Medications for Viral Upper Respiratory Infections (Colds and Influenza)
The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions.Use each of these medications as recommended by your doctor or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.Only influenza can be specifically treated with antiviral medication, and those medications should be used only in serious cases because they may have unwanted side effects. Most people with the flu do not need antiviral medication. If you have the flu, check with your doctor to see if you need antiviral medication. You will need it if you are in a high-risk group or if you have a severe illness (like breathing problems). In general, uncomplicated influenza and the common cold should not be treated with antibiotics for several reasons:
- Antibiotics, though generally safe, have side effects and are not as harmless as the common cold.
- Antibiotics do not cure influenza or the common cold since both are caused by viruses; they only work against bacterial infections.
- Misuse and overuse of antibiotics has caused a worldwide crisis—the emergence of resistant bacteria. Some infections are now resistant to every known antibiotic.
Prescription MedicationsOseltamivir and ZanamivirAmantadine and Rimantadine
Prescription MedicationsOseltamivir and ZanamivirOseltamivir and zanamivir are used in adults and children to prevent or treat infections with types A and B influenza viruses.Oseltamivir and zanamivir interfere with specific viral chemical processes. Like other antiviral medications, oseltamivir and zanamivir do not cure the flu, but may shorten the duration of illness if taken within 48 hours of when symptoms first appear. In addition to treating flu symptoms, these medications may reduce the spread of the flu virus to others. Zanamivir may worsen asthma or chronic obstructive pulmonary disease (COPD). Some kinds of seasonal influenza virus are resistant to oseltamivir in the US. The FDA has warned of possible adverse effects in patients, especially children, taking oseltamivir. In some cases, these effects (such as hallucinations, delirium, abnormal behavior) resulted in injury and death. Amantadine and RimantadineAmantadine and rimantadine affect only influenza A viruses. They are used for treatment, as well as for prevention in high-risk people during an epidemic. These medications do not cure the flu, but may shorten the duration of illness if taken within 48 hours of when symptoms first appear. Viral resistance has often been a problem with both of these medications. Amantadine is approved for the treatment and prevention of the flu for those aged one year and older. Rimantadine is approved for treatment in those aged 13 years and older and for prevention for those aged one year and older.Possible side effects include:
- Mood and mental changes
- Dry mouth
- Loss of coordination
Over-the-counter MedicationsWith each type of OTC medication, the active ingredients are listed. There are many brand name preparations for each of these active ingredients. Only a few brand names are listed here, but be aware that there are other brands to choose from. Read labels and look for the active ingredients when choosing a product.The Food and Drug Administration (FDA) recommends that OTC cough and cold products should not be used to treat infants or children less than 2 years old and supports not using them in children less than 4 years old. Rare, but serious side effects have been reported, including death, convulsions, rapid heart rates, and decreased levels of consciousness. OTC cough and cold products include decongestants, expectorants, antihistamines, and antitussives (cough suppressants). The FDA is still reviewing data concerning the safety of these products in children aged 2-11 years. There have been serious side effects reported in this age group as well.Decongestants Common names include:
- Over-stimulation, such as nervousness and insomnia.
- Increase in blood pressure.
- Rebound congestion—If these drugs are used for long periods of time, membranes get used to the effects, so that stopping the medication produces the swelling and congestion that was originally being treated. This is a common problem with nose drops and sprays.
- Drying of secretions, which impairs their clearance and may lead to complications (sinusitis, otitis, and pneumonia)
- Retention or difficulty passing urine
- Urinary problems due to an enlarged prostate gland
- Breathing problems
- Stomach irritation, ulceration, and bleeding
- Allergic reactions
- Kidney damage (very rare)
- Liver damage (very rare)
- Allergic reactions that damage blood cells or cause rashes
- Taking too much can damage the liver or kidneys
- Codeine (available by prescription)
- Take your medications as directed. Do not change the amount or the schedule.
- Ask what side effects could occur. Discuss them with your doctor.
- Talk to your doctor before you stop taking any prescription medication.
- Plan ahead for refills if you need them.
- Do not share your prescription medication with anyone.
- Drugs can be dangerous when mixed. Talk to your doctor if you are taking more than one drug, including over-the-counter products and supplements.
- New symptoms develop after the initial onset
- Significant fever (over 101°F for colds, and fever beyond 3-4 days for influenza)
- Yellow, green, or bloody sputum (secretions from your lungs)
- Persistence of symptoms beyond two weeks (most colds last 1-2 weeks)
- Localized pain anywhere (ears, sinuses, head, chest)
- Yellow secretions on your tonsils
- Difficulty eating, drinking, or swallowing
- Difficulty breathing
- Changes in your mental status
- Neck stiffness
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