Are OTC Cold Remedies Harmful to Your Heart?

Are you one of the millions of Americans who reach into their medicine cabinets at the first sign of a stuffy head, cough or sore throat? If so, you're not alone. Over-the-counter cold remedies are a $4 billion dollar business in the United States, according to a 2010 congressional report.

But if you are one of the 100 million Americans with high blood pressure, or millions more with other risk factors for heart disease, those handy OTC medicines could be risky business. In fact, if you've never checked the fine-print instructions on those remedies, you are in for a shock. Dizziness, nausea, elevated heart rate, and even death are listed among the "possible side effects."

The dangers lie in some common ingredients in decongestants and multi-symptom cold medications.

Decongestants can raise blood pressure. So if you have high blood pressure to begin with or if you are taking medication to regulate blood pressure the American Heart Association warns that you should avoid taking a decongestant. Instead, ask your doctor about using a decongestant-free cold medicine.

The FDA is studying the risks of over-the-counter cold medications in the general population. For the time being, they've issued a warning to parents of children age 2 and under. The FDA cites "a wide variety of serious adverse events" reported with cough and cold products administered to infants and small children. These include "death, convulsions, rapid heart rates, and decreased levels of consciousness."

The ingredients cited as dangerous when administered to young children include decongestants (for unclogging a stuffy nose), expectorants (for loosening mucus so that it can be coughed up), antihistamines (for sneezing and runny nose), and antitussives (for quieting coughs).

But the risks extend to many in the general population. Dr. Allen Bruckheim, whose syndicated column "The Family Doctor" runs in major news outlets nationwide, describes another little-known ingredient, phenylpropanolamine, a chemical that is commonly found in non-prescription cold preparations.

Phenylpropanolamine is used in more than 100 different medications-including appetite suppressants, nasal decongestants and cold medications. It even passes as a "street drug," as a substitute for or combined with amphetamines. Patients with hyperthyroidism, hypertension or other heart-related disease, or diabetes, should avoid products containing phenylpropanolamine. According to Dr. Bruckheim, the adverse effects associated with this chemical most commonly affect the heart, but "can even include severe psychological disturbances, bizarre behavior and disorientation."

Another red flag to watch for: NSAIDS, which are added for pain relief in many OTC cold remedies. These nonsteroidal anti-inflammatory drugs (which include Advil, Aleve and many other brands) can make your body retain fluid and decrease the function of the kidneys, which can cause blood pressure to rise even higher adding stress to the heart. NSAIDs have also been known to prevent high blood pressure drugs from working properly.

So, what can you do to relieve the symptoms of a cold or seasonal allergies? There are many safer, natural remedies available. Ask your health-care practitioner for suggestions, especially if you are at risk for heart disease.

OTC Cough and Cold Products: Not for Infants and Children Under 2 Years of Age FDA Advisory
High blood pressure and drug safety WebMD
Chemical In Cold Medications Can Cause Side Effects Chicago Tribune
Cost Of Over-The-Counter Medicine As A Medical Care Expense Joint Committee on Taxation

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