By Eileen B. Wyner, NP
Bulfinch Medical Group

It is certainly winter in New England. Who doesn’t love wooly mittens, ice skating on the Frog Pond, or curling up with hot tea and a big book? Unfortunately, there is a flip side to these happy scenes:  people get sick. Illness can occur at any time of year but there seems to be an increase in illness in winter.  People with diabetes have a few more challenges in their self-care, so I want to highlight a few points about over the counter medications to consider as you try to stay healthy this winter and all year long.

Over the counter medications (or OTCs) are available without a prescription, but this doesn’t mean they’re harmless.  Tell your healthcare provider about any OTCs you are taking.  Many medications have a combination of the ingredients listed below, so read the label and follow the directions carefully.  You can always ask your pharmacist for help or to check if any OTCs will interact with other medications you’re taking.

• Non-steroidal anti-inflammatory medications (NSAIDS) are used to lower fever and relieve pain. You may be more familiar with ibuprofen (Motrin, Advil) or naproxen (Aleve, Naprosyn).  You should not use these medications if you are allergic to aspirin, have kidney disease, trouble with your stomach or a bleeding disorder.  NSAIDS can raise blood pressure, so check with your healthcare provider before taking.
• Acetaminophen (Tylenol) is also used to lower fever and relieve pain. If you have liver disease, use with caution or avoid altogether.
• Antihistamines are used to relieve allergic symptoms and nasal congestion, and may be combined with other medications. They can make you feel sleepy, jittery, and/or have a dry mouth. Talk to your healthcare provider before taking these medications if you have high blood pressure, thyroid disease, glaucoma, or prostate problems.
• Pseudoephedrine (Sudafed) is a decongestant used to relieve nasal congestion and sinus pain. This medication can make you feel anxious, increase heart rate, and/or interfere with sleep.  It can also interact with many other medications.  Do not use if you take medications for high blood pressure, thyroid medications, or some psychiatric medications until discussing with your healthcare provider.  Pseudoephedrine can also raise blood sugar, so if you have high blood sugar while taking this medicine it’s best to avoid it.
• Dextromethorphan is a cough suppressant and a common ingredient in many cold medications. Cough suppressants help reduce coughing.  It can be taken any time during the day, but it is  best taken at night. The potential side affects are drowsiness, dizziness, anxiety, and upset stomach. Medications with the initials DM at the end of the name have this ingredient.
• Guaifenesin (Mucinex) is an expectorant found in many cold medications or combined with other medications mentioned above, though it can also be taken by itself. Expectorants help break up mucus so you can cough it out.  This medication may cause upset stomach and dizziness, but it is not known to interact with other medications.

Many of the medications discussed here are available in pill and liquid form.  The liquid types are syrups made with sugar.  Sugar free versions may not be easily available, but these medications are taken in small amounts for a short period so the impact on blood sugar may not be too hard to manage.  However, it is best to avoid products that contain sucrose, dextrose, fructose, lactose, and honey whenever possible.

If you are looking for sugar free cough and cold medications, these are ones that are available:

• Chlor-Trometon tablets
• Dimetapp Elixir
• Scot-Tussin DM Liquid
• Cerose-DM Liquid

I hope this information clarifies the best medications to have in your sick day tool box. Please check with your pharmacist and health care provider with any questions.  I truly hope that you won’t need to use any of these suggestions and your winter remains cozy and healthy.