Could Your Cold Medicines Be Dangerous?

By Stephanie Watson and Temma Ehrenfeld @temmaehrenfeld
December 04, 2023
Could Your Cold Medicines Be Dangerous?

While OTC cold medicines are generally safe when used correctly, they can be risky for certain groups of people. Don’t abandon them — just use them more wisely.

Before you reach for a cold remedy from your medicine cabinet or drugstore shelf, consider how it could affect not only your symptoms but also your health. While over-the-counter (OTC) cold medicines are generally safe when used correctly, they can be risky for certain groups of people, including young children and those with high blood pressure.

Here’s a guide to avoiding side effects when you take OTC cold medicines.


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Don’t give your children cold medicine

Most children get up to 10 colds before they are two years old. Later, they come down with at least one — and usually several — colds each year. Each can last up to 10 days, and symptoms sometimes come on suddenly.

While that number may seem like a lot of time to be sick, parents who are tempted to dispense OTC cold medicines should look elsewhere for symptom relief, experts say. 

“These products don’t reduce the time the infection will last, and misuse could lead to serious harm,” said pediatrician Matt Davis, MD, MAPP. “What can be confusing, however, is that often these products are labeled prominently as ‘children’s’ medications.”

OTC cough and cold medicines are ok for older kids but, because of the risk for side effects like allergic reactions, increased heart rate, and slowed breathing, many now carry a warnings to avoid their use in children under four years old.

According to the American Academy of Pediatrics, you should check with a doctor before giving an OTC cold medicine to children between age four and six.

Blood pressure risks

Decongestants containing pseudoephedrine relieve stuffiness, narrowing blood vessels in your nose. But what’s good for your nose is bad for your heart because narrowed blood vessels lead to higher blood pressure. When taken with blood pressure-lowering drugs called beta-blockers, pseudoephedrine also increases the risk for irregular heart rhythm.

If you have high blood pressure, you might use a product that doesn’t contain decongestants. If you do take a traditional decongestant, monitor your blood pressure often and alert your doctor to any spikes. Blood pressure numbers less than 120/80 are normal.

Also avoid products containing salt (which may be written as “sodium” or “soda” on the ingredients list), another ingredient on the blood pressure watchlist.

Be careful about using multi-symptom cold medicines that include nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) or naproxen (Aleve).

“These medicines may raise blood pressure a little and at higher doses they can damage the kidneys,” said Willie E. Lawrence, Jr., MD, a cardiologist in Kansas City, Mo.

Cold relief in older adults

Cold medicine side effects can be even more pronounced in older adults. As you get older, your body doesn’t clear medicines as effectively as it once did. Plus, people over 65 often take several medicines simultaneously to manage multiple conditions. Together, those factors can lead to a greater risk for drug interactions and side effects.

In particular, watch out for older-generation antihistamines such as diphenhydramine (Benadryl), which can cause drowsiness, confusion, and blurred vision, increasing your risk for falls and car accidents.

Pain relievers in multi-symptom cold remedies may be linked to stomach ulcers and kidney and liver damage. NSAIDs like ibuprofen and naproxen cause your body to retain water, increasing blood pressure and putting you at greater risk for a heart attack or stroke.

Take no more than the recommended dose, and stay away from alcohol to protect your liver and kidneys.

Cold medicine abuse

OTC cough and cold medicines are particularly dangerous when they’re used for the wrong purpose. Ingredients like dextromethorphan, found in many cough medicines produce a high if you take them in larger-than-recommended amounts.

Abusing cold medicines can affect your brain much like other illicit drug abuse, leading to addiction, as well as increased blood pressure, liver damage, and eventually brain damage.

Safe cold medicine use

You don’t necessarily have to stop taking cold medicines, but you should use them more wisely.

  • Read the package instructions carefully to make sure you take no more than the recommended dose.
  • Use a medicine that targets your symptoms.
  • Avoid multi-symptom products unless you really need them.

If you’re in doubt about whether to take a particular OTC cold remedy, check with your doctor.


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December 04, 2023

Reviewed By:  

Janet O’Dell, RN