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CBC MARKETPLACE: YOUR HEALTH » COLD/FLU MEDICATIONS
The potential danger: Non-prescription pills pack a punch
Broadcast: January 30, 2005

Dr. Graydon Meneilly

Dr. Graydon Meneilly says the medications can lead to confusion, constipation and bladder problems in seniors.

Typical cough and cold pills contain powerful antihistamines and decongestants.

They’re great for drying up a runny nose, but because we metabolize drugs much more slowly as we age – they take longer to run through our systems as we grow older. They can also affect an older person’s body much more forcefully than younger adults.

Dr. Graydon Meneilly, an expert on the elderly and head of medicine at Vancouver General Hospital, says the medications can lead to confusion, constipation and bladder problems in seniors.

Meneilly says warnings should be prominently displayed on all over-the-counter cold medications. But they’re not.

“It isn’t emphasized enough on the label,” says Meneilly, “that ‘if you’re a senior, and you have the following conditions, you shouldn’t take this at all.’”

FACT

The cold vs. the flu: how can you tell the difference?

Colds attack the head, causing a stuffy nose and congestion. The flu goes into the chest. It usually starts with a fever, chills, severe aches and pains and a dry cough.

MORE: Cold vs. flu symptoms »

For example, Meneilly cites the labelling on Tylenol Flu Extra Strength:

“It has a caution: ‘Keep out of reach of children, talk to a doctor if you have a variety of medical conditions or are on medication.’ But it doesn’t say anything about being careful if you’re an old person.”

It’s not just the odd package that doesn’t carry a warning – we found more than a dozen over-the-counter cough and cold medications—best-selling brands—that carried no warnings for seniors. 

Meneilly says that’s a potentially disastrous omission: “It’s a big problem … All we see is the molehill, but it’s in fact a mountain.” In Meneilly’s estimation, case’s like Nick Ciolfitto’s happen “much more frequently than we think.”

The ingredients

Close-up of an elderly woman's face.

Diphenhydramine and chlorpheniramine can cause serious problems in seniors

Two of the most powerful, common ingredients in cold and flu medications are diphenhydramine and chlorpheniramine.

They’re big words that appear in small print on the ingredient lists of many over-the-counter cold and flu medications.

Diphenhydramine and chlorpheniramine are antihistamines. They’re found in more than 30 products in the Canadian market.

MORE: Products containing diphenhydramine and chlorpheniramine (but no warning for seniors) »

Both can cause serious problems in seniors: confusion, heavy sedation, bladder retention, severe constipation… and in the case of diphenhydramine, delirium.

FACT

Cold viruses are transmitted in one of two ways: 1) touching a person's skin (when shaking hands, for example) or surfaces (like doorknobs or handrails) and then touching the eyes, nose or mouth, or 2) by inhaling infectious particles in the air (like secretions from a cough or sneeze).

The best way to break the chain of infection is to wash your hands regularly – and avoid touching your nose, eyes or mouth.

Diphenhydramine and chlorpheniramine can be so problematic they’re ranked on something called ‘the Beers Critera,’ [link] a list of medications compiled by leading medical researchers in the U.S. The list includes drugs the researchers warn are “highly inappropriate” for seniors to take.

“In some cases,” Meneilly says seniors using the drugs can suffer effects “serious enough to require hospitalization. And sometimes people even die.”

And while Meneilly admits changing the actual compositions of the medications –getting rid of diphenhydramine and chloropheniramine– may be too tall an order, “but at least if the labels and the warnings are better, that would really help people to avoid side effects from them.”

Unfortunately, in Canada the regulations guiding the labelling of over-the-counter medications don’t seem to measure up.

NEXT: Product labelling doesn't measure up »

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OUT IN THE COLD: MAIN PAGE THE POTENTIAL DANGER: NON-PRESCRIPTION PILLS PACK A PUNCH PRODUCT LABELLING DOESN'T MEASURE UP LIST OF PRODUCTS THAT DON'T CARRY A WARNING TIPS: COLD REMEDY ALTERNATIVES COLD VS. FLU SYMPTOMS

CREDITS
MORE MARKETPLACE: CHICKEN SOUP FOR THE COLD? MARKETPLACE ARCHIVES: YOUR HEALTH ORDER TAPES
WATCH THE STORY:

Out in the Cold (Runs 12:49)
[download RealVideo]

RELATED:

CBC News Indepth: The Flu

CBC News Indepth: Faint Warning: How Canada tracks dangerous drugs


Canada's Adverse Drug Reaction Database

Cold medicines may be too strong for seniors: geriatrician (January 28, 2005)

Hope for cold season, Alberta company claims (October 7, 2004)

Costs of common cold nothing to sneeze at (February 24, 2003)

Echinacea won't soothe your cold: report (December 19, 2002)

Common food ingredient fights colds: study (October 3, 2001)

Mom was right – chicken soup helps fight colds (October 17, 2000)

Sneezing for science (August 29, 2000)

EXTERNAL LINKS:

CBC does not endorse and is not responsible for the content of external sites. Links will open in new window.

The Beers Criteria -
list of medications compiled by medical researchers that they warn are “highly inappropriate” for seniors to take. That list includes diphenhydramine and chlorpheniramine

Health Canada FluWatch reports - biweekly summary of influenza surveillance activities in Canada

Health Canada: Influenza/Flu


Health Canada: Adverse Drug Reaction Information

The Common Cold - information from the Canadian Lung Association

Common Cold Sense - fact sheet from Ontario's Ministry of Health and Long-Term Care

Seniors and Medication - information from the Canada Safety Council

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