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==Efficacy==
==Efficacy==
There are conflicting studies showing the effectiveness of over-the-counter cold medicine in reducing cold and flu symptoms. A number of trials have found acetaminophen (alone and in combination) to be effective<ref>http://www.clinicaltherapeutics.com/article/S0149-2918(06)00216-5/abstract</ref><ref>http://www.ncbi.nlm.nih.gov/pubmed/17474541</ref> and a safe<ref>http://www.ncbi.nlm.nih.gov/pubmed/12510944</ref> treatment for common cold symptoms such as sore throat and body aches. In contrast, a systematic review including 26 [[randomized controlled trials]] compared the use of over-the-counter cough medicines with placebo (no treatment) in children and adults exhibiting cough in the [[ambulatory]] or [[outpatient]] setting<ref>http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001831.pub4/abstract;jsessionid=37913D4FD7536094559F574F940421A1.f02t02</ref>. Among the trials, there was conflicting evidence of the effectiveness of cough medicines containing an [[antitussive]], [[antihistamine]] or [[antihistamine decongestant]] in providing better cough resolution outcomes versus placebo.
There are conflicting studies showing the effectiveness of over-the-counter cold medicine in reducing cold and flu symptoms. A number of trials have found acetaminophen (alone and in combination) to be effective<ref>http://www.clinicaltherapeutics.com/article/S0149-2918(06)00216-5/abstract</ref><ref>http://www.ncbi.nlm.nih.gov/pubmed/17474541</ref> and a safe<ref>http://www.ncbi.nlm.nih.gov/pubmed/12510944</ref> treatment for common cold symptoms such as sore throat and body aches. In contrast, a systematic review including 26 [[randomized controlled trials]] compared the use of over-the-counter cough medicines with placebo (no treatment) in children and adults exhibiting cough in the [[ambulatory]] or [[outpatient]] setting<ref>http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001831.pub4/abstract;jsessionid=37913D4FD7536094559F574F940421A1.f02t02</ref>. Among the trials, there was conflicting evidence of the effectiveness of cough medicines containing an [[antitussive]], [[antihistamine]] or [[antihistamine decongestant]] in providing better cough resolution outcomes versus placebo.


<ref name="review of OTC medications for cough">{{cite web | url = http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001831.pub4/abstract;jsessionid=37913D4FD7536094559F574F940421A1.f02t02 | author = Smith SM et al. | title = Over-the-counter (OTC) medications for acute cough in children and adults in ambulatory setting | publisher = Cochrane Database of Systematic Reviews 2012 }}</ref>


==Warnings==
==Warnings==

Revision as of 04:59, 3 November 2014

File:Allergydayquil.jpg
DayQuil Sinus Relief

Vicks DayQuil is an over-the-counter combination medication product used for the temporary relief of common cold and flu symptoms. Dayquil is available in several formulations[1] including:

  • DayQuil Cough (Dextormethorphan)
  • DayQuil Cold & Flu (Acetaminophen, Dextromethorphan, Phenylephrine)
  • DayQuil Severe Cold & Flu (Acetaminophen, Dextromethorphan, Doxylamine succinate, Phenylephrine)
  • DayQuil Mucus Control DM (Dextromethorphan, Guaifenesin)
  • Dayquil Sinex (Acetaminophen, Phenylephrine, or Oxymetazoline)

DayQuil was introduced in 1974 under the name "DayCare" and is currently advertised for daytime use because of its non-drowsy active ingredients. The brandname was reintroduced as "DayQuil" in 1992. DayQuil's nighttime counterpart, NyQuil, is also available for the relief of cold and flu symptoms during the night. These products are not intended to cure the common cold or the flu.


Indication and Ingredients

Indications

DayQuil is intended for the temporary relief of cold and flu symptoms including:

The indications for each active ingredient are as follows:
Acetaminophen: Pain relief and fever reduction
Dextromethorphan: Cough suppressant
Doxylamine succinate: Relief of allergic rhinitis symptoms such as runny nose and sneezing
Guaifenesin: Expectorant
Phenylephrine: Nasal decongestant
Oxymetazoline: Nasal decongestant

Ingredients

DayQuil Cough (Liquid)

Per 15ml (1 Tablespoon): Dextromethorphan Hbr 15mg

DayQuil Cold & Flu (Liquid and LiquiCaps)

Per 15mL and per LiquiCap: Acetaminophen 325mg, Dextromethorphan HBr 10mg, Phenylephrine HCl 5mg

DayQuil Severe Cold & Flu (Liquid and Caplets)

Per 15ml and per Caplet: Acetaminophen 325mg, Dextromethorphan Hbr 10mg, Gauifenesin 200mg, Phenylephrine HCl 5mg

DayQuil Mucus Control DM(Liquid)

Per 15ml: Dextromethorphan Hbr 10mg, Guaifenesin 200mg

Dayquil Sinex(LiquiCaps and Nasal Spray)

Per LiquiCap: Acetaminophen 325mg, Phenylephrine HCl 5mg
Per Spray: Oxymetazoline HCl 0.05%

Product Selection

Selecting a product should depend on the specific symptom presentation of the user. Products should be selected with active ingredients limited only to those symptoms, thereby reducing the risk of over treatment with medications that the user is not showing symptoms for. Additionally, careful note should be taken when purchasing multiple over-the-counter cold and flu medicines because many products may contain the same active ingredient. The potential for overdose increases when consumers are unaware of the duplication of active ingredients in these medicines [2].

Products should also be chosen based on the age of the user. Certain formulations (eg. liquid, liquid capsules or spray) are only FDA approved for those a certain age.

  • Approved in ages 6+: DayQuil Cough, DayQuil Cold & Flu (Liquid only), DayQuil Mucus Control DM, DayQuil Sinex (nasal spray)
  • Approved in ages 12+: DayQuil Cold & Flu (LiquiCaps), DayQuil Severe Cold & Flu, DayQuil Sinex (LiquiCaps)

For proper dosing, see package insert for the recommended dose and frequency. Medication should only be used for the suggested length of time indicated on the package insert and should not exceed the maximum recommended daily dose.

Efficacy

There are conflicting studies showing the effectiveness of over-the-counter cold medicine in reducing cold and flu symptoms. A number of trials have found acetaminophen (alone and in combination) to be effective[3][4] and a safe[5] treatment for common cold symptoms such as sore throat and body aches. In contrast, a systematic review including 26 randomized controlled trials compared the use of over-the-counter cough medicines with placebo (no treatment) in children and adults exhibiting cough in the ambulatory or outpatient setting[6]. Among the trials, there was conflicting evidence of the effectiveness of cough medicines containing an antitussive, antihistamine or antihistamine decongestant in providing better cough resolution outcomes versus placebo.


[7]

Warnings

Products Containing Acetaminophen

There is a risk of severe liver damage with the concurrent use of acetaminophen products and excessive alcohol use (≥3 alcoholic drinks/day). Acetaminophen is an active ingredient of many over-the-counter single ingredient products (e.g. to treat headache), multiple ingredient combination products as well as prescription-only medications written by a physician [8]. Each formulation also varies per dose. When purchasing over-the-counter medications, avoid purchasing multiple products with acetaminophen ingredients. The suggested maximum daily intake of acetaminophen is limited to <4 grams (4,000 mg) daily in adults or <2.6g (2,600mg) daily in children <12 years of age to reduce the risk of liver damage [9] [10].

Products Containing Dextromethorphan

Those prescribed monoamine oxidase inhibitor (MAO-i) should avoid the use of DayQuil products containing dextromethorphan within 2 weeks to avoid risks of Serotonin Syndrome [11].

Abuse and recreational use of dextrometorphan have been reported with over-the-counter preparations and can cause euphoric and dissociative effects at higher than recommended doses[12].

References

  1. ^ Vicks DayQuil
  2. ^ http://www.ncbi.nlm.nih.gov/pubmed/23680341
  3. ^ http://www.clinicaltherapeutics.com/article/S0149-2918(06)00216-5/abstract
  4. ^ http://www.ncbi.nlm.nih.gov/pubmed/17474541
  5. ^ http://www.ncbi.nlm.nih.gov/pubmed/12510944
  6. ^ http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001831.pub4/abstract;jsessionid=37913D4FD7536094559F574F940421A1.f02t02
  7. ^ Smith SM; et al. "Over-the-counter (OTC) medications for acute cough in children and adults in ambulatory setting". Cochrane Database of Systematic Reviews 2012. {{cite web}}: Explicit use of et al. in: |author= (help)
  8. ^ Tylenol. "Common Meds List" (PDF).
  9. ^ Schilling A; et al. "Acetaminophen: Old drug, new warnings". Cleveland Clinic Journal of Medicine. {{cite web}}: Explicit use of et al. in: |author= (help)
  10. ^ FDA. "Acetaminophen Overdose and Liver Injury - Background and Options for Reducing Injury" (PDF).
  11. ^ Gillman PK. "Monoamine oxidase inhibitors, opioid analgesics and serotonin toxicity". British Journal of Anesthesia.
  12. ^ Bryner JK; et al. "Dextromethorphan abuse in adolescence: an increasing trend". Archives of Pediatrics and Adolescent Medicine. {{cite web}}: Explicit use of et al. in: |author= (help)

External links

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