AircraftOwner Online

When should you use over the counter cold medicines when flying or otherwise? Almost never!  Since this is cold and flu season, their use goes up and many pilots are faced with a choice.

Over the counter cold medications are just plain horrible.  Although their advertisements may imply they shorten the course of a cold, they do not.  In fact, most of the over counter cold medications have never been proven safe or effective for anything.  Their ingredients were grandfathered in prior to having to prove so and even now, new drugs only have to show they are better than nothing.

The implications for flying are significant.  Many of these cold medications are stimulating like pseudoephedrine which may induce symptoms ranging from being jittery to having tremors—not a good thing in the cockpit.  Plus, altitude may increase ones sensitivity to such medications. 

Other cold medications may cause such symptoms as sedation, dry eyes, dry mouth, and nose bleeds.  Also side effects that are troublesome in an aircraft.

It is important to remember that an antihistamine is for symptoms induced by allergy.  They may dry up a runny nose caused by a cold but that is not how they are supposed to be used. In fact, the dryness caused by antihistamines and other specific cold medications may actually prolong illness since it prevents your body from getting rid of the offensive material.

Although the FAA has accepted a large number of these medications (and even a longer list with a doctor’s note), I would not recommend them for flying unless you have really tried them on the ground and know they will not adversely affect you.  But first, ask yourself the question “Is it really doing anything for me?”

Let me give you an example.  One of the most painful situations we see with colds is related to sinus pressure.  The sinuses are like caves—big on the inside with small drainage openings.  They are lined with mucous membranes just like you nose and produce significant amounts of mucous during a cold.  The over the counter cold medications may dry you up but they thicken the mucous which blocks the small opening of the sinuses.  Then the pressure and pain begins.

What is safe over the counter?  Aspirin, ibuprofen, acetaminophen, and naproxen are the only ones I recommend.  Be sure not to be fooled into by something like “Tylenol Sinus” which is just expensive acetaminophen plus phenylephrine and guaifenesin.  Phenylephrine is similar to the stimulant pseudoephedrine and I have never seen guaifenesin do anything.  From my viewpoint, if you think “expectorants” and “decongestants” do anything, I would like to speak to you about ghosts and goblins.

Aspirin, Ibuprofen, and naproxen are anti inflammatory medications (called NSAIDs—non steroidal anti inflammatory drug) which also reduce fever and pain.  Acetaminophen reduces fever and pain but does not have any anti inflammatory effect.  Always buy the generics unless you like wasting money supporting drug companies!

The bottom line is that everyone gets common colds and nothing will shorten the course.  Lots of fluids (both oral and vapor), rest, and controlling fever are the only things that will help but nothing shortens the course.