The Common Cold and Viral Upper Respiratory Illness

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What should I do if I think that I have a viral upper respiratory infection (URI)?
Get plenty of rest and drink plenty of fluids. Also take one or more of the following medications:

  • For fever and pain, Acetaminophen (Tylenol®) is generally preferred. Ibuprofen (Advil®) and/or naproxen (Naprosyn®) appear to carry less risk for Reye's syndrome than aspirin.
  • For other symptoms, over-the-counter cold (OTC) preparations (Nyquil®, Tylenol Cold & Sinus®, others) can provide significant relief. Be sure to read product labels to find the best cold preparation to match your symptoms and to determine if that medicine is safe for you.
  • To dry out the nose and relieve nasal obstruction, try a traditional antihistamine (diphenhydramine [Benadryl®], others). All antihistamines are best used for allergy, but they can be helpful for suppressing some viral URI symptoms. Because these products can make you sleepy, avoid driving and other complex tasks when taking these medications. Newly available OTC loratadine (Claritin®) is non-sedating but may not be as effective for suppressing viral URI symptoms.
  • To relieve a "stuffy," clogged nose, try an oral decongestant (pseudoephedrine [Sudafed®], others). Note that these products can be associated with insomnia, nervousness, and irritability in some patients. Often decongestants are combined with other drugs (especially antihistamines) in OTC medications. A "-D" at the end of a medication's name suggests that the medication includes an oral decongestant.
  • To make blowing your nose easier, take guaifenesin (Robitussin®, Mucofen®, Humibid LA®, Mucinex®, Humibid-e®). These products thin mucous and can help thin thick discolored drainage.
  • To suppress coughing, taking dextromethorphan can be helpful as a cough suppressant.

Prescription anti-flu medications (amantadine, rimantadine, zanamivir, oseltamivir) can be used to treat and prevent flu.Typically they must be started within 48 hours of the start of symptoms.These products shorten the severity and duration of the infection, but they can have significant side effects.

When should I seek treatment?
Viral infections can be associated with bacterial overgrowth and occasionally lead to a bacterial infection (acute bacterial rhinosinusitis), which typically requires antibiotic therapy. Viral URIs also may worsen asthma symptoms (wheezing) in patients with asthma; such symptoms also require further evaluation and treatment.

Seek medical advice or treatment if:

  • Symptoms are getting worse after 7 days
  • Symptoms are unchanged or getting worse after 10 days
  • You experience shortness of breath or have any respiratory difficulty
  • You experience a high fever (greater than 102°F)
  • You develop eye pain, swelling and/or vision changes
  • You develop severe head or facial pains, or swelling

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Last Updated: 8/7/2007

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