The definitive guide to cold cures

Almost everybody suffers from at least one cold every winter, so it's not

surprising that more and more new remedies are flooding the market claiming

to relieve every symptom from a sore throat to a persistent cough. Some

undoubtedly work, but are they really worth the money, or would you be

better off with a cheap packet of paracetamol and a tube of menthol

lozenges? Keren Williams reports.

Sore throat

Viral and bacterial infections can inflame the lining of the throat and

cause discomfort. Cold viruses can also cause the lymph nodes behind the

ears and tonsils to enlarge, which may make swallowing painful.

Best option: Gargle with soluble aspirin - it's very soothing - but any

analgesic will help (you should swallow the aspirin after gargling).

Worth a try: Gargle with warm water; throat lozenges containing syrup,

such as Halls Soothers (49p).

Don't bother: Antibiotics won't help in most cases, so don't go to your GP

unless you have great difficulty swallowing or your symptoms are severe and

have lasted for longer than a couple of weeks.

A blocked nose

Caused by swelling and inflammation of the blood vessels in the nasal

lining. Your nose will start to tingle and drip just eight hours after

being infected with a cold virus.

Best option: A nasal spray containing decongestants which work by

constricting the blood vessels and reducing the swelling. Sprays are much

more effective than decongestants in tablets or hot drinks and safer, since

they are unlikely to affect the rest of the body, says Dr Brian Furman,

reader in pharmacology at the University of Strathclyde. They also work

more quickly and usually last for longer; up to 12 hours in some cases. The ingredients to look for are oxymetazoline and xylometazoline, contained in sprays such as Otrivine decongestant nasal spray (£2.79) and Vicks Sinex Decongestant Nasal Spray (£3.49).

Worth a try: Menthol steam inhalation will give some relief, but usually

your nose fills up soon afterwards, so it has limited value. Olbas Oil

inhalation drops (£2.19) can be added to a steam inhalation or drops added

to a tissue. It contains a blend of oils, including menthol and eucalyptus and

will help unblock your nose temporarily. Oral decongestants in powder and tablet cold remedies, such as Beechams Cold & Flu drinks (£2.79 for 10), which include pseudoephedrine, phenylpropanolamine (PPA) and phenylephrine, can be useful if you don't like using sprays. But they can have a stimulant effect and could keep you awake at night unless you choose a remedy such as Benylin 4 Flu (£3.69 for 24 tabs), which also contains a sedative such as an anti-histamine (diphenhydramine and promethazine), or codine, warns Dr Furman.

Don't bother: Using a nasal spray for more than seven days, as symptoms are

likely to get worse. Stick to the recommended dosage. According to a

Cochrane Review (a review of the best research papers by leading experts),

nasal sprays do work, but after repeated doses they become less effective

due to a rebound effect, when the blood vessels swell even more. Don't take any oral decongestants if you have high blood pressure 'because they all raise blood pressure,' warns Maeve O'Connell, pharmacy manager for Boots.

Tickly cough

Caused by throat inflammation and mucus dripping down the throat from the

nasal passages (a post nasal drip).

Best option: Any syrup-based medicine, such as Veno's Tickly Coughs range

(£3.19), that coats your throat will help. Honey based throat lozenges (see sore throats), and cough syrups give instant, but not sustained relief. Some medicines also contain decongestants, such as Sudafed Linctus non-drowsy, (£3.39) to help reduce the post nasal drip, which might help if you think that is the cause of your cough.

Worth a try: Make your own syrup by heating a couple of tablespoons of

honey and lemon. Professor Ron Eccles, director of the Common Cold Centre

in Cardiff, says increasing the humidity in your bedroom may also help

night coughing. Try putting a damp towel on a warm radiator.

Don't bother: Cough suppressants are supposed to help, but according to a Cochrane Review, there is no evidence that any of the so called 'active ingredients' - codine, dextromethorphan and pholcodine in remedies such as Benylin Dry Coughs (£3.39) and Robitussin for Dry Coughs (£3.49) - actually work. Dr Brian Furman says the doses are too low to have any effect.

Productive cough

If the airways in your lungs become inflamed, which is what happens in

bronchitis, you may develop a chesty cough that produces large amounts of

phlegm.

Best option: Steam inhalation, says Dr Furman. A steam inhalation

containing menthol will help loosen the mucus and clear your airways. This

will help you to cough the phlegm up and clear your sinuses and if you do

it a couple of times a day, it will eventually clear your chest.

Worth a try:Take a hot shower and drink lots of hot drinks to loosen the mucus.

Don't bother: Cough medicines containing expectorants such as guaifenesin

and squill liquid extract in medicines such as Actifed Expectorant (£3.39)

and Buttercup Syrup (£4.15), are supposed to help reduce the volume and

viscosity of mucus, making it easier for you to clear your chest. But Dr Furman says, 'there's no evidence that any of these actually change mucus secretions in the doses used,' so you may as well save your money. Don't take any

medicine containing cough suppressants, (see tickly coughs), as coughing is

vital to clear your chest. And don¿t take antibiotics - research in the

British Medical Journal shows that they don't help get rid of this type of cough,

even if you are coughing up a lot of phlegm and mucus.

Aches and pains caused by a common cold

Nasal congestion, viral infection and a high temperature can all

contribute to a throbbing headache, facial and muscle pains.

Best option: A good pain reliever is all you need, so don't be conned into buying expensive combination remedies containing unnecessary

ingredients. Paracetomol, (500mg-1g, 4-6hrly), ibuprofen (200-400mg 4hrly) and aspirin (300-900mg 4hrly), all work equally well and also help reduce a high temperature. Prices vary enormously between pharmacies, but non-branded versions are extremely cheap - from around 30p for 16 tablets. Paracetamol works differently to the other two types of pain killers, so if you take

Worth a try: A hot bath will ease muscle pains temporarily and steam

inhalation will give some relief from pain caused by nasal congestion.

Massage using lavender oil, available from most health food shops and

pharmacies, sleep and relaxation techniques will also help ease a headache.

Don't bother: If you are in a lot of pain, avoid combination cold remedies

that contain less than the recommended adult dose of analgesia, says Maeve

O'Connell, pharmacy manager for Boots. These include Beechams Cold and Flu

(£2.79 for 10 sachets) and Mu-Cron decongestant and paracetamol (£4.29 for 30 tabs). Some 'cold' remedies also contain little more than a pain

killer, such as Lemsip non-decongestant formula. At £3.99 for 10 sachets, it's

an expensive way to take paracetamol and a low dose of vitamin C. If you have a stomach ulcer you should avoid medications containing aspirin or ibuprofen; sensitivity to both these drugs is greater than with paracetamol, especially in asthmatics.

(NB Prices are taken from a local London pharmacy. Prices do vary though and supermarkets tend to be slightly cheaper.)