FDA to reevaluate 'useless' over-the-counter cold meds

I'm A Doctor – Here's My Guide To Which Pill You Should Pop For Which Pain

USERS of painkillers pop 373 each year on average, with one in 20 taking at least six every time they feel ill.

Pharmacologists warn that such high levels could lead to addiction to over-the-counter pills such as aspirin, paracetamol, ibuprofen or codeine.

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Users of painkillers pop 373 each year on average, with one in 20 taking at least six every time they feel ill.Credit: Getty

Dr Deepak Ravindran, clinical lead for pain medicine at Royal Berkshire NHS Foundation, told Sun on Sunday Health: "What's most staggering about these figures is that they're averages.

"There's a significant number of people out there taking far more than this, and often without understanding the risks or consideration of the underlying causes or knowing what potentially harmful interactions there may be with other medications.

"They are very effective at reducing pain, but some are dependence-inducing if taken for too long. They can also make the pain they are intended to cure worse if taken excessively.

"Pain relief medication just blocks the neural messages being sent to your brain — it doesn't deal with the root cause, which could be anything from dehydration to a more serious physical injury or condition."

But which pill should you be popping? Here Dr Ravindran gives his guide.

PARACETAMOL

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Great for multiple pains, but watch how much you takeCredit: Sainsburys

The pills are sold under brand names such as Panadol or combined with aspirin in Anadin Extra. Brands marked "extra" or "plus" often contain added caffeine but not more paracetamol. Found in cough, cold and flu remedies.

BEST FOR: Pain relief such as backache, toothache and mild headache. It lowers temperature and reduces inflammation.

SIDE EFFECTS: Dangerously toxic to the liver in high doses.

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DOSAGE: For adults, 500mg to 1g every four to six hours, with a maximum of eight 500mg tablets in 24 hours. If the pain is severe alternate paracetamol with ibuprofen every four hours.

DON'T TAKE IF: You have a weak or unhealthy liver or if you are regularly in chronic pain.

EXTRA BENEFITS: Paracetamol doesn't cause stomach irritation, making it ideal for those who need to take painkillers regularly. Unlike aspirin and ibuprofen, paracetamol can be taken without food, and it's safe to take with small amounts of alcohol.

ASPIRIN

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Has benefits beyond pain relief, but can cause serious problems for some peopleCredit: Alamy

This is sold under brand names such as Disprin and in combined preparations such as Anadin Extra. Soluble tablets act faster than coated ones, which partly protect from stomach irritation.

BEST FOR: Stress-induced headaches, toothache or flu symptoms as it lowers temperature and relieves joint pain. Gargling and then swallowing soluble aspirin eases throat infections.

SIDE EFFECTS: Irritates the stomach lining, so can cause stomach ulcers and bleeding.

DOSAGE: Take from one to three 300mg tablets every four to six hours over a 24-hour period.

DON'T TAKE IF: You are taking any anticoagulant drugs or if you have a stomach ulcer.

It increases bleeding so don't take it before or after surgery.

Aspirin can trigger attacks in asthmatics.

EXTRA BENEFITS: In low 75mg daily doses it thins the blood and helps prevent clots that can cause strokes and heart attacks. It only should be used in this way by people who have already had an attack.

Scientists have found that a daily dose reduces chances of developing breast cancer by 28 per cent and can reduce the risk of prostate, colon and lung cancer. It can also delay the onset of Alzheimer's and stabilise diabetes.

CODEINE

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Potent painkiller, but it's also highly addictiveCredit: Alamy

It is mainly sold in a combination, such as Solpadeine (paracetamol and codeine) or Nurofen Plus (ibuprofen and codeine).

BEST FOR: Intense muscular pain after an injury or tooth extraction. With period pain, it helps relax abdominal muscles that can cause menstrual cramps.

SIDE EFFECTS: Can cause sluggish bowel movements, constipation, light-headedness and drowsiness.

DOSAGE: 8mg pills no more than four times in 24 hours. GPs can prescribe higher doses.

DON'T TAKE IF: If you have liver, kidney or lung problems. Don't take it regularly as it is highly addictive. You can also develop tolerance to it, making it less effective.

EXTRA BENEFITS: Helps suppress a dry or irritating cough.

IBUPROFEN

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An anti-inflammatory painkiller that can tackle the likes of rheumatoid arthritis, migraine and osteoarthritis, but has potential side-effects

SOLD under brand names such as Nurofen, this non-steroidal anti-inflammatory drug also comes in a topical cream branded with the name Voltarol.

BEST FOR: Inflammatory pain and chronic pain that comes with rheumatoid arthritis, migraine and osteoarthritis.

SIDE EFFECTS: Can irritate the stomach lining, causing indigestion and nausea. Long-term, it can lead to gastric ulcers. Regular use can also lead to kidney and liver damage, as well as elevated blood pressure.

DOSAGE: Maximum of 1,200mg in 24 hours.

DON'T TAKE IF: You have stomach ulcers or a gastric disorder.

EXTRA BENEFITS: A study found anti-inflammatory agents such as ibuprofen could curb low moods.

New Natural Bioactive Molecules Effectively Relieve Cold And Flu Symptoms

Researchers have discovered that natural bioactive molecules, including lysozyme and lactoferrin (collectively termed the "Mucosal Immune Complex"), can effectively relieve cold and flu symptoms by protecting and strengthening the mucosal barrier function and reducing inflammation. A randomized, double-blind placebo-controlled study confirmed that formulas containing this complex, when combined with low-dose aspirin or other anti-inflammatory agents, significantly reduced symptoms, offering a promising alternative to traditional over-the-counter remedies that have been shown to potentially damage the mucosal barrier and increase inflammation.

Scientists at Applied Biological Laboratories Inc. Have identified how natural bioactive molecules can effectively relieve cold and flu symptoms by protecting the mucosal barrier function and reducing inflammation during these infections. Together, they call these molecules, which include lysozyme and lactoferrin, the "Mucosal Immune Complex."

The research, led by Nazlie Sadeghi-Latefi, Ph.D., highlights the importance of supporting mucosal barrier immunity to prevent and treat colds and flu. This work was recently presented at the American Chemical Society Fall 2023 Meeting on August 15, 2023.

Mucosal immunity is the body's first line of defense against invading pathogens, such as those causing the common cold and influenza. While the mucosal barrier functions primarily as a part of the innate immune response, it provides a crucial bridge to adaptive immunity. Once someone is infected, the mucosal immunity and barrier integrity determine the extent of the infection, and thus the illness severity and duration. Popular cold & flu remedies may do more harm than good A previous peer-reviewed study by researchers at Applied Biological Laboratories compared the effects of natural bioactive molecules to those of the most popular over-the-counter cough and cold medications using in vitro respiratory mucosal barrier models. The researchers found that these popular OTC medications damage the mucosal barrier and increase inflammation (the underlying cause of cold symptoms), which they say may translate to possibly worsening symptoms, prolonging infections, and increasing the risk of secondary infections. Smith Johnston, MD, clinical faculty at the University of Texas Medical Branch, former Medical Officer emeritus for NASA's Medical Operations Branch, and a member of Applied Biological Laboratories' scientific advisory board adds that decades of meta-analyses of clinical trials have found inconclusive evidence of safety and effectiveness for many popular over-the-counter common cold and flu medications. Although these medications often claim to provide the indicated symptomatic relief, they have not been shown to effectively reduce the severity and duration of illness better than a placebo. Many of these were approved for over-the-counter (monograph) marketing before the FDA required rigorous clinical trials to approve over-the-counter drugs. Lysozyme and Lactoferrin strengthen mucosal barrier immunity, block viral entry, and synergize with more specific COX inhibitors One of the key inflammatory signals in respiratory inflammation and cold symptoms involves prostaglandin generation via COX enzymes. When low doses of plant-based acetylsalicylic acid (aspirin), or other naturally derived COX inhibitors such as aloe vera extract were combined with lysozyme, lactoferrin, and menthol the anti-inflammatory effects through inhibition of COX-mediated inflammation and bradykinin-mediated IL-8 were even greater than with the COX inhibitor alone. Thus, this combination of natural bioactive molecules has powerful synergistic effects for relieving cold and flu symptoms. Unlike common OTC cold & flu remedies, which do not focus on inflammation at all, and which may damage the mucosal barrier, specific concentrations of natural bioactive ingredients like lactoferrin and lysozyme did not damage the mucosal barriers but strengthened it according to the previously mentioned peer-reviewed study. According to numerous other peer-reviewed studies, lactoferrin and lysozyme activate local innate immune cells, such as macrophages and dendritic cells, and may also bind to viruses, preventing them from docking and infecting respiratory epithelial cells. Clinical trial confirms the synergistic benefits of natural bioactive molecules with low-dose aspirin in treating cold & flu symptoms To confirm their findings and test their formulations clinically, researchers at Applied Biological Laboratories conducted a randomized, double-blind placebo-controlled multi-center study. Relief of sore throat, a measure of upper respiratory inflammation was assessed as the primary endpoint and reduction of other common cold symptoms such as nasal discharge and congestion, sneezing, sore/scratchy throat, cough, headache, malaise, and fever/chills, as assessed by the modified Jackson scores were measured as secondary endpoints. The trial assessed 179 participants who were randomly assigned to either placebo or one of three treatment groups each containing the mucosal immune complex and a mix of other anti-inflammatory ingredients. By the second day of the study, the treatment groups had a significant reduction of up to 4.59 points in modified Jackson scores, whereas the placebo group did not demonstrate any improvement in any category of Jackson scores. The researchers conclude that formulas containing the mucosal immune complex are an effective treatment for alleviating cold and flu symptoms, including nasal congestion, discharge, sneezing, sore throat, cough, headache, malaise, and fever/chills. Implications and Impact The potential implications of these results are significant, given the vast number of people affected by the common cold and flu every season. Every year, an average household shops for over-the-counter medications 26 times a year, spending an average of $338. To date, few studies have evaluated the impact of these medications on mucosal barrier integrity, which can affect symptom severity and susceptibility to secondary infections. In addition, clinical evidence that demonstrates the safety and effectiveness of cold and flu remedies has been scarce, even in FDA-approved medications. Meeting: American Chemical Society Fall 2023 Meeting

In The Season Of Flu And Fevers, Here Is Everything That You Should Know

Fevers are often an insinuation that our body is fighting off an underlying viral or bacterial illness. Viral fevers are mostly triggered by viral infections.

The incessant rain and changing weather conditions welcomed many diseases. This season has been the season of flu and fever with cornucopia of cases coming each day. After experiencing high rainfall in the monsoon, country has seen some continuous rise in viral fever cases.

Since there are multiple cases coming each day, there's a need to make people aware of the viral fevers and all they should know about it

Let's know what a viral fever is!

A fever is defined as a body temperature higher than the normal 37 degrees Celsius (98.6 degrees Fahrenheit). Elevated temperatures indicate the body's defense mechanism against viral or bacterial infections. Generally, a temperature above 98.6 F is considered a fever. Fevers are often an insinuation that our body is fighting off an underlying viral or bacterial illness. Viral fevers are mostly triggered by viral infections.

Symptoms of Viral Fevers

Viral fevers can vary in intensity, ranging from 99 F to over 103 F, depending on the specific virus involved. Common symptoms include chills, sweating, headache, muscle aches, dehydration, weakness, and loss of appetite. These symptoms usually last for a few days.

Causes of Viral Fevers

Viral fevers result from infections caused by viruses, tiny infectious agents that multiply within body cells. Fever is the body's natural response to combat viruses. Viruses are sensitive to temperature shifts; an increase in body temperature makes the environment less favorable for them. Viral infections can occur through inhalation, ingestion, bites from insects/animals, and contact with infected bodily fluids.

Diagnosis of Viral Fevers

Distinguishing viral and bacterial infections can be challenging due to similar symptoms. Doctors often eliminate bacterial infections first. They consider symptoms, medical history, and test samples for bacteria. For instance, a throat swab can detect strep throat bacteria. If negative, a viral infection is likely. Blood or bodily fluid samples might reveal markers indicating a viral infection, such as white blood cell count.

Treatment of Viral Fevers

Viral fevers typically don't necessitate specific treatment like antibiotics, which target bacteria. Instead, focus on alleviating symptoms: using over-the-counter fever reducers (acetaminophen, ibuprofen), resting, staying hydrated, and occasionally employing antiviral drugs like oseltamivir phosphate. Lukewarm baths help lower body temperature.

When to Seek Medical Attention

Mild viral fevers usually pose minimal concern. However, temperatures of 103 F (39 C) or higher warrant medical attention. The same applies to babies with rectal temperatures at or exceeding 100.4 F (38 C). Critical symptoms requiring medical assistance include severe headache, difficulty breathing, chest pain, abdominal pains, frequent vomiting, rapidly worsening rash, stiff neck with pain when bent forward, confusion, and convulsions/seizures.

Conclusion

Viral fevers, characterized by elevated body temperatures due to viral infections, are part of the body's immune response. Symptoms range from chills and sweating to muscle aches and loss of appetite. Diagnosis involves ruling out bacterial infections through symptoms and tests. Treatment primarily focuses on symptom relief, with no antibiotics involved. Seeking medical attention becomes necessary for high fevers and critical symptoms. Understanding viral fevers aids in timely and appropriate medical intervention.

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