The Meds Pharmacists Take When They Get Sick

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When sickness strikes, Americans tend to turn first to the white coat behind the pharmacy counter. Why? One word: convenience. In a recent Center for Medicine in the Public Interest survey, 77 percent of U.S. consumers said they value the 24/7 availability of over-the-counter cough medicines — and 78 percent think it would be a burden to have to seek a prescription from their doctor when the coughing kicks in.

That means pharmacists are a valuable — even critical — resource when trying to decide which cold and flu meds to buy (seriously, who wants to read all of those labels?). Lucky for you, you don’t even have to talk to your pharmacist to get the scoop: The American Pharmacists Association recently asked 1,000 pharmacists which over-the-counter cold and flu medications they’re most likely to recommend — and Yahoo Health asked the experts to explain exactly how these OTC meds can help make you feel better, ASAP.

SINUS HEADACHE MEDS

The winner: Advil Cold & Sinus

This non-drowsy formula contains two misery-fighting ingredients: ibuprofen and pseudoephedrine. Ibuprofen is a painkiller that works by binding to an enzyme responsible for the production of inflammatory substances, like prostaglandins. “Reducing prostaglandin levels reduces inflammation and pain sensation,” Michelle Arkin, an associate professor of pharmaceutical chemistry at UC San Francfisco, told Yahoo Health in an email.

The second ingredient, pseudoephedrine, acts as a decongestant. “It will open the nasal passages — it shrinks the blood vessels, and helps you breathe better,” said W. Steven Pray, a professor of pharmacy at Southwestern Oklahoma State University. It will also probably give you a burst of energy, which you may welcome if you’ve been dragging all day: “Pseudoephedrine can cause an adrenaline rush and suppress appetite,” Arkin said.

Still, although it may provide some relief, you should see a doctor if you suspect you have a sinus infection, Pray cautioned. “There’s nothing to treat a sinus infection other than an antibiotic.”

The runner-up: Sudafed 12 Hour Pressure + Pain

Related: How to Avoid Getting Sick on Vacation

ADULT LIQUID COLD MEDS

The winner: Mucinex Cold, Flu & Sore Throat

Take one gulp of this powerful liquid, and you’ll simultaneously target coughing, congestion, and pain. One of the ingredients, guaifenesin, is an expectorant, which means “it helps thin the junk in your lungs, so when you cough, the junk will come up more readily,” Pray told Yahoo Health. The cough suppressant dextromethorphan, on the other hands, halts your hacking by zeroing in on the part of your brain that controls coughing, he said.

But, warned Pray, since dextromethorphan suppresses coughing, it may reduce your ability to hack up the mucus that guaifenesin is encouraging you to expel. Times when this combo is worth considering: If your symptoms are keeping you up at night, the cough-suppressing power of dextromethorphan may help you sleep, while your lungs work on clearing the mucus with the help of guaifenesin, he said. The other occassion it might be worth a try: when there’s fluid begging to break free, but you’re hacking so hard it hurts.

The third ingredient, acetaminophen (what you find in Tylenol), helps relieve the pain that can accompany a cold, while phenylephrine combats congestion. It’s essentially a less potent version of pseudoephedrine, said Arkin.

The runner-up: Tylenol Cold Multisymptom

ADULT MULTI-SYMPTOM COLD OR FLU MEDS

The winner: Mucinex D

This funk fighter contains guaifenesin (an expectorant, see above) and pseudoephedrine (a decongestant, see above). It’s perfectly safe to take these ingredients together; however, Pray did caution against stocking your shelves with too many multi-symptom products. You may need all of the ingredients for this cold — but the next time you get sick, you may need only one of them, which means if you take the meds you have on hand, you’re downing an unnecessary drug. “As long as you have the symptoms that each ingredient is indicated for, these combination products aren’t bad,” he said.

The runner-up: Coricidin HBP Cold & Flu

ADULT NIGHTTIME MULTI-SYMPTOM COLD OR FLU MEDS

The winner: Tylenol Cold Multi-Symptom Nighttime

This bottle contains many of the same ingredients as the drugs above — acetaminophen for headache and other pain, dextromethorphan for coughing, and phenylephrine for congestion. But this product throws one extra drug into the mix: doxylamine succinate, an antihistamine. “Doxylamine helps you sleep — it’s what is in some of the Unisom products,” said Pray. “It also helps with runny nose and sneezing.” Just keep in mind, since this product targets four separate symptoms, it may not be the solution every time you’re under the weather.

The runner-up: Nyquil

ADULT DECONGESTANTS

The winner: Sudafed

If you just need a basic decongestant, this over-the-counter staple is your go-to. (See “Sinus headache meds” above for details on its active ingredient, pseudoephedrine.)

The runner-up: Sudafed PE

ADULT TOPICAL DECONGESTANTS

The winner: Afrin

This decongestant goes straight to the source of your sniffling. “You spray Afrin inside your nose, and when it hits the little blood vessels in your nostrils, it acts on the surface to shrink them,” Pray told Yahoo Health.

That means it provides more instant relief than Sudafed — but at a price: The oxymetazoline in Afrin can be pretty darn addicting. “Don’t use it for more than three days, because you can become dependent on it,” said Pray. In fact, you may actually start to experience “rebound congestion,” where overuse of the drug exacerbates your symptoms, compelling to you to keep squirting, until you’ve created a vicious cycle.

The one potential upshot to Afrin? Oxymetazoline doesn’t enter your bloodstream as much as pseudoephedrine does, so it has less of an alerting effect, said Arkin — which is good news if you need nighttime relief.

The runner-up: Neo-Synephrine

CHILDREN’S DECONGESTANTS

The winner: Little Noses Decongestant Nose Drops

These snot-stopping drops contain the decongestant phenylephprine, which shouldn’t be used in children under the age of two without a doctor’s approval. “People tend to make up doses for kids — like, my kid is two, so I’ll just give her half of the four-year-old dose,” said Pray. “You can’t do that. You really need to see a physician if your child isn’t above the age on the label.”

The runner-up: Children’s Sudafed Nasal Decongestant Liquid

CHILDREN’S MULTI-SYMPTOM COLD OR FLU MEDS

The winner: Children’s Dimetapp

Consider this purple liquid a fix-all for sick kids: It contains acetaminophen (fever and pain), dextromethorphan (coughing), phenylephrine (congestion), and chloropheniramine maleate (runny nose and sneezing). Be warned: Chloropheniramine can cause drowsiness, said Arkin, so you may not want to dose up your little one on this drug before sending him to school.

The runner-up: Children’s Mucinex

Related: Get More Protection Out of Your Flu Shot Like This

SALINE NASAL DECONGESTANTS 

The winner: Ocean

This saline solution is nothing more than sodium chloride — i.e. table salt. And this is one time a little extra sodium does your body good: A quick squirt of Ocean can help hydrate dried-out nostrils (a common wintertime problem), allowing you to more easily remove the crud that’s clogging them, explained Pray. In the truest sense of the word, “Saline solution are not decongestants,” he said. “They’re just getting some fluid into your nose.”

The runner-up: Ayr

ADULT ANTITUSSIVES 

The winner: Delsym

Antitussive is just a fancy way of saying “this drug stops coughing” — and in this category, dextromethorphan is consistently king. But not all versions of the drug are created equal: Some meds contain “dextromethorphan hydrobromide,” while others, like Delysm, use “dextromethorphan polistirex.” What’s the difference? “You have to dose hydrobromide more often,” said Pray. “The polisterix version is a long-acting product.” In fact, a single dose of Delysm can last 12 hours — about twice the time you can expect from other cough-suppressing drugs.

The runner-up: Mucinex DM

CHILDREN’S ANTITUSSIVES

The winner: Delysm

You’re more likely to get your sick kid to cooperate if you have 12 hours, rather than just six, between doses. Plus, dextromethorphan polistirex tends to taste better than the hydrobromide version of the drug, said Pray.

The runner-up: Children’s Mucinex Cough