How do Advil Cold and Flu products work to relieve symptoms. What are the active ingredients in various Advil cold and flu formulations. Is ibuprofen safe and effective for treating cold and flu symptoms. How does ibuprofen compare to other pain relievers in terms of tolerability.

Understanding Advil Cold and Flu Formulations

Advil offers a range of cold and flu relief products designed to address multiple symptoms simultaneously. These formulations typically contain ibuprofen as the primary active ingredient, along with additional components tailored to specific symptom profiles.

Advil Cold and Flu

This standard formulation contains 200 mg of ibuprofen per caplet. It’s designed to alleviate common cold and flu symptoms, including:

• Sore throat
• Sinus pain
• Headache
• Fever
• Minor body aches and pains

In addition to ibuprofen, it contains 38 mg of diphenhydramine citrate, which can help with allergy-related symptoms often associated with colds.

Advil Cold, Cough and Flu Nighttime

This nighttime formula also contains 200 mg of ibuprofen per caplet but replaces the diphenhydramine citrate with 25 mg of diphenhydramine hydrochloride. This ingredient can help with:

• Cough suppression
• Runny nose
• Sneezing
• Promoting sleep

Advanced Formulations for Targeted Symptom Relief

Advil has developed several specialized cold and flu products to address specific symptom combinations and severity levels.

Advil Cold and Sinus Liqui-Gels

These fast-acting gel capsules contain:

• 200 mg ibuprofen
• 30 mg pseudoephedrine hydrochloride

The addition of pseudoephedrine targets nasal and sinus congestion specifically, making this formulation ideal for those with prominent sinus symptoms.

Advil Cold and Sinus Nighttime

This nighttime formula combines:

• 200 mg ibuprofen
• 30 mg pseudoephedrine hydrochloride
• 2 mg chlorpheniramine maleate

The chlorpheniramine maleate adds antihistamine properties, helping to reduce allergy-like symptoms while potentially aiding sleep.

Advil Cold and Sinus Plus

This enhanced daytime formula mirrors the nighttime version, containing:

• 200 mg ibuprofen
• 30 mg pseudoephedrine hydrochloride
• 2 mg chlorpheniramine maleate

It’s designed for those who need comprehensive symptom relief during waking hours without the sleep-inducing effects of some nighttime formulas.

Extra Strength Options for Severe Symptoms

For those experiencing particularly intense cold and flu symptoms, Advil offers an extra strength formulation.

Advil Cold, Sinus and Flu Extra Strength

This powerful combination includes:

• 400 mg ibuprofen (double the standard dose)
• 60 mg pseudoephedrine hydrochloride
• 4 mg chlorpheniramine maleate

The increased dosages of all active ingredients make this suitable for managing severe cold and flu symptoms when standard formulations prove insufficient.

The Science Behind Ibuprofen in Cold and Flu Relief

Ibuprofen, the core component of Advil products, belongs to a class of medications known as nonsteroidal anti-inflammatory drugs (NSAIDs). Its multifaceted action provides several benefits in managing cold and flu symptoms:

• Analgesic: Relieves pain, including headaches and body aches
• Antipyretic: Reduces fever
• Anti-inflammatory: Decreases inflammation in the respiratory tract and sinuses

These properties make ibuprofen an effective choice for addressing the most common and uncomfortable symptoms associated with colds and flu.

Comparative Tolerability of Ibuprofen

The safety and tolerability of over-the-counter (OTC) pain relievers are crucial considerations for consumers and healthcare providers alike. A large-scale study known as the PAIN study provides valuable insights into how ibuprofen compares to other common pain relievers.

The PAIN Study: Key Findings

This randomized trial, published in Clinical Drug Investigation, compared nonprescription doses of acetylsalicylic acid (ASA), acetaminophen, and ibuprofen in 8,677 adults. The study focused on the rates of significant adverse events related to tolerability. Key findings include:

• Ibuprofen’s overall tolerability was statistically equivalent to that of acetaminophen
• Ibuprofen demonstrated superior tolerability compared to ASA

The primary outcome measure was the number of patients experiencing at least one significant adverse event, defined as an event that was:

• Serious, severe, or moderate
• Resulted in a second physician consultation
• Led to cessation of treatment
• Of missing intensity

Study Design and Scope

The PAIN study was a comprehensive investigation with the following characteristics:

• Blinded, multicenter study conducted in general practice settings
• Treatment duration of up to 7 days
• Compared ASA and acetaminophen (both up to 3 g daily) with ibuprofen (up to 1.2 g daily)
• Focused on common painful conditions
• Used patient-generated data with physician assistance
• Involved 1,108 general practitioners and 8,677 adult patients

The main indications for treatment in this study were:

• Musculoskeletal or back pain (48% of cases)
• Sore throat, common cold, and flu (31% of cases)

Gastrointestinal Tolerability of Ibuprofen

A common concern with NSAIDs is their potential impact on the gastrointestinal (GI) system. The PAIN study provided valuable data on this aspect as well.

When used as directed for acute pain, OTC ibuprofen demonstrated good tolerability, including with respect to GI events. The study specifically looked at total GI events, which included instances of dyspepsia (indigestion).

These findings suggest that when used appropriately and for short-term relief of acute symptoms, ibuprofen presents a favorable tolerability profile, including for GI-related concerns.

Safe and Effective Use of Ibuprofen-Based Cold Medicines

While the data supports the safety and efficacy of ibuprofen-based cold and flu medications, it’s crucial to use these products as directed. Here are some key points to remember:

• Follow dosage instructions carefully
• Do not exceed the recommended daily limit
• Use for the shortest duration necessary to control symptoms
• Consult a healthcare provider if symptoms persist or worsen
• Be aware of potential interactions with other medications
• Consider individual risk factors, such as a history of GI issues or cardiovascular disease

Are there any precautions to take when using ibuprofen-based cold medicines? Yes, there are several important considerations:

• Avoid use if you have a history of allergic reactions to NSAIDs
• Use caution if you have a history of stomach ulcers or bleeding disorders
• Consult a doctor before use if you are pregnant, breastfeeding, or have chronic health conditions
• Be aware of the potential for drowsiness with nighttime formulations
• Do not combine multiple products containing ibuprofen to avoid overdose

Choosing the Right Advil Cold and Flu Product

With the variety of Advil cold and flu products available, selecting the most appropriate option can be challenging. Consider the following factors when making your choice:

Symptom Profile

Identify your most prominent symptoms to guide your selection:

• For general cold and flu symptoms: Standard Advil Cold and Flu
• For nighttime relief and sleep aid: Advil Cold, Cough and Flu Nighttime
• For sinus-specific issues: Advil Cold and Sinus Liqui-Gels
• For severe symptoms: Advil Cold, Sinus and Flu Extra Strength

Time of Day

Consider when you’ll be taking the medication:

• Daytime use: Opt for non-drowsy formulations
• Nighttime use: Choose products with sleep-promoting ingredients

Duration of Action

Think about how long you need symptom relief:

• For quick, short-term relief: Consider Liqui-Gels formulations
• For extended relief: Standard caplets may provide longer-lasting effects

Individual Sensitivities

Be mindful of your personal health history:

• If prone to stomach upset: Choose formulations with the lowest effective dose of ibuprofen
• If sensitive to drowsiness: Avoid nighttime formulas during the day
• If you have allergies: Check for antihistamine content in the product

By carefully considering these factors, you can select the Advil cold and flu product that best suits your individual needs and symptoms.

The Role of Complementary Treatments

While Advil cold and flu products can provide significant symptom relief, they are most effective when used as part of a comprehensive approach to managing colds and flu. Consider incorporating these complementary strategies:

Hydration

Proper hydration is crucial during illness. It helps to:

• Thin mucus secretions, making them easier to expel
• Prevent dehydration, especially if you have a fever
• Support overall immune function

Aim to drink plenty of water, herbal teas, and clear broths throughout the day.

Rest and Sleep

Adequate rest is essential for recovery. It allows your body to:

• Direct energy towards fighting the infection
• Reduce stress on your immune system
• Promote healing and regeneration

Use nighttime formulations to help ensure quality sleep when symptoms are interfering with rest.

Nutritional Support

A balanced diet rich in vitamins and minerals can support your immune system. Consider incorporating:

• Vitamin C-rich foods like citrus fruits and bell peppers
• Zinc-containing foods such as lean meats and legumes
• Probiotic-rich foods to support gut health and immunity

Humidity Control

Maintaining proper humidity levels can alleviate respiratory symptoms:

• Use a humidifier to add moisture to dry air
• Take steamy showers to temporarily relieve congestion
• Use saline nasal sprays to moisturize nasal passages

By combining these strategies with appropriate use of Advil cold and flu products, you can create a comprehensive approach to managing your symptoms and supporting your body’s natural healing processes.

When to Seek Professional Medical Advice

While over-the-counter medications like Advil cold and flu products can effectively manage many cold and flu symptoms, there are instances when professional medical advice should be sought. Be aware of the following situations:

Persistent or Worsening Symptoms

If your symptoms don’t improve after several days of self-treatment, or if they worsen, it’s time to consult a healthcare provider. This is particularly important if you experience:

• High fever (over 103°F or 39.4°C) that doesn’t respond to fever reducers
• Severe headache or neck stiffness
• Difficulty breathing or chest pain
• Persistent cough lasting more than two weeks

Signs of Complications

Some symptoms may indicate a more serious condition or complication. Seek immediate medical attention if you notice:

• Severe sinus pain or swelling of the face
• Coughing up blood or bloody mucus
• Severe ear pain or discharge from the ear
• Confusion or altered mental state

High-Risk Individuals

Certain groups should be more cautious and consult a healthcare provider sooner. This includes:

• Elderly individuals (65 years and older)
• Young children (especially those under 2 years old)
• Pregnant women
• People with weakened immune systems
• Individuals with chronic health conditions (e.g., diabetes, heart disease, lung disease)

Adverse Reactions to Medication

If you experience any unusual or severe reactions to Advil cold and flu products, discontinue use and seek medical advice. Watch for:

• Allergic reactions (rash, itching, swelling)
• Gastrointestinal issues (severe stomach pain, black or bloody stools)
• Cardiovascular symptoms (chest pain, rapid heartbeat)
• Neurological symptoms (severe headache, dizziness, vision changes)

Remember, while Advil cold and flu products are effective for many people, they are not suitable for everyone in all situations. When in doubt, it’s always better to err on the side of caution and consult with a healthcare professional.

Advil Cough, Cold & Flu and Advil for Cold & Sinus

Advil Cold and Flu works hard to relieve cold and flu symptoms

Proven safe and effective when used as directed, Advil Cold and Flu contains 200 mg of ibuprofen available in caplet format to relieve sore throat, sinus pain, headache, fever and minor body aches and pains due to the common cold and flu. Other active ingredients include 38 mg diphenhydramine citrate (see Advil Cold, Cough & Flu and Cold & Sinus Product Details section for more information)

Advil Cold, Cough and Flu Nighttime works hard to relieve cold and flu symptoms

Proven safe and effective when used as directed, Advil Cold, Cough and Flu Nighttime contains 200 mg of ibuprofen available in caplet format to relieve sore throat, sinus pain, headache, fever and minor body aches and pains due to the common cold and flu. It also contains 25 mg of diphenhydramine hydrochloride (see Advil Cold, Cough & Flu and Cold & Sinus Product Details section for more information)

Advil Cold and Sinus Liqui-Gels work hard to relieve cold and flu symptoms

Proven safe and effective when used as directed, fast acting Advil Cold and Sinus Liqui-Gels contains 200 mg of ibuprofen available in gel capsule format to relieve sore throat, sinus pain, headache, fever and minor body aches and pains due to the common cold. It also contains 30 mg of pseudoephedrine hydrochloride (see Advil Cold, Cough & Flu and Cold & Sinus Product Details section for more information)

Advil Cold and Sinus Nighttime works hard to relieve cold symptoms

Proven safe and effective when used as directed, Advil Cold and Sinus Nighttime contains 200 mg of ibuprofen available in caplet format to relieve sore throat, sinus pain, headache, fever and minor body aches and pains due to the common cold. It also contains 30 mg of pseudoephedrine hydrochloride and 2 mg of chlorpheniramine maleate (see Advil Cold, Cough & Flu and Cold & Sinus Product Details section for more information)

Advil Cold and Sinus Plus works hard to relieve cold symptoms

Proven safe and effective when used as directed, Advil Cold and Sinus Plus contains 200 mg of ibuprofen available in caplet format to relieve sore throat, sinus pain, headache, fever and minor body aches and pains due to the common cold. It also contains 30 mg of pseudoephedrine hydrochloride and 2 mg of chlorpheniramine maleate (see Advil Cold, Cough & Flu and Cold & Sinus Product Details section for more information)

Advil Cold, Sinus and Flu Extra Strength works hard to relieve cold and flu symptoms

Proven safe and effective when used as directed, Advil Cold, Sinus and Flu Extra Strength contains 400 mg of ibuprofen available in caplet format to relieve sore throat, sinus pain, headache, fever and minor body aches and pains due to the common cold and flu. It also contains 60 mg of pseudoephedrine hydrochloride and 4 mg of chlorpheniramine maleate (see Advil Cold, Cough & Flu and Cold & Sinus Product Details section for more information)

Advil contains ibuprofen – a nonsteroidal anti-inflammatory drug (NSAID)

Ibuprofen is the active ingredient in Advil that relieves pain and reduces fever. Like all NSAIDs, ibuprofen is an analgesic, antipyretic, and anti-inflammatory.^1,2

NSAID = nonsteroidal anti-inflammatory drug.

Overall & GI Tolerability Profile

Ibuprofen comparative tolerability in a large-scale randomized trial

In the PAIN study, published in Clinical Drug Investigation, overall tolerability of ibuprofen was:^2,3

• Statistically equivalent to that of acetaminophen
• Superior to that of ASA

This large-scale randomized trial comparing nonprescription doses of ASA, acetaminophen, and ibuprofen in 8,677 adults measured rates of significant adverse events related to tolerability. The primary outcome measure was the number of patients with at least one significant adverse event, defined as an event that was serious, severe or moderate, resulted in a second physician consultation, led to cessation of treatment, or was of missing intensity. Statistical analysis tested for equivalence between ibuprofen and acetaminophen and for difference with ASA.^2,3*

ASA = acetylsalicylic acid; GI = gastrointestinal.* This was a blinded, multicentre study in general practice of up to 7 days of ASA, acetaminophen (both up to 3 g daily) or ibuprofen (up to 1.2 g daily), administered for common painful conditions, using patient generated data with physician assistance. 1,108 general practitioners included 8,677 adults (2,900 ASA; 2,886 ibuprofen; 2,888 acetaminophen; 3 patients had no code label number). The main indications were musculoskeletal or back pain (48%), sore throat, the common cold and flu (31%).

When used as directed for acute pain, OTC ibuprofen is well tolerated

^2*

In the PAIN study, which included over 8,500 patients, total GI events (including dyspepsia) and abdominal pain were less frequent with ibuprofen (200 mg) compared to ASA (500 mg) or acetaminophen (500 mg) ) (all p<0. 035)^2,3

This large-scale randomized trial comparing nonprescription doses of ASA, acetaminophen, and ibuprofen in 8,677 adults measured rates of significant adverse events related to tolerability. The primary outcome measure was the number of patients with at least one significant adverse event, defined as an event that was serious, severe or moderate, resulted in a second physician consultation, led to cessation of treatment, or was of missing intensity. Statistical analysis tested for equivalence between ibuprofen and acetaminophen, and for difference with ASA.^2,3*

GI: gastrointestinal; ASA: acetylsalicylic acid; OTC = over the counter.

* This was a blinded, multicentre study in general practice of up to 7 days of ASA, acetaminophen (both up to 3 g daily) or ibuprofen (up to 1.2 g daily), administered for common painful conditions, using patient generated data with physician assistance. 1,108 general practitioners included 8,677 adults (2,900 ASA; 2,886 ibuprofen; 2,888 acetaminophen; 3 patients had no code label number). The main indications were musculoskeletal or back pain (48%), sore throat, the common cold and flu (31%).

Cardiovascular Safety Profile

Cardiovascular safety profile

Cardiovascular risk of ibuprofen is dose-dependent and did not increase with use at OTC doses (≤1200mg/day):^4-8†

* Long term continuous use may increase the risk of heart attack or stroke.

CHD = coronary heart disease; CI = confidence interval; HR = hazard ratio; MI = myocardial infarction; NSAID = nonsteroidal anti-inflammatory drug; OTC = over the counter; RR = relative risk.

^† Andersohn F and colleagues conducted a nested case-control study in a cohort of 486,378 persons registered within the United Kingdom General Practice Research Database with at least 1 prescription of an NSAID between June 1, 2000 and October 31, 2004. Rate ratios of acute MI associated with use of COX-2–selective and –nonselective NSAIDs were calculated. The duration of each NSAID prescription was determined by dividing the quantity of prescribed tablets by the number of tablets to be taken daily. “Current” exposure was defined as a NSAID prescription that lasted into the 14-day period before the index date. “Recent” exposure denoted a supply that ended between 15–183 days before the index date, and “past” exposure denoted a supply that ended between 184 days and 1 year before the index date. “Nonuse” was defined as no use of any NSAID during the year before the index date. Rate ratios appeared to increase with higher daily doses of COX-2 inhibitors and were also increased in patients without major cardiovascular risk factors.

Garcia Rodriguez LA and colleagues conducted a population-based, nested case-control analysis of medical records from The Health Improvement Network database in the United Kingdom. The risk of MI was assessed in 716,394 individuals 50–84 years of age between January 2000 and October 2005 (followed up on average of 4.1 years). NSAID exposure was categorized as: “current” when the supply of the most recent prescription lasted until the index date (day of first sign leading to hospitalization) or ended in the 7 days before the index date; “recent”, when it ended 8–90 days before the index date; “past”, when it ended 91–365 days before the index date; and “nonuse”, when there was no recorded use in the year before the index date. “Current use” was subdivided into: “single” when there was use of only one individual NSAID the month before the index date; “multiple” when the patient received prescriptions for 2 or more individual NSAIDs the week before the index date; and “switcher” when there was use of only one NSAID in the week before the index date, but there was use of at least one other NSAID 8–30 days before the index date.

van Staa TP and colleagues conducted a retrospective cohort study that included 729,294 patients from the UK General Practice Research Database (GPRD). The RR of MI was examined in patients that were ≥40 years of age at first NSAID prescription. Data collection started in 1987 and ended for this study in 2006, and the median follow-up for the NSAID cohort was 6.1 years. Patients were followed from the first NSAID prescription (the index date) to the patient’s death, patient’s transfer out of general practice, the last GPRD data collection available for the study (first quarter of 2006), or the date of the first selective COX-2 NSAID prescription, whichever came first. The total follow-up of NSAID users was divided into periods of “current” and “past” exposure, with patients moving between these two groups according to their NSAID use. “Current” exposure was defined as the period from the date of a NSAID prescription to the end of expected duration, plus 3 months. The expected duration of NSAID use was estimated using the daily dose as prescribed by the general practitioner and the number of NSAID tablets.

Fosbøl EL and colleagues conducted a historical cohort study using data from over 1 million healthy Danish individuals over the age of 10 that evaluated the risk of MI and death associated with NSAID use. Healthy is defined according to a history of no hospital admissions and no concomitant selected pharmacotherapy (refer to study for the complete list). NSAIDs were used for 9–34 days.

McGettigan P and Henry D conducted a systematic review of community-based controlled observational studies to determine the cardiovascular risks of NSAIDs. This review included 38 studies with ibuprofen. NSAID prescription was categorized as “current” if it covered a period that included the index day or continued to within 1 week or less of the index day (the day the adverse cardiac event occurred). The outcomes studied included MI, CHD related death or composite of MI, and CHD death.

Hepatic & Renal Safety Profile

Hepatic and renal safety profile

Clinical studies suggest that ibuprofen was associated with less acute liver injury compared to other NSAIDs:

Archives of Internal Medicine, 1994 (Garcia Rodriguez LA et al. )

• The lowest incidence of liver injury among 8 NSAIDs occurred in ibuprofen users and was 1.6/100000 (1.6/100k). The other incidence in increasing order is as follows: oral diclofenac (3.6/100K), naproxen (3.8/100K), mefenamic acid (2.5/100K), ketoprofen (8.8/100K), piroxicam (6.0/100K), fenbufen (11.9/100K), sulindac (148.1/100K)^12†

Postgraduate Medicine, 2018 (Moore N et al.)

• Compared to ibuprofen, risks of hepatoxicity are somewhat higher and better documented with acetaminophen, and reported to be higher amongst specific NSAIDs, such as oral diclofenac and sulindac^13†

Epidemiologic studies do not suggest that low dose ibuprofen (e.g., ≤1200 mg daily) is associated with an increased risk of renal adverse events (e.g., renal failure, renal injury)^‡

American Journal of Epidemiology, 2000 (Griffin MR et al.)

• Use of ibuprofen at ≤1200mg/day led to an odds ratio of 0.94 (95% CI: 0. 58, 1.51) for renal AEs (i.e., renal failure)^9†

Pharmacotherapy, 1999 (Perez-Gutthann S et al.)

• No major adverse events related to renal injury (i.e., acute renal failure) were identified during the study^10†

Pharmacotherapy, 1992 (Furey SA et al.)

• After non-prescription doses of ibuprofen, renal injury (i.e., acute renal failure or any renal injury) were not amongst the reported adverse effects^11†

AE = adverse event; CI = confidence interval; GI = gastrointestinal; NSAID = nonsteroidal anti-inflammatory drug; OTC = over the counter.

^† Garcia Rodriguez LA and colleagues conducted a retrospective cohort study with secondary case-control analysis. The study included 536 general practitioners’ practices in England and Wales for the period October 1987 through August 1991. A total of 625,307 persons who received more than 2 million prescriptions for 1 of 12 NSAIDs, were followed up to estimate the risk of newly diagnosed acute liver injury. The incidence of acute liver injury was 3.7 per 100,000 NSAID users. Sulindac was the only NSAID with a substantially greater risk of acute liver injury than that for the overall NSAID group. The incidence of acute liver injury for indomethacin, diflunisal, tenoxicam, and fenoprofen was not provided. It was concluded that the risk of acute liver injury is sufficiently small as to be of minimal concern for most NSAIDs.

Moore N and colleagues conducted a review of available literature on the GI and hepatic safety of non-aspirin OTC analgesics, including NSAIDs (ibuprofen, ketoprofen, diclofenac, and naproxen) and acetaminophen. Safety in overdose was also reviewed. Articles describing clinical trials, meta-analyses, and epidemiological studies were evaluated for inclusion in the review, and focus was placed on studies discussing doses and durations of use consistent with OTC use. GI effects accounted for 75% of total AEs in the study. Across all studies reviewed here, the risk of serious GI toxicity, including upper GI bleeding and peptic ulcers, was low at OTC doses.

Griffin MR and colleagues is a nested case-control study using Tennessee Medicaid enrollees aged ≥65 years to determine the role of NSAIDs in acute deterioration of renal function. Cases included patients who had been hospitalized with community acquired acute renal failure. For ibuprofen, the odds ratio associated with dosages of ≤1200 mg/day was 0.94 (95% Cl: 0.58, 1.51) and increased as the dosage increased (>1200 to <2400 mg/day was 1.89 [95% Cl: 1.34, 2.67], while >2400 mg/day was 2.32 [95% Cl: 1.45, 3.71]). The researchers identified all prescriptions filled for these drugs in the 365 days before the index date (date of initial hospitalization for cases): 6% current NSAID users began in the past 30 days; 33% had less than 180 days’ use in the past year; 61% had more than 180 days’ use.

Pérez-Gutthann S and colleagues conducted a cohort study in the United Kingdom to evaluate the risk of a newly diagnosed episode of upper GI bleeding, acute liver and renal failure, agranulocytosis, aplastic anemia, severe skin disorders, and anaphylaxis occurring within 30 days after the first prescription for a low dose of oral diclofenac, naproxen, or ibuprofen. There was 22,146 persons using oral diclofenac (≤75 mg), 46,919 using naproxen (≤750 mg), and 54,830 using ibuprofen (≤1200 mg). Age, gender, and comorbidity were similar in the 3 cohorts and consisted of patients aged 15–85 (men and women). Of the 54,830 using ibuprofen (≤1200 mg/day) in the study, there were 2 cases of hepatic injury. A single case of potential renal failure for naproxen was reported and none for ibuprofen.

Furey SA and colleagues evaluated the safety of single doses of non-prescription strength ibuprofen by examining reported side effects from 15 double-blind, randomized, controlled trials conducted of the drug to treat various common painful conditions (e.g., headache, sore throat). All studies included placebo and another nonprescription analgesic, acetaminophen. A total of 878 subjects received ibuprofen 200 mg (n=171) or 400 mg (n=707), 849 subjects received acetaminophen 650 mg (n=237) or 1000 mg (n=612), and 852 subjects received placebo. Subjects were 16–79 years of age, had various pain conditions, but were otherwise in good health. Results indicated that no renal AEs were reported (side effects were predominantly related to the GI tract and the central nervous system).

^‡ Safety was demonstrated when ibuprofen was used as directed at a low dose (≤1200 mg/day) and for short term use. Advil should not be taken for fever for more than 3 days or for pain for more than 5 days, unless directed by a physician. Please consult the Product Monograph for complete dosing instructions and safety profile.

Like other NSAIDs, ibuprofen inhibits renal prostaglandin synthesis, which may decrease renal function and cause sodium retention. Renal blood flow and glomerular filtration rate decreased in patients with mild impairment of renal function who took 1200 mg/day of ibuprofen for 1 week. Patients at greatest risk of renal toxicity are those with impaired renal function, heart failure, liver dysfunction, those taking diuretics and the elderly. Use of ibuprofen in patients at risk of renal toxicity or with prerenal conditions should be approached with caution. For full safety information please refer to the warnings and precautions and adverse reactions of the product monograph.

Clinically Proven Efficacy

Clinically proven to relieve mild to moderate pain symptoms due to the common cold and flu

¹

Published studies have documented the efficacy of 200 mg doses and 400 mg doses of ibuprofen in treating mild to moderate pain including sore throat pain, headache and muscle aches in adults.¹

One Advil is often all it takes to relieve mild to moderate pain including:²

• Sore throat pain
• Headache & migraine
• Muscle aches
• Menstrual pain
• Toothache (dental pain)

Advil also reduces fever.

Clinically proven efficacy in sore throat pain

Ibuprofen offered statistically significant effective sore throat relief in the following study:

Clinical Pharmacology and Therapeutics, 1988 (Schachtel BP et al. )

• A double-blind, single dose parallel study was conducted to evaluate treatment of sore throat pain. Ibuprofen was more effective on all rating scales from 180 to 360 minutes (p<0.01) vs. acetaminophen and at all time points vs. placebo (p<0.01).^14*

*Schachtel BP et al conducted a double-blind, single-dose parallel study of patients with tonsillopharyngitis who randomly received either 400 mg ibuprofen, 1000 mg acetaminophen or placebo. At hourly intervals for 6 hours, patients reported pain intensity and pain relief on conventional scales and two sensory qualities of throat pain (“swollen throat” and “difficulty swallowing”) on two new visual analogy scales.

What can Advil Cold, Sinus and Flu Extra Strength do for Sarah?

Sarah wants effective relief for her sore throat and other common cold symptoms

Sarah* has two young children who require constant supervision. She has had a fever for a day and woke up this morning to symptoms of a sore throat, sinus pain and body ache. Since she works from a home office and is on virtual calls or on her phone frequently, she needs to be extra alert of balancing the needs of her family even though she is suffering from the symptoms of a cold or flu. Sarah is hoping for effective relief, especially from her sore throat, so she can stay on top of everything.

Her symptoms: Sore throat, sinus pain, body ache and fever.

Advil Cold, Sinus and Flu Extra Strength is indicated to treat pain and fever related to a cold and flu. Studies have demonstrated a proven effect of Advil on:^1,2

• sore throat pain
• headache
• body aches
• fever

*Fictional case study.

The Best Way to Treat a Cold: Cold Medicine

Some popular cold medications may be better than others when it comes to soothing sore throats, stuffy noses, and aches and pains caused by the common cold.

By Jennifer WarnerMedically Reviewed by Niya Jones, MD, MPH

Reviewed: January 2, 2014

Medically Reviewed

Ibuprofen may be powerless when it comes to treating the common cold.

A new British study found the popular pain reliever ineffective at treating symptoms like sore throat, cough, and sinus pain associated with respiratory tract infections, such as colds.

Doctors often recommend ibuprofen either alone or in combination with acetaminophen to relieve aches and reduce fever associated with the common cold. These results may change that advice, but there’s still plenty you can do to feel better when a cold has you down.

Ibuprofen No Good at Cold Treatment

“I was a little surprised that ibuprofen didn’t help versus a placebo in reducing discomfort,” said Brian Oostman, DO, a family doctor with Dreyer Medical Clinic in Oswego, Ill. “It goes against what we say.”

The study, published in the British Medical Journal, looked at the effectiveness of ibuprofen, paracetamol (similar to acetaminophen), and steam inhalation at treating symptoms associated with respiratory infections in 889 people. The results showed no benefit in using ibuprofen in combination with or instead of paracetamol in relieving cold symptoms. Steam inhalation was also ineffective.

In fact, the study showed that return visits to the doctor for new or unresolved symptoms were more common among those who took ibuprofen than those who took acetaminophen (20 percent vs. 12 percent).

“I do think this changes how we should use ibuprofen for patients just simply for the pain aspect of treating for sore throat and ear pain,” Dr. Oostman said. However, he said ibuprofen still works for headaches associated with colds and for more complicated lung infections.

Easy Advice for Treating Colds

Regardless of the latest study’s findings, Oostman said the best advice for treating your cold symptoms remains simple.

Get plenty of rest. Getting a good night’s sleep helps your immune system fight off infection. “If you’re having a hard time sleeping, I always recommend adults use a product like NyQuil to help them recover faster and feel better during the day,” Oostman said.

Take it easy.  Don’t work out on days when you feel ill, Oostman advised. First, this helps prevent the spread of illness. Second, such activity can affect your immune system and may make you feel sicker.

Stay hydrated. Drinking plenty of fluids keeps you from becoming dehydrated and also loosens mucus. If you’re not well-hydrated, it’s harder to blow out the mucus. Oostman recommends using a nasal saline spray and gargling with warm saltwater to break up the mucus and keep things moving.

Best Over-the-Counter Medications for Colds

To ease common cold symptoms, there are a few key active ingredients to look for in cold medications.

To treat coughs, Oostman said his best advice is to look for cough medicines with dextromethorphan (one brand is Robitussin) or guaifenesin (such as Mucinex). Dextromethorphan is a cough suppressant, which can help you rest, and guaifenesin helps break up the mucus.

If you have a fever, taking acetaminophen (such as Tylenol) can help bring it down and reduce body aches and pain.

For sore throats, sucking on a lozenge or using a throat spray that contains an oral anesthetic like chloraseptic can soothe the pain.

For children or those who don’t want to take decongestants or are unable to because they have hypertension or heart disease, Oostman suggested a menthol-based topical rub applied to the chest to relieve nasal congestion. Decongestants contain pseudoephedrine, which constricts blood vessels and can increase blood pressure.

Many people swear by home remedies like eating chicken soup, drinking hot tea, or eating ice cream to relieve a sore throat or cold, and Oostman said it’s fine to do what makes you feel better. “But I think really the best home remedy is a good night’s sleep, rest during the day, and pushing fluids,” he said.

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Ibuprofen or Paracetamol – What to choose at a temperature

The temperature torments many who are ill with colds, SARS, influenza, RVI and other viral diseases of this category. The temperature is not only poorly tolerated by our body, but also potentially dangerous. Only a doctor can correctly prescribe medicines for healing. We strongly do not recommend that you self-medicate. Simply because the symptoms of diseases of this group are very similar, and the drugs for recovery and procedures can even differ diametrically.

If you are prescribed ibuprofen or paracetamol at your doctor’s appointment, you should consider the specific situation so as not to be mistaken.

Ibuprofen

Ibuprofen is one of the tested non-steroidal drugs with a pronounced anti-inflammatory effect. It successfully stops inflammatory processes in the body, lowers the patient’s body temperature and relieves pain.

The healing effect is good because it is complex. Experts recommend choosing this drug if you need not only to bring down the temperature, but also get rid of pain and inflammation.

Attention, an important nuance! If there is thermoneurosis in the acute phase of severe stress, or if you are very nervous and your temperature has risen, these drugs will not be effective. Antipyretics in the absence of inflammation will not work as you would expect. Therefore, we recommend taking an aspirin tablet. If the temperature has dropped, then you have a cold. If not, the reason is different. “Aspirin test” is an excellent test.

Each person’s body is unique, so any drug can cause so-called side effects:

1. Mild heartburn;
2. Gastrointestinal disorders;
3. Vomiting;
4. Nausea;
5. Bloating;
6. Constipation;
7. Headaches;
8. Gases;
9. Decreased or absent appetite;
10. Diarrhea;
11. Nervousness;
12. Dizziness;
13. Allergic reactions in the form of rash or slight itching;
14. Unpleasant ringing in the ears.

Doctors do not recommend taking ibuprofen for a long time. It should not be taken during lactation and pregnancy, the elderly, in the presence of hepatic or renal insufficiency.

Paracetamol

Paracetamol successfully copes with almost any type of pain. It is quite effective. Effortlessly relieves the symptoms of an unpleasant fever, which often accompanies colds. Its success lies in the impact on the center in the hypothalamus, which ensures the process of thermoregulation in the system of our body. The temperature is dropping rapidly.

Most often prescribed for influenza, SARS and RVI. It has a high level of safety, it is used to treat children and adults. It just doesn’t cure inflammation. Microbial varieties of infections cannot be defeated with it. Here it is necessary to take p ibuprofen and other drugs with similar properties.

Paracetamol is acceptable for use during lactation and pregnancy. It is not dangerous for children and the elderly. Virtually no side effects. Easily works in conjunction with other drugs without compromising effectiveness.

Ibuprofen VS paracetamol? What is better and in what cases?

Both drugs are able to cope with the presence of fever. Paracetamol is safer and causes almost no side effects from its use. It is not effective in inflammatory processes that accompany diseases of microbial origin.

Ibuprofen relieves inflammation, relieves pain and fights high fever. Paracetamol is less successful as an analgesic drug.

Unlike aspirin, it does not cause Reye’s syndrome in children aged 4 to 12 years. This is a rare liver disease.

It is necessary to choose taking into account whether there is an inflammatory process in the body, whether it is accompanied by pain. If there is pain and inflammation, then you should buy ibuprofen . If only the temperature is of concern, then paracetamol is sufficient.

Can ibuprofen and paracetamol be taken together?

With a cold, this method is quite justified and acceptable if you have no health contraindications for taking ibuprofen. Only the intake of tablets should be alternated, observing the rule of an interval of 6 hours and 1 strictly tablet. This will avoid the risk of side effects and drug overdose.

Paracetamol will reduce pain and fever, ibuprofen will enhance this effect and help reduce inflammation in the body, because it is the root of the disease.

The combined use of these drugs requires specialist advice. There are a number of contraindications when such treatment is unacceptable. It is also important to choose the optimal doses of drugs. Do not be too lazy to study the instructions, especially regarding the description of contraindications.

Analogues of conventional medicines abroad

So it is better not to take pills on a trip

Even novice travelers know that they need to take a first aid kit with them on a trip, but anything can happen. Gathering in a hurry, you can forget it, and luggage, unfortunately, can be lost. And here you are in a foreign country without a minimum set of medicines. Sucks.

Most of the time when we travel we suffer from colds in various manifestations, indigestion and headaches. We tell you what to buy from these ailments in pharmacies in Europe, the USA, Turkey and others.

What medicines to buy in Europe

On the forums they write that all medicines in Europe are sold by prescription and if you get sick, then the only method of treatment is drinking plenty of water and bed rest. This is wrong. In European pharmacies, you will not be able to buy antibiotics or strong drugs without a prescription, but the rest of the usual medicines are freely available.

Antiviral or immunomodulating agents (such as our famous Kagocel) cannot be found in European pharmacies. Treatment will be targeted – from temperature, from headaches, from a runny nose, etc. Although something revitalizing, such as the usual “Theraflu”, it is quite possible to find.

• For headaches, ask your pharmacist for Aspirin Complex. This is a universal strong tool that will help bring down the temperature.
• For fever and inflammation, buy the same Aspirin Complex and combine it with plenty of warm drinks.
• The legendary Sinupret of the European company Bioronika is suitable for a runny nose. In most European countries, you can find the familiar “Snoop” (SNUP).
• For a sore throat, ask for sage or Strepsils. And also drink tea with ginger, it is in every supermarket.
• For indigestion, buy the familiar and effective Imodium. Fortunately, it is sold in any European city.

Medicines in the USA: what to buy for colds

Pharmaceutical companies produce a huge amount of cold medicines for residents and visitors to the United States. And the beauty of these drugs is that they are combined. Unlike Europe, having caught a cold in the USA, it will be enough to buy a vial of medicine, take the drug in accordance with the instructions, and the state of freshness of the cucumber will not make you wait too long.

• Alka-Seltzer Cold&Flu (better to take Day&Night) – drink them every 4 hours, 2 capsules, but at the same time you need to somehow manage not to drink more than 10 capsules in 24 hours.
• Vicks Dayquil & Nyquil is also good for colds.
• Also in America you can buy the usual for us “Theraflu”. Be sure to pay attention to the packaging: if it says night-time, then the drug causes drowsiness.

By the way, in the USA the coupon-sticker system is better developed than in Pyaterochka, so look for coupons with discounts – perhaps there will be an attractive offer for your case.

Medicines in India

Dietary supplements and homeopathic remedies are very common in India. At the entrance to a pharmacy or store, you can see a huge number of white jars with green lids. These are dietary supplements manufactured by Himalaya Herbals.

If you are positive about this kind of treatment, then read the composition, as a rule, it is also presented in Russian. Buy and get well.

If you are a supporter of a more traditional treatment, then Ibuprofen, Paracetamol and Aspirin will save you from a cold in India. For indigestion, ask the pharmacist for Loperamide, Intestopan, or Diarex.

Turkey: drug analogues

• Activated carbon – Eucarbon
• TeraFlu analogue – Tylolhot
• No-Spa analogue – Buskopan
• For eye allergies and conjunctivitis – Dexa-sine and Visine drops
• Strong pain reliever – Advil, Nurofen
• Migraine – Avmigran Film Tablet
• Wound healing – FITO Krem
• D-panthenol analogue – Bepanthen
• Throat antiseptics – Tantum Verde 900 22
• Flu – Deflu
• Lozenges for sore throat – Strepsils
• Diarrhea – Reflor
• Allergy – Rynset, Cetrin

Analogues of popular medicines that can be bought abroad

Below is a list of active ingredients, their scope, as well as commercially e drug names that contain this component.

• Acetylsalicylic acid / Analgesic, antipyretic, anti-inflammatory – Aspirin, Upsarin, Aspro, Disprin, Rivo, Colsprin, Empirin, Salospir.
• Ibuprofen / Pain reliever, antipyretic – Ibuprofen, Cuprofen, Nurofen, Advil, Moment, Brufen, Combiflam.