Cold and flu remedies

Just how effective are cold and flu remedies?

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There are big bucks to be made selling cold and flu remedies. Last year, Kiwis forked out $38 million at the supermarket on pills and potions for fighting winter bugs.

We looked at more than 50 cold and flu products, from decongestants and antihistamines through to cough drops, to find which offer the most effective relief from winter ills. Considering the hefty price of some products, you might think there’s strong science supporting their effectiveness. But we found it’s often less than convincing.

Oral decongestants

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Cough medicines

Double dosing

Antibacterial and antiviral action

Natural remedies

What may work

How effective?

Remedy Price per dose[width=medium] Ingredients[width=medium] Strength of evidence behind medication
Decongestant and painkiller
CODRAL Cold & Flu Tablets $1.25 Codeine, paracetamol, phenylephrine Alleviates aches (paracetamol), inconsistent evidence for congestion relief (phenylephrine), adverse effects reported for codeine
CODRAL RELIEF Cold & Flu with Decongestant Sachets $1.40 Paracetamol, phenylephrine Alleviates aches (paracetamol), inconsistent evidence for congestion relief (phenylephrine)
CODRAL RELIEF Cold & Flu with Decongestant Tablets $1.40 Paracetamol, phenylephrine Alleviates aches (paracetamol), inconsistent evidence for congestion relief (phenylephrine)
COLDREX PE Congestion Clear Tablets $1.50 Paracetamol, phenylephrine Alleviates aches (paracetamol), inconsistent evidence for congestion relief (phenylephrine)
ETHICS Cold & Flu Relief Tablets $1.20 Paracetamol, phenylephrine Alleviates aches (paracetamol), inconsistent evidence for congestion relief (phenylephrine)
LEMSIP Max Cold & Flu Cold Remedy Lemon-Flavoured Sachet with Decongestant $1.40 Paracetamol, phenylephrine Alleviates aches (paracetamol), inconsistent evidence for congestion relief (phenylephrine)
MAXICLEAR Cold & Flu Relief Tablets $1.53 Paracetamol, phenylephrine Alleviates aches (paracetamol), inconsistent evidence for congestion relief (phenylephrine)
NUROFEN Cold Remedy Cold & Flu PE Tablets $1.25 Ibuprofen, phenylephrine Eases discomfort (ibuprofen), inconsistent evidence for congestion relief (phenylephrine)
PANADOL Cold & Flu Max Cold Remedy with Decongestant Caplets $1.30 Paracetamol, phenylephrine Alleviates aches (paracetamol), inconsistent evidence for congestion relief (phenylephrine)
SUDAFED PE Cold Remedy Sinus Pain Relief Tablets $1.40 Paracetamol, phenylephrine Alleviates aches (paracetamol), inconsistent evidence for congestion relief (phenylephrine)
Decongestant, painkiller and expectorant
CODRAL RELIEF Cold Remedy 6 Signs Capsules $1.87 Paracetamol, guaifenesin, phenylephrine Alleviates aches (paracetamol), inconsistent evidence for congestion relief (phenylephrine) and cough relief (guaifenesin)
CODRAL RELIEF 6 Signs Cold & Flu Sachets $1.50 Paracetamol, guaifenesin, phenylephrine Alleviates aches (paracetamol), inconsistent evidence for congestion relief (phenylephrine) and cough relief (guaifenesin)
COLDREX PE Remedy Cough, Cold & Flu Tablets $1.87 Paracetamol, guaifenesin, phenylephrine Alleviates aches (paracetamol), inconsistent evidence for congestion relief (phenylephrine) and cough relief (guaifenesin)
LEMSIP Max All-In-One Cold & Flu Capsules $1.87 Paracetamol, guaifenesin, phenylephrine Alleviates aches (paracetamol), inconsistent evidence for congestion relief (phenylephrine) and cough relief (guaifenesin)
Decongestant, painkiller and anti-histimine
CODRAL Cold, Flu & Cough Tablets $1.83 Paracetamol, phenylephrine, dextromethorphan, chlorpheniramine Alleviates aches (paracetamol) and small effect on overall common cold symptoms (antihistamine), inconsistent evidence for congestion relief (phenylephrine) and cough relief (dextromethorphan)
CODRAL Day and Night Tablets 24 $1.92 Paracetamol, phenylephrine, codeine, chlorpheniramine Alleviates aches (paracetamol) and small effect on overall common cold symptoms (antihistamine), inconsistent evidence for congestion relief (phenylephrine), adverse effects reported for codeine
CODRAL Multi-Action Cold & Flu Tablets $1.83 Paracetamol, codeine, phenylephrine, chlorpheniramine Alleviates aches (paracetamol) and small effect on overall common cold symptoms (antihistamine), inconsistent evidence for congestion relief (phenylephrine), adverse effects reported for codeine
CODRAL PE Day and Night Tablets 48 $1.54 Paracetamol, phenylephrine, chlorpheniramine, dextromethorphan Alleviates aches (paracetamol) and small effect on overall common cold symptoms (antihistamine), inconsistent evidence for congestion relief (phenylephrine) and cough relief (dextromethorphan)
COLDREX PE Cold & Flu Day and Night Tablets $1.54 Paracetamol, phenylephrine, dextromethorphan, chlorpheniramine Alleviates aches (paracetamol) and small effect on overall common cold symptoms (antihistamine), inconsistent evidence for congestion relief (phenylephrine) and cough relief (dextromethorphan)
DEMAZIN Cold Relief Colour-Free Syrup 200ml $1.80 Phenylephrine, chlorpheniramine Small effect on overall common cold symptoms (antihistamine), inconsistent evidence for congestion relief (phenylephrine)
DIMETAPP Elixir Cough & Cold Colour-Free Syrup 200ml $1.25 Phenylephrine, brompheniramine Small effect on overall common cold symptoms (antihistamine), inconsistent evidence for congestion relief (phenylephrine)
DIMETAPP PE Day & Night Cough, Cold & Flu Tablets $2.00 Paracetamol, phenylephrine, dextromethorphan, chlorpheniramine Alleviates aches (paracetamol) and small effect on overall common cold symptoms (antihistamine), inconsistent evidence for congestion relief (phenylephrine) and cough relief (dextromethorphan)
DIMETAPP PE Sinus Day and Night Tablets $0.91 Paracetamol, phenylephrine, chlorpheniramine Alleviates aches (paracetamol) and small effect on overall common cold symptoms (anithistamine), inconsistent evidence for congestion relief (phenylephrine)
MAXICLEAR Cold & Nasal Relief Tablets $0.77 Phenylephrine, loratadine Small effect on overall common cold symptoms (antihistamine), inconsistent evidence for congestion relief (phenylephrine)
SUDAFED PE Sinus Day and Night Tablets $1.03 Paracetamol, phenylephrine, chlorpheniramine Alleviates aches (paracetamol) and small effect on overall common cold symptoms (anithistamine), inconsistent evidence for congestion relief (phenylephrine)
Cough medicine, dry
BENADRYL Dry Cough & Nasal Congestion Syrup 200ml $1.20 Dextromethorphan, phenylephrine Inconsistent evidence for congestion relief (phenylephrine) and cough relief (dextromethorphan)
DUROTUSS Dry Forte Syrup 200ml $0.72 Pholcodine Inconsistent evidence for cough relief (pholcodine)
LEMSIP Dry Cough Syrup 200ml $1.30 Glycerol, honey, lemon oil Some limited evidence for cough relief (honey)
ROBITUSSIN Dry Cough Forte Syrup 100ml $1.90 Dextromethorphan Inconsistent evidence for cough relief (dextromethorphan)
VICKS Formula 44 Dry Cough Syrup 180ml $1.81 Dextromethorphan Inconsistent evidence for cough relief (dextromethorphan)
Cough medicine, chesty
BENADRYL Chesty Forte Syrup 200ml $2.40 Guaifenesin, bromhexine Modest but positive effect for cough in other conditions (bromhexine), inconsistent evidence for cough relief (guaifenesin)
BISOLVON Chesty Forte Syrup 200ml $1.25 Bromhexine Modest but positive effect for cough in other conditions (bromhexine)
CODRAL RELIEF Mucus Cough & Cold Syrup 200ml $0.70 Guaifenesin, phenylephrine Inconsistent evidence for cough relief (guaifenesin) and congestion relief (phenylephrine)
CODRAL RELIEF Mucus Cough Syrup 150ml $2.10 Guaifenesin Inconsistent evidence for cough relief (guaifenesin)
ROBITUSSIN Chesty Cough Syrup 200ml $1.50 Guaifenesin Inconsistent evidence for cough relief (guaifenesin)
ROBITUSSIN Mucus Cough Relief Double Action Syrup 200ml $1.15 Guaifenesin, bromhexine Modest but positive effect for cough in other conditions (bromhexine), inconsistent evidence for cough relief (guaifenesin)
VICKS Formula 44 Chesty Cough Syrup 180ml $1.81 Guaifenesin Inconsistent evidence for cough relief (guaifenesin)
Nasal spray
DIMETAPP Nasal Spray 20ml $0.60 Oxymetazoline Evidence of modest congestion relief (oxymetazoline)
DRIXINE No Drip Formula Nasal Spray 15ml $0.60 Oxymetazoline Evidence of modest congestion relief (oxymetazoline)
OTRIVIN Menthol Nasal Spray 10ml $0.48 Xylometazoline, menthol, eucalyptus Evidence of modest congestion relief (xylometazoline)
OTRIVIN Nasal Spray 10ml $0.53 Xylometazoline Evidence of modest congestion relief (xylometazoline)
OTRIVIN Plus Nasal Spray 10ml $0.43 Xylometazoline, ipratropium bromide Evidence of effective congestion relief (ipratropium bromide), modest congestion relief (xylometazoline)
SUDAFED Nasal Decongestant Spray 20ml $0.38 Oxymetazoline Evidence of modest congestion relief (oxymetazoline)
UNIVENT Nasal Spray 15ml $0.20 Ipratropium bromide Evidence of effective congestion relief (ipratropium bromide)
VICKS Sinex Nasal Spray 15ml $0.42 Oxymetazoline Evidence of modest congestion relief (oxymetazoline)
Cough drops
DIFFLAM Anti-Inflammatory Lozenges with Cough Suppressant Sugar-Free Blackcurrent-Flavoured $1.00 Benzydamine, cetylpyridinium chloride, pholcodine Inconsistent evidence for cough relief (pholcodine), very limited but positive evidence for pain relief (benzydamine), anti-bacterial agent of no effect for common cold (cetylpyridium chloride)
HALLS Throaties $0.13 Vitamin C, menthol, eucalyptus oil Inconsistent evidence for common cold relief (Vitamin C)
STREPSILS Dry Cough Lozenges $0.50 Dextromethorphan Inconsistent evidence for cough relief (dextromethorphan)
Antihistamine (non-drowsy)
AERIUS Tablets $1.14 Desloratadine Small effect on overall common cold symptoms (antihistamine)
CLARATYNE Tablets $1.60 Loratadine Small effect on overall common cold symptoms (antihistamine)
FEXOFAST 120mg Tablets $0.80 Fexofenadine hydrochloride Small effect on overall common cold symptoms (antihistamine)
HISTACLEAR Allergy Relief Tablets $1.20 Cetirizine hydrochloride Small effect on overall common cold symptoms (antihistamine)
LORACLEAR Allergy Relief Hayfever Tablets $1.20 Loratadine Small effect on overall common cold symptoms (antihistamine)
TELFAST Allergy Relief 60mg Tablets $2.00 Fexofenadine hydrochloride Small effect on overall common cold symptoms (antihistamine)
TELFAST Allergy Relief 120mg Tablets $2.00 Fexofenadine hydrochloride Small effect on overall common cold symptoms (antihistamine)
TELFAST Allergy Relief 180mg Tablets $3.00 Fexofenadine hydrochloride Small effect on overall common cold symptoms (antihistamine)
ZETOP 10mg Tablets $0.39 Cetirizine hydrochloride Small effect on overall common cold symptoms (antihistamine)
ZYRTEC Tablets $1.80 Cetirizine hydrochloride Small effect on overall common cold symptoms (antihistamine)

GUIDE TO THE TABLE Products listed in alphabetical order. Number of doses determined by the maximum recommended adult dose outlined on pack. Price is from a store survey conducted in March 2017.

What are the rules?

Consumers rely on health agencies to ensure they’re not wasting their money on something that doesn’t work the way it claims.

Medsafe, the Ministry of Health’s medicines-safety agency, is tasked with ensuring medicines are safe and effective, and of high quality.

So what is Medsafe’s view of over-the-counter decongestant and cough remedies?

Medsafe group manager Chris James says medicines for treating the symptoms of a minor illness have a different bar to pass than a drug for a life-threatening condition – and a medicine’s effectiveness is weighed against its safety risks.

“If new data is showing the benefits [for the formulations] do not outweigh the risks any more, we’ll be taking regulatory action.

“From what we’re seeing at the moment, we consider the benefits still outweigh the risks for these products for the population. That’s not to say that we’re not looking at what’s coming through … at the Cochrane Reviews and the studies. We’ll be paying very close attention to what some of the big regulators in the world are doing,” he says.

We’ve asked Medsafe to review the efficacy and marketing of these medications. We believe regulations should require a higher standard of evidence for over-the-counter medications than what’s currently accepted.

Unsafe for under 6

Unsafe for under 6

17may cold and flu under 6 promo default

Unsafe for under 6

The risk of adverse effects means Medsafe recommends the following substances are not given to children under the age of 6:

  • Cough expectorants guaifenesin or ipecacuanha
  • Cough suppressants dextromethorphan or pholcoldine
  • Decongestants phenylephrine and pseudoephedrine
  • Antihistamines brompheniramine, chlorphenamine, diphenhydramine, doxylamine, promethazine or triprolidine

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