We know you sometimes have burning questions that can best be answered by a pharmacist. Our feature, Ask Your Pharmacist, seeks to address some of those issues. Send your questions to healthandwealth@jamaicaobserver.com.

Question: I am hypertensive. Why can’t I take certain cough and cold medicines?

Answer: Coughs and colds are common recurring ailments. They are annoyingly uncomfortable, especially if we are congested. Thankfully, there are many remedies to help us feel better as we wait for the common cold virus to exit our bodies. Many of these remedies are even over-the-counter (OTC), making access to them easy. However, if we are hypertensive, we have to be a little more careful when selecting OTC medicines to help with coughs and colds.

Cough and cold medicines often have a combination of ingredients to help with the different symptoms that may be present. These medications typically have some combination of the following agents:

• An antihistamine or allergy medication. This helps with runny nose and itchy throat. Examples of antihistamines include diphenhydramine (DPH) and chlorpheniramine (Histal).

• A painkiller. Paracetamol is a common painkiller in cough and cold remedies. NSAID painkillers are also popular. NSAIDS include ibuprofen (Advil) and naproxen (Aleve).

• A decongestant to clear nasal congestion. Examples of decongestants include ephedrine, pseudoephedrine, and phenylephrine.

• An expectorant to help cough up mucous. An example of an expectorant is guaifenesin.

• A cough suppressant to reduce the frequency of coughs. An example of a cough suppressant is dextromethorphan.

It is clear that all these ingredients are helpful to relieve the symptoms of coughs and colds. However, two of these components – NSAID painkillers, and decongestants – are not recommended for people who are hypertensive.

NSAIDS are very effective painkillers. Not only do they help with pain, but they also help to relieve inflammation. NSAIDS cause an increase in blood pressure because of their effects on the kidneys. NSAIDS cause the kidneys to retain salt and water, leading to increased blood volume and increased blood pressure. If you are hypertensive, NSAIDS will definitely make the hypertension worse and they will reduce the effectiveness of anti-hypertensive medications. NSAIDS also increase the risk of blood clots, which can lead to heart attacks and strokes. If you are hypertensive, you are already at increased risk of these cardiovascular events so you do not want to do anything to make it worse.

The other dangerous component of cough and cold medicines are decongestants. Decongestants work magic by relieving nasal stuffiness. They work by narrowing blood vessels and reducing swelling in the nose. Unfortunately, they can cause other blood vessels in the body to narrow, reducing blood flow, causing the heart to work harder, and inevitably increasing blood pressure. Decongestants interfere with the effectiveness of prescribed blood pressure medications. They are not to be used in persons with hypertension.

How then can hypertensive patients manage cough and cold symptoms if there are so many restrictions? The answer lies in treating the specific symptoms that are present at any given time. Often, we may not have all the symptoms of the common cold, but multi-symptom preparations give us all these different components to treat symptoms that may arise. If you have pain and fever, take some paracetamol. Avoid NSAID painkillers like Ibuprofen and Naproxen as they increase blood pressure. To relieve nasal congestion, use a saline nasal spray. To soothe your throat, gargle with salt water, drink warm water or tea with honey and lemon, or suck on menthol lozenges. Use a humidifier to make the air inside the house easier to breathe. Drink lots of fluids and get plenty of rest. Another option is to use cough medicines specifically formulated for persons with high blood pressure.

Remember the common cold is a virus that will likely leave your system in about two weeks. None of these medications can actually help the cold heal faster. The medicines are meant to treat the symptoms to help you better cope with the virus while it is in your system. Hence, you are not at any disadvantage if you treat specific symptoms as opposed to using a multi-symptom therapy.

In conclusion, whatever medication you choose to use to relieve your cough and cold symptoms, be sure to read the list of ingredients or ask your pharmacist to ensure that the medication does not contain a decongestant or an NSAID painkiller.

Novia Jerry Stewart, MSc, RPh, is a pharmacist who specialises in ophthalmic care. She may be contacted at novia_jerry@yahoo.com.