A GP is urging people to check exactly what is in their cold and flu medicines before taking them alongside regular prescriptions, as some ingredients in over-the-counter medicines aren't suitable for people with specific medical conditions.
Millions of people buy pills or powders for colds and flu at this time of year as respiratory viruses thrive in autumn and winter - when people head indoors, close doors and windows and spend hours closer together. Common cold and flu medicine freely available in shops and supermarkets can help with the symptoms of everything from a simple virus to RSV and Covid.
Four ingredients to watch for
Dr Rupa Parmar, GP and Medical Director at Midland Health, said you need to look for four ingredients on the medicine you buy to deal with cold and flu symptoms.
Dr Parmar said: “Combination cold and flu remedies are convenient, but they usually put three or four medicines into one sachet or capsule, and most people don't realise it. If you're already taking tablets for your blood pressure, heart, diabetes, or pain, those extra ingredients can clash with what you've been prescribed, or double up on something you're already taking, like paracetamol.
“As we get older, the liver and kidneys can take longer to clear medicines, so they stay in the body for longer and side effects can be stronger. If you're already on multiple prescriptions, adding a cold and flu remedy without checking the ingredients makes it much harder to know exactly what you're taking.
“My advice is to treat the symptom you actually have rather than reaching for an all-in-one product. If it's just a headache and a temperature, you may only need plain paracetamol. And if you're on regular medication, have a quick word with your pharmacist first. It's free, and they can check what's safe to take together.”
Decongestants and paracetamol risks
Decongestants can raise blood pressure and heart rate, so they aren’t recommended for people with heart disease, high blood pressure, or diabetes. They can also worsen urinary problems in men with an enlarged prostate. Drugs like ramipril and lisonpril are commonly prescribed for high blood pressure. Metformin is the most commonly prescribed diabetes drug. Atorvastatin, simvastatin and rosuvastatin are commonly prescribed for people with cholesterol-related heart problems, alongside beta-blockers.
Many combination products already contain paracetamol, so taking them alongside regular paracetamol can push you over the daily maximum (8 standard tablets in 24 hours) and increase your risk of liver damage.
Anti-inflammatories and antihistamines
Some cold and flu remedies contain anti-inflammatories such as ibuprofen. Older adults are more likely to experience side effects from these, including stomach bleeding and ulcers, kidney problems, and heart concerns. They can also increase bleeding risk if you are already taking other blood-thinning medications - like aspirin or warfarin.
Common in night-time cold remedies, sedating antihistamines leave the body more slowly in older adults. This can mean experiencing next-morning grogginess, confusion, and a higher risk of falls. They can also make it harder to pass urine.
Practical steps to take
Read the active ingredient list. Keep an up-to-date list of medicines. Always follow the instructions; don’t take anything for longer than recommended. Ask a pharmacist before buying anything if you’re on regular medication. Check whether you’re eligible for a free flu vaccine; everyone over 65 qualifies.
