Nasal congestion, cough, stuffy nose and sinus pain are symptoms that tend to send people to their local drugstore to find relief. Mucinex and Sudafed are 2 common over-the-counter (OTC) options used to counter symptoms related to the common cold, allergies and other upper respiratory ailments. These medications target different symptoms with some overlapping benefits, so if you aren't sure which would be most appropriate for your situation, ask your doctor or a pharmacist for advice.
Mucinex is an OTC medication that contains the active ingredient guaifenesin, an expectorant that works by loosening and thinning mucus. This medication is a good choice when you have excessive or thick mucus or a wet, productive cough. An expectorant assists your body in fighting the infection by making it easier to cough up mucus, and can ease symptoms of chest congestion. Mucinex will not help a dry, hacking cough, and won't improve nasal or sinus congestion. To improve the effectiveness of Mucinex, drink plenty of fluids.
Sudafed is an OTC nasal decongestant. Sudafed products contain the active ingredient pseudoephedrine or phenylephrine. These decongestants work by reducing inflammation and narrowing the blood vessels in the nasal passages and airways, making it easier to breathe. So Sudafed is a good choice if you have a stuffy nose, sinus congestion or plugged ears due to congestion. It won't help the symptoms of a runny nose or cough, and it won't thin or reduce mucus buildup.
When it comes to product options, both guaifenesin, pseudoephedrine and phenylephrine are available in a variety of formulations. You can purchase Sudafed or Mucinex products, for example, in single formulation or in combination with other OTC drugs. Some formulations include an expectorant and a decongestant, or combine one of these ingredients with a pain reliever, antihistamine or cough suppressant. These combination products may help if you have more than one symptom you want to treat, but if you aren't careful, these products can give you more medicine than you need.
While Mucinex and phenylephrine-containing Sudafed products are readily available in drug and grocery stores, Sudafed products that contain pseudoephedrine have restrictions on their sale, since this ingredient can be used to make crystal methamphetamine -- a highly addictive stimulant and commonly abused street drug. Consequently, pseudoephedrine products are located behind the counter at pharmacies. Depending on your state law, you may need to provide a photo ID and signature to purchase products containing pseudoephedrine, or you may need a prescription from your doctor.
The potential side effects of OTC drugs depends on the specific product, so it's important to read the package directions and take exactly as directed. Guaifenesin-containing products may cause nausea, stomach upset or vomiting, while Sudafed products may cause restlessness, fast heart beat, anxiety or sleeplessness. If you have diabetes, heart disease, high blood pressure, eye disease or enlarged prostate, a decongestant may not be safe for you, so speak to your doctor before using OTC cold remedies. Also, do not use decongestant nasal sprays for more than 3 days, since your body can become dependent on them.
See your doctor if you have a cough that lasts more than 2 weeks, or sooner if your respiratory symptoms are severe. Also see your doctor right away if you have a fever, shortness of breath, wheezing, dehydration or if you have any signs of infection, such as coughing up thick, greenish-yellow phlegm.
Reviewed by Kay Peck, MPH RD
- Pharmacy Times: OTC Cough, Cold, and Flu Products: Finding Symptomatic Relief
- US Food and Drug Administration: Legal Requirements for the Sale and Purchase of Drug Products Containing Pseudoephedrine, Ephedrine, and Phenylpropanolamine
- Canadian Family Physician: Treating the Common Cold During Pregnancy
- American Family Physician: Treatment of the Common Cold in Children and Adults
- American Academy of Family Physicians: Decongestants: OTC Relief for Congestion