Its cold and flu season. What do we all reach for when coughing, sneezing and feeling miserable? Over-the-counter cold products!!!!
Terms to know:
Expectorants are substances claimed to make coughing easier while enhancing the production of mucus and phlegm. Two examples are acetylcysteine and guaifenesin.
Antitussives, or cough suppressants, are substances which suppress the coughing itself. Examples are codeine, pholcodine, dextromethorphan. If a product has DM in the name - for example Tussin DM, the product contains Dextromethorphan
Decongestants may improve nasal congestion in sinus infections. Examples are ephedrine, phenylephrine, pseudoephedrine,
Fever or pain medication. Examples are acetaminophen and NSAIDs such
as ibuprofen.
OTC Products:
Manufacturers combine these specific ingredients in hundreds of ways. You really have to read the label to know what the ingredient includes. For example, Mucinex can be purchased with guaifenesin as a single ingredient, or with guaifenesin, tylenol and dextromethorphan. Talk to your healthcare provider or pharmacist as to which product best matches your symptoms.
Case Study:
Mr. Sneezy has been sick with a head cold for the last two weeks. He has been coughing and sneezing but not had a fever or body aches. His covid swab has been negative twice. Mr. Sneezy has been self-treating his congested sinuses with Maximum Strength Mucinex Sinus-Max. This product contains Tylenol, guaifenesin and phenylephrine. He has been taking two pills every 4 hours as the package directs. Each pill has 325 mg of Tylenol.
Mr. Sneezy has also been taking a cough syrup for his cough. He has been taking Dayquil Severe Honey Maximum - it coats and soothes. The dose is 30 ml every 6 hours and each dose contains 650 mg of Tylenol .
Symptom: You see Mr. Sneezy for the first time in several weeks and you notice that his skin seems yellow. Should you be concerned?
Answer: Yes - Mr. Smith has been overdosing himself with Tylenol for the last two weeks. This is easy to do because people think that “cough syrup” is different from cold pills. Many times the products have the same ingredients.
Do the math - Mr. Smith has been taking 650mg of tylenol x 6 doses in the pills and 650 mg of tylenol x 4 doses in the liquid per day. How much does that equal? 3900+ 2600 = 6500mg!!
The average recommended daily limit for tylenol is 3000 to 4000mg per day. Mr Smith is well over that limit! Research shows that you can damage your liver just by taking more then 4000mg in 24 hours!!! People who drink alcohol at the same time as taking Tylenol are at an even greater risk!!
What does yellow skin have to do with this??
Yellow skin is a sign of jaundice. Jaundice is when the liver is not working so well and Bilirubin builds up in the skin causing that yellow color. Bilirubin is a product from red blood cell breakdown and is filtered out by the liver.
Tylenol overdose is the leading cause of acute liver damage.
Tylenol can also cause constipation and itching! Look up Tylenol and check out all the potential side effects!
Bottom line:
Read the labels - know what the ingredients are in the over-counter-products that you are taking!! Follow manufacturer's guidelines and know what the potential side effects are!!
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