image copyrightGetty Images
Flu season is back again. If you have a sore throat, a headache, and a stuffy nose that prevents you from sleeping all night, you might want to get back to your normal condition somehow.
So, are expensive, high-strength cold medicines really more effective than regular painkillers?
Professor Jane Lawrence, head of the Department of Pharmacy at the University of Manchester, said: “The famous brands have been on the market for a long time, have been tested for efficacy and are advertised in TV advertisements as being effective.”
“But in reality, it doesn’t make much of a difference. If I were you, I would always choose the cheaper product, because even the cheaper drugs have been tested for efficacy.”
An industry group representing over-the-counter drug manufacturers explains that familiar brands give consumers a sense of trust and help them find the right medicine for them in supermarkets with numerous products on display.
The medicines examined this time all contain similar ingredients, with only slight differences in the content of each ingredient.
Cold and flu symptom relievers are broadly divided into three categories. These include well-known brand products such as Remship and Sudafed, supermarket own brand (PB) products, and medicines containing a single ingredient such as paracetamol or ibuprofen.
The price difference is significant.
End of TOP News
The selling price of a box of 16 tablets of Remship All-in-One Max Strength is approximately 12,900 won (7.30 pounds). It is more than 20 times more expensive than paracetamol tablets, which sell for around 620 won (£0.35) in some supermarkets.
Both products contain 500mg of paracetamol. Paracetamol doesn't cure the infection itself, but it helps relieve pain and reduce fever.
Many competing products, including Remship, also contain phenylephrine, an ingredient that relieves nasal congestion.
This ingredient is designed to constrict blood vessels to reduce leakage or swelling of blood vessels in the nose, which can cause nasal congestion.
However, Professor Lawrence pointed out that there is little evidence that phenylephrine is effective when taken in pill form rather than as a nasal spray. This is because a significant portion of the drug breaks down before it reaches the bloodstream.
In 2024, U.S. drug regulators announced plans to remove phenylephrine from all cold and flu symptom relief pills, saying it is ineffective. However, the proposal has not yet been finalized.
Some cold and flu symptom relievers also contain a third active ingredient, guaifenesin. This ingredient dilutes the mucus accumulated in the respiratory tract and makes it easier to expel.
However, the effects of guaifenesin are not yet clear. Some studies have reported improvement in symptoms of phlegm in the chest, while others have found little or no effect.
A spokesperson for Reckitt, which owns Remship and Nurofen, said the ingredients in its products have been approved by regulatory authorities and are formulated to relieve symptoms including fever, nasal congestion and cough.
caffeine effects
Among the widely sold high-strength cold medicines, many contain up to 65 mg of caffeine per pill. This is similar to the amount contained in a cup of instant coffee.
Research has shown that caffeine not only produces a mild stimulating effect, but can also increase the effectiveness of paracetamol and help the drug take effect more quickly. However, the effect is likely not large.
Almost all brands also sell flavored powder products that can be mixed with hot water and consumed. Typically, a single dose costs a little more than a pill.
Warm drinks can help soothe symptoms. Additionally, a study funded by a pharmaceutical company found that this form of the drug may be absorbed more quickly into the bloodstream. However, it is much less clear whether patients can actually notice a significant difference in symptoms.
However, the ingredients of the drug are not everything.
Big brands can spend more on in-store advertising and product displays, according to a former manager at a large pharmacy chain.
Famous brands or high-end private label products are often placed on shelves that match the consumer's eye level, while cheaper products are often placed on the bottom shelf.
“You always end up promoting more expensive products,” said the former manager, who requested anonymity because he still works in the industry.
When purchasing medications, some consumers believe that paying more will get them a more reliable or effective product.
“Nine out of ten people come into a store and look for a specific brand,” he said. “Even if you explain that it doesn’t make a big difference and you’re just trying to save money, they still want the name brand.”
The Pharmaceutical Council of Great Britain (PAGB), which represents the consumer healthcare industry, argues that at a time when “health misinformation is widespread”, “trustworthy and recognizable” brands can simplify consumer choice and increase trust.
What doctors recommend
If you are suffering from cold or flu symptoms, doctors offer the following advice:
