What is the most recommend / effective OTC for cold/flu symptoms ?

[RxRetailRx]

There are so many OTC items out there for cold | flu symptoms, in your Opinion , what is the most recommend / effective one ? Do you recommend Coricidin to HBP patients ? Any input will be great appreciated !

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[npage148]

Benadryl and Advil is all i recommend. If they are flying I'll suggest pse too, that's it.

 

[Rouelle]

Hand soap

But seriously, yeah, Benadryl and ibuprofen and/or APAP

 

[RxPreceptor]

Often, there is no 1 best OTC. Just talk to the person, what they've tried already, what meds he/she is on, Dx states, what Sxs are most bothersome, are they ok with something sedating or stimulating?, etc. Then just use your brain...

 

[njac]

Honey


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[owlegrad]

I would ask people what they heard was affective and then agree with them. Got the "consult" over so quickly.

Well, more honestly, I simply didn't argue with people. If they really wanted info, great. If they wanted confirmation that airborne prevents flu, sure it does, they wouldn't make it if it didn't work. If they wanted to hear how great Theraflu is, hey, what's even the point of Tamiflu? Whatever gets me to the next 'consult' as quickly as possible. And the people were so appreciative!

 

[Charcoales]

Runny nose/mucus = loratadine since no side effects

Pain/fever = acetaminophen + ibuprofen (can be taken together if severe)

Cough = usually loratadine since cough can be often due to a post nasal drip which can improve if mucus is dried up by an antihistamine. Otherwise a numbing spray if sore throat like benzocaine spray.

 

[wagrxm2000]

Um, NyQuil of course. It's the nighttime, sniffling, sneezing, aching, coughing, stuffy-head, fever, so you can rest medicine. Haven't you seen the commercials?

 

[owlegrad]

Runny nose/mucus = loratadine since no side effects

I realize I JUST posted that I would say whatever the patient wanted to hear, so I am hardly in a position to judge, but you know that second generation antihistamines are too selective to help with non-histamine related runny nose, right? They are ok for allergy related runny nose but for cold and flu they are worthless.

 

[owlegrad]

Um, NyQuil of course. It's the nighttime, sniffling, sneezing, aching, coughing, stuffy-head, fever, so you can rest medicine. Haven't you seen the commercials?

Now that's my kind of consult!

 

[Charcoales]

I realize I JUST posted that I would say whatever the patient wanted to hear, so I am hardly in a position to judge, but you know that second generation antihistamines are too selective to help with non-histamine related runny nose, right? They are ok for allergy related runny nose but for cold and flu they are worthless.

Yeah doesn't really have the anticholinergic drying effects but mostly the peripheral antihistamine effects for allergy but seems to help some since they say they don't want to be impaired during work from depressing effects

 

[CetiAlphaFive]

I realize I JUST posted that I would say whatever the patient wanted to hear, so I am hardly in a position to judge, but you know that second generation antihistamines are too selective to help with non-histamine related runny nose, right? They are ok for allergy related runny nose but for cold and flu they are worthless.

Ain't that there a what's it who's it whatcha call it,

Anti colon nerdgic?

 

[RxPreceptor]

Most often recommended:
Doxylamine succinate + DXM (+/- APAP)
PSE (+\-) guaifenisen (+\-) IBU or APAP
Guaifenisen (+/-) DXM
Benzocaine + Menthol (+\-) DXM....honey flavored obviously (we don't carry sucrets for some reason? Pectin just tastes so damn good)

 

[PharmDBro2017]

Homeopathic oscillococcinum and elderberry combined is the best treatment evar


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[zelman]

Chicken soup and sleep.

 

[zelman]

Homeopathic oscillococcinum and elderberry combined is the best treatment evar


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You forgot prayer.

 

[pharm B]

Homeopathic oscillococcinum and elderberry combined is the best treatment evar

I’ve been giggling like crazy lately when patients ask about oscillococcinum, and have no idea how to say it. Bonus: we haven’t had any in weeks.

 

[PharmDBro2017]

You forgot prayer.

Coffee enema > prayer


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[RxRetailRx]

Does “Homeopathic” really work? Never recommended anything like that in the past...

 

[Rouelle]

Does “Homeopathic” really work? Never recommended anything like that in the past...

You’re setting yourself up to be flamed pretty hard by asking that.

But to answer your question: no. People recommending it in this thread are exercising sarcasm.

 

[PharmDBro2017]

Does “Homeopathic” really work? Never recommended anything like that in the past...

It’s literally water...

Placebo works though.


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[beautifulrobot]

I hear wearing socks soaked in apple cider vinegar cures pretty much everything.

(ETA: I am being facetious, just in case it wasn't clear.)

 

[owlegrad]

I hear wearing socks soaked in apple cider vinegar cures pretty much everything.

(ETA: I am being facetious, just in case it wasn't clear.)

If your problem is too many friends, yes that should cure that.

 

[wucool33]

I learned a long time ago that consults are mostly worthless. Most people already have something in mind and just want your confirmation. Even if you don’t agree with them, they will still go with their original choice anyway.

 

[CetiAlphaFive]

I learned a long time ago that consults are mostly worthless. Most people already have something in mind and just want your confirmation. Even if you don’t agree with them, they will still go with their original choice anyway.

The absolute worst patient population

 

[PharmDBro2017]

Update to my recommendation:

I’m hearing that Tide Pods work very well for curing the flu. Make sure you wash them down with organic non-gmo water.


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[lord999]

If you are still a student, you might want to crack open the Pray book and read it. You won't be wasting your time.

Nonpharmaceutical options that should always be recommended:
1. Rest
2. Fluids
3. Avoid contact with other sick people, ESPECIALLY day-care children
4. If it gets better and then gets worse, immediately seek medical attention.

My (sarcastic) 1% combo recommendation for colds, if it doesn't cure, it certainly comforts:
Methamphetamine 5 mg q 4 h for stuffed nose and energy
Hydromorphone 2 mg q 2-4 h as needed for cough
Ibuprofen 800 mg tid atc for fever and cytokine suppression
Cocaine HCl 100 g ad lib for McAfee's nursing care and stuffed nose refractive to methamphetamine
Oxymetazoline nasal for runny nose (and yes, while this list is satirical, I really hate that Afrin is OTC)

Very NSFW Reference on nursing care: How To Uninstall McAfee Antivirus by John McAfee

 

[RxPreceptor]

I would have to disagree that consults are worthless...just take a look at the hundreds of products people have to choose from (consults save them a huge time playing "what if" & seeing past the marketing bull ****/advertisement). I have never recommended any oral phenylephrine type products because they simply do not work (this is the #1 most useless cough/cold ingredient, not everyone is aware of that)

 

[Sine Cura]

The absolute worst patient population

You mean like 90% of all customers?

 

[npage148]

I learned a long time ago that consults are mostly worthless. Most people already have something in mind and just want your confirmation. Even if you don’t agree with them, they will still go with their original choice anyway.

Them:Where's the ZzQwil? It's the only thing that helps me sleep.

Me: could I interest you in some generic diphenhydramine? It's the same thing and 1/100 the price

Them: you stupid boy? I said sleep not allergies like it says on the box

Me: probably, the ZzQwil is down there.

 

[owlegrad]

“You stupid boy” LMAO

 

[owlegrad]

I learned a long time ago that consults are mostly worthless. Most people already have something in mind and just want your confirmation. Even if you don’t agree with them, they will still go with their original choice anyway.

That is why I asked my magic question. “What have you heard about?” It very quickly separated people who are legitimately asking for your professional knowledge and people that just want to hear that whatever their neighbors said is true. A huge time saver.

 

[CetiAlphaFive]

You mean like 90% of all customers?

The absolute worst patient population

I pressed "post reply" before i was done.
The worst patient population for me is Mexicans from rural parts of Mexico.

They'll come in and the other pharmacists or techs will call me over for an OTC consult in Spanish.


Without fail, every single time, it'll end up being that they want me to sell/prescribe them an Rx only item or give them an injection.

I'll tell them that is illegal, American pharmacies are different, and then I repeat my OTC recommendation a few times while they keep asking for the Rx drug/ injection with a blank look on their face.

They then begrudgingly buy the most expensive brand OTC item that I *didn't* recommend, and then they come back after a few days wanting a refund because it didn't work.

 

[txpharmguy]

I pressed "post reply" before i was done.
The worst patient population for me is Mexicans from rural parts of Mexico.

They'll come in and the other pharmacists or techs will call me over for an OTC consult in Spanish.


Without fail, every single time, it'll end up being that they want me to sell/pres c ribe them an Rx only item or give them an injection.

I'll tell them that is illegal, American pharmacies are different, and then I repeat my OTC recommendation a few times while they keep asking for the Rx drug/ injection with a blank look on their face.

They then begrudgingly buy the most expensive brand OTC item that I *didn't* recommend, and then they come back after a few days wanting a refund because it didn't work.

Give them Beeks BayPoRoob

 

[CountBy5s]

Windex

 

[CetiAlphaFive]

Give them Beeks BayPoRoob

My go to is usually Nahy gwill or Sube Feb.

 

[KimChiSlap]

Pho

 

[quickpic007]

Them:Where's the ZzQwil? It's the only thing that helps me sleep.

Me: could I interest you in some generic diphenhydramine? It's the same thing and 1/100 the price

Them: you stupid boy? I said sleep not allergies like it says on the box

Me: probably, the ZzQwil is down there.

Lol I should get a commission from zquil...I hustle that stuff for sleep like no other.

 

[Sparda29]

I've self-dosed with 150 mg diphenhydramine to sleep through a cold + cough + stuffy nose. For headaches, I like using APAP 1000 mg + Ibuprofen 800 mg + coffee.

Whenever I recommend these doses to my non-healthcare field friends, they think I'm trying to kill them.

 

[CetiAlphaFive]

I've self-dosed with 150 mg diphenhydramine to sleep through a cold + cough + stuffy nose. For headaches, I like using APAP 1000 mg + Ibuprofen 800 mg + coffee.
Whenever I recommend these doses to my non-healthcare field friends, they think I'm trying to kill them.

You don't use... You know...

For headaches?

 

[BidingMyTime]

There are so many OTC items out there for cold | flu symptoms, in your Opinion , what is the most recommend / effective one ? Do you recommend Coricidin to HBP patients ? Any input will be great appreciated !

Yeah, so many OTC products, and they are either the same thing, or different combinations of maybe 6 ingredients. The only thing special about Coricidin, it doesn't have pseudoephedrine or phenylephrine in it, just like many other options. And the other options are probably cheaper than Coricidin. If you aren't following Owlegrad's advice, which I wash I would have thought of sooner, he's right it will save a lot of time....but if you aren't following his advice, ask the patient what their symptoms are, and if they don't know then ask them specific questions, dry hacky cough or do you feel like you have something in your lungs you need to cough up, runny nose or stuffy nose, sore throat or muscle aches or headache.) Then recommend the cheapest product your store sells that will treat those symptoms....unfortunately, that usually means getting more than one product, which people don't like to do.

Does “Homeopathic” really work? Never recommended anything like that in the past...

Absolutely, it is every bit as effective as placebo. I don't recommend it, and I used to try to discourage people against it....but people didn't want to believe me, so now I just tell them that there is no evidence it works, but if they have the money to spend, then no reason not to give it a try. Most people asking about homeopathy want to believe it works, so no reason not to sell them their placebo.

You don't use... You know...
For headaches?

I'm guessing he was coughing so bad that he couldn't inhale?

 

[PharmDBro2017]

The amount of homeopathic warriors on Facebook is disturbing... one little comment saying that homeopathy is bull**** and the next thing you know, ten uneducated crunchy organic moms are ready to crucify you.


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[owlegrad]

...ask the patient what their symptoms are, and if they don't know then ask them specific questions, dry hacky cough or do you feel like you have something in your lungs you need to cough up...

I remember once back when I was a good pharmacist I asked a person what kind of cough he had. He was standing right next to me. He literally coughed in my face. In case you are wondering it was a productive cough.

If I could possibly trace back my pharmacy career to the exact point I started to hate the public I am sure that would be a milestone event. I never asked another question about coughing.

 

[CetiAlphaFive]

Homeopathic oscillococcinum and elderberry combined is the best treatment evar
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Bruh I've been making SICK profit with selling kids sambucol to adults.


"It's the same as the kids.
Just take twice as much.

It doesn't work, by the way"

 

[CetiAlphaFive]

Also, some ****face MD went on the local news telling people to buy oscillocuckinum and sambullcol.

I'm gonna call and scream at them from my Google voice number.

 

[Old Timer]

You treat the symptoms that are present only........ I hate combinations products.

Be careful of:

First Generation antihistamines:

• Men over 50 especially with BPH
• People with dry eyes (common in older folks)
• People with any type of arrhythmia. A-fib is pretty common in people over 70
• People taking any CNS depressants

NSAIDS:

• People with GERD
• People with Ulcers
• People with uncontrolled or barely controlled hypertension
• People with kidney disease

Pediatric Patients: I usually recommend analgesics, a vaporizer and tissues. Kids should be observed for lethargy and food consumption. Once a kid stops eating and playing it's time to see a physician. When they come up holding a box of cough medicine and ask if they can give it to their child, my standard response is: If it will make you feel better.


Basically rest, hydration, analgesics, and specific symptomatic treatment.

 

[CetiAlphaFive]

You treat the symptoms that are present only........ I hate combinations products.

Be careful of:

First Generation antihistamines:

• Men over 50 especially with BPH
• People with dry eyes (common in older folks)
• People with any type of arrhythmia. A-fib is pretty common in people over 70
• People taking any CNS depressants

NSAIDS:

• People with GERD
• People with Ulcers
• People with uncontrolled or barely controlled hypertension
• People with kidney disease

Pediatric Patients: I usually recommend analgesics, a vaporizer and tissues. Kids should be observed for lethargy and food consumption. Once a kid stops eating and playing it's time to see a physician. When they come up holding a box of cough medicine and ask if they can give it to their child, my standard response is: If it will make you feel better.


Basically rest, hydration, analgesics, and specific symptomatic treatment.

Breddy good.

I always tell people who ask me if they can give their 3 year old ________ product that says it's for kids older than 3, "if your pediatrician told you to, then go with their recommendation.
Other than that, no. Your kid might be the 1 in a million that might die."

 

[txpharmguy]

Also, some ****face MD went on the local news telling people to buy oscillocuckinum and sambullcol.

I'm gonna call and scream at them from my Google voice number.

There was this nonsense from Good Morning America a few weeks ago. SMDH.
3 complementary natural remedies for the flu

 

[RxRetailRx]

I had a patient hold a picture exactly like this today and asked me where she could find them ??? Time to watch some commercials ... so misleading...

 

[BidingMyTime]

I remember once back when I was a good pharmacist I asked a person what kind of cough he had. He was standing right next to me. He literally coughed in my face. In case you are wondering it was a productive cough.

Good point, Owlegrad.

OP, Owelegrad is obviously more experienced in this area than I am. So, based on his wisdom, I would suggest not asking any questions.

Probably best to just recommend Theraflu, since the general public thinks "it's just lie Tamaflu" anyway.