat and sinuses.
  • Decongestants are available as nasal sprays or as tablets or capsules and are often not safe for children. 
  • Examples of decongestants found in cold and flu tablets and capsules are phenylephrine. 
  • Decongestant tablets and capsules can cause increased blood pressure and heart rate, anxiety, restlessness and sleep problems (insomnia).
  • Decongestant nasal sprays clear a blocked nose immediately. Tablets or capsules may take a little longer to work because they need to be absorbed into your body. Read more about nasal decongestants.

Antihistamines

  • Antihistamines may stop runny nose and sneezing in some people but its unclear how effective they are.
  • Examples of antihistamines found in cold and cough preparations are chlorpheniramine, brompheniramine and doxylamine.
  • These antihistamines cause drowsiness and may affect your driving.
  • Read more about antihistamines.

Other products to treat coughs and colds

  • Throat lozenges and sprays: Sore throat products are available as lozenges, sprays or gargles. Some contain anaesthetics (numbing agents) and may provide temporary relief from sore throat. Most of them can be used every 2 to 3 hours. Some lozenges have a lot of sugar in them and may not be suitable for people with diabetes. Read more about medicines for sore throat.
  • Cough syrups: Some cough syrups are thought to loosen mucus making it easier to cough up (called expectorants) while others may control the urge to cough (called suppressants). Examples of cough suppressants found in cold and cough medicines are dextromethorphan, pholcodine and codeine. It is unclear whether cough syrups work.

Always carefully read and follow the instructions provided on the packaging

The dose of the different cold and cough medicines will be different, depending on the product. They are available as capsules, tablets, liquid or as a powder that you mix in water. Follow the directions on the label or the packaging. It will tell you how much to take, how often to take it, and any special instructions. Ask your pharmacist for advice, if you have any questions.

Some cough and cold medicines may make you drowsy 

Some cold and cough preparations have a day and night combination. The night doses contain ingredients that may make you drowsy. The day doses are usually non-drowsy. However, be careful when driving or using tools until you know how this medicine affects you. Read more about driving and medicines.

Rongoā Māori

Numerous native plants are used to treat a variety of conditions including colds. Below are some examples. Read here about using Rongoā Māori safely.

  • Kumarahou (Gumdiggers soap): Leaves and infusion for coughs and colds.
  • Manuka and Kanuka (tea tree): Leaves, infusion and gum for coughs.

Other natural remedies

Natural remedies like vitamin C and echinacea are marketed for the treatment and prevention of colds, but the evidence to support them is weak.  

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Vitamin C (ascorbic acid)

For most people, vitamin C does not prevent colds and only slightly reduces their length and severity. Vitamin C is generally considered safe, but high doses can cause stomach problems such as diarrhoea, nausea and stomach cramps.

Echinacea

Echinacea is marketed for the relief of symptoms of cold and flu, such as sore throat and cough. Although there is the potential that some preparations of echinacea are more effective than placebo for treating colds, the overall evidence for clinically relevant treatment effects is weak. Read about echinacea.

Garlic

Garlic is thought to have properties that fight off some viruses such as viruses causing the common cold. There’s not enough evidence to show whether garlic is helpful for the common cold. Garlic is probably safe for most people in the amounts usually eaten in foods but it can interact with medicines so check with your health care provider whether it is safe for you.

References

  1. Cold season: managing without antibiotics BPAC, NZ
  2. Cold season in primary care BPAC, NZ
  3. Demystifying Rongoā Māori: Traditional Māori healing BPAC, NZ
  4. The Common Cold and Complementary Health Approaches NIH National Centre for Complementary and Integrative Health, US 

Additional resources for healthcare professionals

Cough cold preparations NZ Formulary
Reminder – using cough and cold medicines in children is inappropriate Medsafe, NZ, 2016

Credits: Health Navigator Pharmacists. Reviewed By: Sandra Ponen, BPharm, MPH, Auckland Last reviewed: 08 Apr 2022