There are some patients that should be seen by a doctor or other healthcare professionals before taking over-the-counter cold and cough medication as these medications may cause serious complications, drug interactions or adverse effects in these patients.
Infants and young children
Many of the over-the-counter medications contain ingredients that should not be used in children, especially children under 2-6 years of age. 1,2 Check with your doctor or pharmacist before giving your child any medication.
Women who are pregnant or breastfeeding
When you are pregnant or breastfeeding, whatever medication you are taking may reach your baby so it is important to check with your healthcare professional before taking over-the-counter medication. Long-term or high doses of cough and cold medication may be harmful to your baby. 3,4
Elderly people often have other conditions and are on many medications that can interact with cold and cough medication. 5,6 Ask your doctor or pharmacist before taking any over-the-counter medication.
People with heart conditions
- Heart failure
- Heart attack or stroke
- Warfarin treatment
Cold and flu remedies may contain anti-inflammatories that can cause you to retain fluid and make your heart failure worse. Many cold medicines also contain decongestants, which can raise blood pressure. 7 Over-the-counter medication may also interfere with your heart medication, especially if you are on warfarin. 8
People with kidney conditions
- Kidney failure
If you have kidney disease it is important to check with your doctor before taking any over-the-counter medication as some of them may interfere with your kidney medication or damage your kidney function. 9
People with liver conditions
- Liver failure
If you have liver disease you may not be able to tolerate normal medication doses so it is important to check with your doctor what medications you can take and at what doses. 10 Never double up on over-the-counter cold medications as these often contain paracetamol, which can be toxic to the liver in large doses. 10
People with mental conditions
If you have a mental condition you will most likely be on long-term medication. Check with your healthcare professional before taking any over-the-counter medications as these may interfere with your treatment and result in unwanted severe side effects such as seizures or psychosis. 11-13
People with diabetes
Over-the-counter cough and cold remedies may contain agents such as sugar, alcohol, oral decongestants or NSAIDs that may negatively affect your blood vessels and blood sugar levels. Speak to your healthcare professional before using any over-the-counter medication if you have diabetes. 14,15
People with cancer
Over-the-counter medications, even herbal or vitamin products, can interfere with anticancer agents and affect their efficacy and/or safety. 16,17 If you have cancer and are receiving any treatment, it is important to speak to your oncologist or healthcare professional before taking any over-the-counter medications. 16
People infected with HIV
Over-the-counter medications can interfere with HIV medications and affect their efficacy and/or safety. 18 If you have HIV and are receiving any treatment, it is important to speak to your healthcare professional before taking any over-the-counter medications.
NSAIDs = nonsteroidal anti-inflammatory drugs; HIV = human immunodeficiency virus
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