If you have diabetes and you catch a cold or flu, there are over-the-counter (OTC) medicines that are safe for you to take to help alleviate your symptoms.

If you catch a cold or flu and have diabetes: Talk to your pharmacist or doctor about which cold and flu medicines would be best for you. Remember to read and follow the instructions that come with your cold and flu medicine. Look for cold and flu medicines that are less likely to affect your blood sugar (glucose) levels, including sugar-free and alcohol-free options. Avoid or use with caution any cold and flu medicines that may worsen complications of diabetes, such as kidney disease and high blood pressure (hypertension). Check your blood sugars regularly because they can be harder to manage when you’re ill. The hormones your body releases to help fight infection can increase your blood sugar levels, causing high blood sugars. However, if you’re not eating and drinking as normal then your blood sugar levels may drop.

There are a wide variety of cold and flu medicines available. Some contain only one ‘active’ ingredient that treats your symptoms, such as Tylenol (acetaminophen) which helps with pain and fever. Others have multiple ingredients that work in different ways to treat a range of symptoms, such as Diabetic Tussin Nighttime Cold and Flu (containing acetaminophen, dextromethorphan and diphenhydramine), which helps with pain and fever, a cough, runny nose and sneezing.

Cold and flu medicines come in many different forms including tablets and capsules, lozenges, chewable tablets, melts, syrups, nasal sprays and more.

Check out our suggestions below for OTC medicines to help relieve your cold and flu symptoms.

What to take for pain and fever, including body aches, sore throats and headaches

Try an analgesic (painkiller) and antipyretic (fever reducer).

Look for products containing:

• Acetaminophen, such as:
  • Tylenol
  • Diabetic Tussin Nighttime Cold and Flu (also contains dextromethorphan and diphenhydramine)
    Acetaminophen is found in many cold and flu medicines. Do not take more than one product containing acetaminophen at a time to avoid an overdose. An overdose of acetaminophen can be fatal.
• Aspirin
• Ibuprofen^*, such as:
  • Advil
  • Motrin IB
• Naproxen^*, such as:
  • Aleve

^*Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, are not suitable for everyone who has diabetes. They should be avoided or used with caution in people with kidney disease. They may also increase blood pressure. Talk to your doctor before taking an NSAID if you have diabetes.

A salt water gargle is a natural remedy that may also help to relieve a sore throat and can be used on its own or alongside your OTC medicine. Try mixing ½ to ¾ of a teaspoon of salt in one cup of warm water. Gargle the mixture as required for 10-15 seconds at a time before spitting it out. A salt water gargle can help to reduce throat inflammation and clear away mucus.

What to take for a dry cough

Try an antitussive or cough suppressant to help reduce a dry, hacking cough.

Look for products containing:

• Dextromethorphan, such as:
  • Diabetic Tussin DM (also contains guaifenesin)
  • Robitussin Sugar-free, Dye-free, Cough+Chest Congestion DM (also contains guaifenesin)
  • Good Sense Tussin DM Cough and Chest Congestion (also contains guaifenesin)
  • Robitussin Long-Acting CoughGels

What to take for a chesty, productive cough

Try a mucolytic and expectorant to help thin and loosen phlegm and mucus. This makes it easier to clear from your airways when you cough.

Look for products containing:

• Guaifenesin, such as:
  • Mucinex extended-release tablets
  • Diabetic Tussin DM (also contains dextromethorphan)
  • Robitussin Sugar-free, Dye-free, Cough+Chest Congestion DM (also contains dextromethorphan)

Drinking plenty of water, including warm water, can also help thin mucus and relieve congestion.
What to take for general cold symptoms

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What to take for general cold symptoms

Try antihistamines, which are commonly used for allergies. While there is little evidence to support the use of antihistamine for colds and flu, they are commonly used and included in nighttime cold and flu preparations, where they may help to dry up your cold and aid sleep.

An antihistamine may also be especially helpful if you have allergies and a cold at the same time.

Antihistamines may help to reduce the severity of overall cold symptoms for 1-2 days, according to the results of a large review.

Look for products containing:

• Cetirizine, such as:
  • Zyrtec
• Diphenhydramine^*, such as:
  • Diabetic Tussin Nighttime Cold and Flu (also contains acetaminophen, and dextromethorphan)
  • Benadryl

• Chlorpheniramine^*, such as:
  • Aller-Chlor

^*Older, first-generation antihistamines can make you sleepy and are best taken before bedtime.

What to take if you have a runny nose or a stuffy, blocked nose

Try a decongestant to help open up your airways and relieve congestion.

People with diabetes are generally recommended to avoid taking products that contain phenylephrine and pseudoephedrine, which are popular decongestants. They narrow blood vessels and reduce swelling to reduce the fluid and secretions in your nose. However, they can increase blood pressure and also raise blood sugar levels. If you have diabetes, check with your doctor before taking products containing phenylephrine and pseudoephedrine to see if they are suitable for you.

Natural remedies and non-medicated options can also help if you have a congested or runny nose. Try:

• A saline nasal spray, which helps to thin the mucus in your nose
• A saline sinus rinse, using a squeeze bottle system or neti pot, can help to clear mucus from the sinuses and relieve congestion
• Nasal strips, which are adhesive strips applied across the nose to help open up sinus passages. Breathe Right Nasal Strips are one example.
• Use a humidifier or vaporizer to increase the moisture in the room, which may help to loosen phlegm or mucus.

If you have diabetes, take steps to avoid colds and flu

People with diabetes are at increased risk of developing complications from the flu. Get a flu shot every year, to help protect yourself from the flu. It will reduce your chances of catching the flu and may help you avoid serious complications and a hospital stay.

If you have diabetes, you’re also recommended to get a pneumococcal vaccination. Pneumococcal disease can cause pneumonia, sinus infections, ear infections and more.

You can also take preventative actions everyday to help you avoid colds and flu, such as:

• Avoiding close contact with people that are sick
• Washing your hands often with soap and water
• Avoiding touching your eyes, nose and mouth with unwashed hands
• Cleaning and disinfecting frequently touched surfaces in your home if someone is sick
• Getting plenty of sleep and exercise, managing your stress, staying hydrated and eating well

The American Diabetes Association also recommends that you have a plan in place and prepare for sick days. Talk to your team of healthcare professionals to put a plan in place before you get sick.

References

• ENT & Sleep Medicine Associates, LLC. Salt Water Gargle Instructions. [Accessed August 24, 2022]. Available from: https://entandsleep.com/wp-content/uploads/2016/11/Salt_Water_Gargle_Instructions-ENTandSleepMedicine.pdf.
• National Kidney Foundation. Watch out for Your Kidney When You Use Medicine for Pain. August 12, 2014. [Accessed August 24, 2022]. Available from: https://www.kidney.org/news/kidneyCare/winter10/MedicinesForPain.
• MedlinePlus. Guaifenesin. January 15, 2022. [Accessed August 24, 2022]. Available from: https://medlineplus.gov/druginfo/meds/a682494.html.
• DailyMed. Mucinex Product Label. June 16, 2022. [Accessed August 24, 2022]. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=dd379cdd-90ab-42e0-ad89-f50d3220f611&audience=consumer.
• DailyMed. Diabetic Tussin DM Product Label. March 3, 2022. [Accessed August 24, 2022]. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=84ad9126-0d42-482d-885c-8a5a0f796de6&audience=consumer.
• DailyMed. Robitussin Sugar-Free, Dye-Free Cough Plus Chest Congestion Product Label. February 18, 2021. [Accessed August 24, 2022]. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=036162c9-f5a6-418e-bd5e-ebd72097d27d.
• DailyMed. Good Sense Tussin DM Cough and Chest Congestion. December 1, 2019. [Accessed August 24, 2022]. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=775bdb11-e719-40ba-9b05-aeb125a0faf8&audience=consumer.
• DailyMed. Robitussin Long-Acting Cough Gels. November 2, 2020. [Accessed August 24, 2022]. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=472c5c1f-eb5a-444b-a17e-f0d71007fb15.
• MedlinePlus. Dextromethorphan. January 15, 2022. [Accessed August 24, 2022]. Available from: https://medlineplus.gov/druginfo/meds/a682492.htm.
• DailyMed. Diabetic Tussin Nighttime Cold and Flu. March 3, 2022. [Accessed August 24, 2022]. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4d5e317f-0e32-4cdc-b56e-b792efa972f5&audience=consumer.
• De Sutter AIM, Saraswat A, van Driel ML. Antihistamines for the common cold. Cochrane Database of Systematic Reviews 2015, Issue 11. Art. No.: CD009345. DOI: 10.1002/14651858.CD009345.pub2.
• De Sutter AIM, Eriksson L, van Driel ML. Oral antihistamine-decongestant-analgesic combinations for the common cold. Cochrane Database of Systematic Reviews 2022, Issue 1. Art. No.: CD004976. DOI: 10.1002/14651858.CD004976.pub4.
• DailyMed. Zyrtec Allergy Product Label. April 25, 2022. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b165db38-b302-4220-8627-77cb07bb078c&audience=consumer.
• DailyMed. Benadryl Product Label. May 4, 2022. [Accessed August 24, 2022]. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=702f9786-7ce9-43e4-921d-e1db09612127&audience=consumer.
• DailyMed. Aller-Chlor Product Label. November 5, 2021. [Accessed August 24, 2022]. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=04ca3806-72be-47d4-9fea-5b0dee087683.
• NeilMed Website. A Leader in OTC Nasal Care Products. [Accessed August 24, 2022]. Available from: https://www.neilmed.com/usa/.
• Breathe Right Website. [Accessed August 24, 2022]. Available at: https://www.breatheright.com/.
• Centers for Disease Control and Prevention (CDC). Living with Diabetes. Managing Sick Days. February 28, 2022. [Accessed August 24, 2022]. Available from: https://www.cdc.gov/diabetes/living-with/managing-sick-days.html.
• Centers for Disease Control and Prevention (CDC). Flu & People with Diabetes. August 26, 2021. [Accessed August 24, 2022]. Available from: https://www.cdc.gov/flu/highrisk/diabetes.htm.
• Centers for Disease Control and Prevention (CDC).. Healthy Habits to Help Protect Against Flu. August 26, 2021. [Accessed August 24, 2022]. Available from: https://www.cdc.gov/flu/prevention/actions-prevent-flu.html.
• American Diabetes Association. Preparing for Sick Days. [Accessed August 24, 2022]. Available from: https://diabetes.org/diabetes/treatment-care/planning-sick-days.

 

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