COLD & FLU FAQ

Frequently asked questions about the common cold,
the flu and Theraflu® cold and flu products.

Cold and flu prevention and transmission

What is the flu (influenza)?

The influenza virus, commonly called the flu is a contagious respiratory infection. Unlike the common cold, the flu causes severe illness and life-threatening complications in many people.

Symptoms of flu include fever, headache, extreme tiredness, dry cough, sore throat, runny or stuffy nose, and muscle aches. Children can have additional gastrointestinal symptoms such as nausea, vomiting, and diarrhea, but these symptoms are uncommon in adults.

CDC, “Seasonal Influenza Q&A”, http://www.cdc.gov/flu/about/qa/disease.htm, 8/13

It’s chilly. Can that cause you to catch a cold or the flu?

No. There is no clinical evidence that going out in the cold can increase your chances of catching a cold or the flu. However, the winter months are often peak seasons for cold and flu infections. It is thought that cold, dry air may allow viruses to survive for longer periods outside the human body. We also tend to stay inside, in close proximity to others, with the windows closed during the colder months – perfect conditions for spreading viruses.

Harvard Health Publications, "10 Flu Myths”, http://www.health.harvard.edu/flu-resource-center/10-flu-myths.htm, 8/13

How does the cold and flu spread?

The common cold and influenza (the flu) are mainly spread through coughs and sneezes. These propel droplets up to four feet through the air where they can land in the mouth, nose or eyes of people nearby. Viruses can also spread when someone touches these droplets and then touches their mouth or nose.

CDC, "How Flu Spreads”, http://www.cdc.gov/flu/about/disease/spread.htm, 8/13

Can anyone get the flu?

Yes, anyone can get the flu and pass it along. Most healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick. That means that you will be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.

On average, approximately 5% to 20% of U.S. residents get the flu, and more than 200,000 persons are hospitalized for flu-related complications each year. About 36,000 Americans die on average per year from complications of flu.

CDC, "Key Facts about Influenza (Flu) & Flu Vaccine”, http://www.cdc.gov/flu/keyfacts.htm, 8/13

Can I catch the same cold or flu twice?

Many people assume that if they’ve had a cold or the flu recently, they can’t get it again. However, the viruses that cause a cold or the flu can mutate. This means you can catch a cold or flu virus, pass it on to your friends, family or work colleagues and then catch the same cold or flu back off them a week or two later. Because the virus has mutated slightly, the immunity your body generated to fight the virus last time around will no longer be effective against the new strain.

RI.gov, "Health Outlines Myths and Facts About Flu and Flu Shots”, http://www.ri.gov/press/view/18359, 8/13

Can the flu cause serious health complications or death?

Yes. Between 5 – 20% of the people living in the United States gets the flu each year; this includes 200,000 hospitalizations. Some of the complications caused by flu include bacterial pneumonia and dehydration.

Those at high risk of complications from the flu are children younger than age two, adults age 65 or older, and people of any age with certain medical conditions, such as chronic heart, lung, kidney, liver, blood or metabolic diseases (such as diabetes), or weakened immune systems.

CDC, “Seasonal Influenza Q &A”, http://www.cdc.gov/flu/about/qa/disease.htm, 8/13

When is the cold and flu season?

The cold and flu season occurs yearly during autumn and winter, generally peaking in January and February.

CDC, “Cold Verses Flu”, http://www.cdc.gov/flu/about/qa/coldflu.htm, 8/13

If I have a cold or the flu, what can I do to stop friends and family from catching it?

Stay at home. Cover your mouth and nose with a tissue when coughing or sneezing. Throw the used tissue into a closed bin immediately after use. Cough or sneeze into the crook of your elbow if you don’t have a tissue.

It’s also good practice to regularly wipe down surfaces, telephones, doorknobs and keyboards with alcohol-based sanitizers.

Clean your hands regularly. Ask anyone who’s caring for you to do the same. Use an alcohol-based hand gel if you don't have access to water.

CDC, “How Flu Spreads”, http://www.cdc.gov/flu/about/disease/spread.htm, 8/13
CDC, “The Flu: A Guide For Parents”, http://www.cdc.gov/flu/pdf/freeresources/updated/fluguideforparents_trifold.pdf, 8/13

What types of good health habits can help prevent the flu?

Good health habits are also an important way to help prevent the flu.

  • Avoid close contact with people who are sick. When you are sick, keep your distance from others to avoid passing the flu virus to them.
  • If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness.
  • Cover your mouth and nose. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from catching the flu virus.
  • Washing your hands often will help protect you from germs. Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.

CDC, “Preventing the Flu: Good Health Habits Can Help Stop Germs”, http://www.cdc.gov/flu/protect/habits.htm, 8/13

Cold and flu treatment

What to do if you get sick.

Diagnosing the Flu:
It is very difficult to distinguish the flu from other infections on the basis of symptoms alone. A doctor's exam may be needed to tell whether you have developed the flu or a complication of the flu. There are diagnostic tests that can help your doctor determine whether you have the flu. You should be tested as close as is possible to the start of symptoms and usually no more than 4-5 days after you first notice symptoms. If you develop flu-like symptoms and are concerned about your illness, especially if are at high risk for complications of the flu, you should consult your healthcare provider. Those at high risk for complications include people 65 years or older, people with chronic medical conditions, pregnant women, and young children.

Antiviral Medications:
Your doctor may recommend use of an antiviral medication to help treat the flu. These are prescription medications, and a doctor should be consulted before the drugs are used. Antiviral treatment is usually taken for 5 days and work best if they are started within two days of getting sick. Therefore, if you get flu-like symptoms, seek medical care early.

Other Ways to Respond to the Flu:
If you get the flu, get plenty of rest, drink a lot of liquids, and avoid smoking. Also, you can take cold and flu medicine such as Theraflu® to temporarily reduce fever and relieve nasal congestion, cough, sore throat, muscle aches and pains associated with the flu. Never give aspirin to children or teenagers who have flu-like symptoms, particularly a fever.

Symptom relief will vary by product. See product label for full details.

CDC, "Flu Symptoms & Severity”, http://www.cdc.gov/flu/about/disease/symptoms.htm, 8/13
CDC, "Rapid Diagnostic Testing for Influenza: Information for Clinical Laboratory Directors”, http://www.cdc.gov/flu/professionals/diagnosis/rapidlab.htm, 8/13
CDC, "What You Should Know About Flu Antiviral Drugs”, http://www.cdc.gov/flu/antivirals/whatyoushould.htm, 8/13
CDC, "Symptom Relief”, http://www.cdc.gov/getsmart/antibiotic-use/symptom-relief.html, 813

How do I treat my cold or flu symptoms?

Drink lots of fluids. But avoid drinks like coffee, tea, and colas, as they contain caffeine that can dehydrate you.

Eat. Your body needs energy to fight the cold or flu virus. If you’ve lost your appetite, try eating simple foods like white rice or soup.

Multi-symptom cold & flu products like Theraflu® contain a combination of active ingredients for symptom relief. Symptom relief will vary by product. See product label for full details.

For nasal and sinus congestion: Decongestants such as phenylephrine and pseudoephedrine are used for the temporary relief of stuffiness in the nose caused by allergies, colds, or flu. They can help make breathing easier by shrinking swollen mucous membranes in the nose. Saline nasal sprays can also open breathing passages and may be used freely.

For fever/sore throat/headache/pain: Pain relievers such as acetaminophen are used to relieve mild to moderate pain and to reduce fever.

For coughs: Antitussive medications such as dextromethorphan and diphenhydramine are used to help relieve coughs due to colds and flu.

For runny nose/watery eyes/sneezing/itchy eyes, nose and throat: Antihistamines such as chlorpheniramine and diphenhydramine help relieve itchy, watery eyes; sneezing, and runny nose caused by allergies, hay fever, and the common cold.

For chest congestion: Expectorants such as guaifenesin work by thinning the mucus in the air passages and making it easier to cough up the mucus and clear the airways.

Mayo Clinic, "Diseases and Conditions”, http://www.mayoclinic.org/diseases-conditions/common-cold/expert-answers/phlegm/FAQ-20058015, 8/13
CDC, "How Flu Spreads”, http://www.cdc.gov/flu/about/disease/spread.htm, 8/13
CDC, “The Flu: Caring for Someone Sick at Home”, http://www.cdc.gov/flu/homecare/index.htm, 8/13

What are antiviral medications?

Your healthcare professional may recommend use of an antiviral medication to help treat the flu. These are prescription medications, so a healthcare professional should be consulted before the drugs are used. Antiviral flu treatment is usually taken for five days and work best if they are started within two days of getting sick.

CDC, "What You Should Know About Flu Antiviral Drugs”, http://www.cdc.gov/flu/antivirals/whatyoushould.htm, 8/13

Do I need to take antibiotics for my cold or flu?

Not under normal circumstances. Antibiotics do not treat a cold or the flu. Antibiotics kill bacteria. Colds and the flu are caused by viruses. If you develop new symptoms not normally associated with a cold or the flu, you need to see your healthcare professional.

Your doctor may prescribe a course of antibiotics to clear up a bacterial infection in your ear, sinuses, throat or chest. All of these infections may develop as complications of having a cold or the flu but are caused by bacteria rather than the cold or the flu viruses.

CDC, "Preventing the Flu: Good Health Habits Can Help Stop Germs”, http://www.cdc.gov/flu/protect/habits.htm, 8/13

How soon can I expect to feel relief from cold and flu symptoms?

Most people recover from a cold within a few days without requiring medical attention.

Most people recover from flu symptoms within a week without requiring medical attention.

Response will vary for everyone.

Theraflu® cold and flu medicines will help ease the symptoms but they will not cure or shorten the duration of your cold or flu.

Contact your healthcare professional if symptoms get worse or don’t start to improve after one week.

CDC, "The Flu: A Guide For Parents”, http://www.cdc.gov/flu/pdf/freeresources/updated/fluguideforparents_trifold.pdf, 8/13

How long am I contagious if I have a cold or the flu?

If you catch the flu, you're contagious for one to two days before you start to show symptoms and for five to seven days after becoming sick. That means you may be able to pass on the flu to someone else before you know you are sick as well as while you are sick. As for a cold, you are most contagious for the first 2 or 3 days. A cold is usually not contagious after the first week.

Wash your hands regularly to minimize any spread of the virus and ask anyone who’s caring for you to do the same. It’s also good practice to regularly sanitize surfaces such as telephones, doorknobs and keyboards with alcohol-based sanitizers.

MedlinePlus, “Common Cold”, http://www.nlm.nih.gov/medlineplus/commoncold.html#cat1, 8/13
CDC, “How Flu Spreads”, http://www.cdc.gov/flu/about/disease/spread.htm, 8/13
CDC, “Preventing the Flu: Good Health Habits Can Help Stop Germs”, http://www.cdc.gov/flu/protect/habits.htm
CDC, “The flu. Caring for someone sick at home”, http://www.cdc.gov/flu/pdf/freeresources/updated/influenza_flu_homecare_guide.pdf, 8/13

What can I do to feel better when I have a cold or the flu?

Get plenty of rest, drink lots of liquids, and avoid smoking. Treat your symptoms with cold and flu remedies like Theraflu® to temporarily reduce fever and relieve chest congestion, sore throat, muscle aches and pains. Use Theraflu® Nighttime with Severe Cough and Cold to relieve your symptoms to help you get sleep at night.

Use all Theraflu® products as directed.

CDC, “Preventing the Flu: Good Health Habits Can Help Stop Germs”, http://www.cdc.gov/flu/protect/habits.htm, 8/13

Taking Theraflu®

Do I need to ask my healthcare professional before using Theraflu®?

Ask your healthcare professional before using Theraflu® if you are:

  • Pregnant or breast feeding
  • Taking the blood thinning drug, warfarin

Do not give to children under 12 years old.

Ask your healthcare professional before using Theraflu® if you have:

  • Liver disease
  • Heart disease
  • High blood pressure
  • Thyroid disease
  • Diabetes
  • Trouble urinating due to an enlarged prostate gland
  • A cough that occurs with lots of phlegm (mucus)
  • A cough that lasts or is chronic such as occurs with smoking, asthma or emphysema
  • For a nighttime product, ask a healthcare professional before using if you have glaucoma, or are taking sedatives or tranquilizers

You should stop use of Theraflu® products and consult your doctor if:

  • Nervousness, dizziness, or sleeplessness occurs
  • Fever gets worse or last more than 3 days
  • Redness or swelling is present
  • New symptoms occur
  • Pain, cough or nasal congestion gets worse or lasts more than 7 days
  • Couch comes back or occurs with a rash or headache that lasts. These could be signs of a serious condition
  • Sore throat is severe, persists for more than 2 days, is accompanied or followed by fever, headache, rash, nausea, or vomiting – consult a doctor promptly

Can I take Theraflu® if I'm pregnant or nursing?

Please read the drug facts on the package. As with any medication, consult your healthcare professional before taking it while pregnant or nursing.

Can I take Theraflu® with other medicines? Are there any potential interactions with other medicines?

Please read the drug facts on the package. Because interactions between drugs are always possible, your doctor or pharmacist should be consulted before taking more than one medication.

Do not use Theraflu® products with:

  • Any other drug containing acetaminophen (prescription or nonprescription). If you are not sure whether a drug contains acetaminophen, ask your healthcare professional. Severe liver damage may occur if you take more than 4,000 mg of acetaminophen in 24 hours.
  • Monoamine oxidase inhibitor (MAOI) (certain drugs for depression, psychiatric, or emotional conditions, or Parkinson's disease), or for two weeks after stopping the MAOI drug. If you do not know if your prescription drug contains a MAOI, ask your healthcare professional before taking this product.

Blood thinning drug warfarin. Always ask your healthcare professional before taking any other medication with warfarin.

Can it be cut / crushed / sprinkled / mixed with food?

No. Please read the Drug Facts on the package. Do not use more than directed.

Can I drink alcohol while taking Theraflu®?

We do not recommend drinking alcohol while taking any medication.

Please read the drug facts on the package and speak to your healthcare professional with questions about alcohol consumption with your medical treatments.

Severe liver damage may occur if you consume three or more alcoholic drinks a day while using Theraflu® products.

I took more than the recommended dose. What should I do?

If you suspect an overdose, get medical help or contact the Poison Control Center immediately.

Quick medical attention is critical for both adults and children, even if you don’t notice any signs or symptoms.

Taking more than the recommended dose can cause serious health problems, including liver damage.

What should I do if I miss a dose? Can I take an extra dose?

No. You should take the next dose as directed. Never take two doses at once.

Severe liver damage may occur if you take:

  • More than 4,000 mg of acetaminophen in 24 hours
  • With other medicines containing acetaminophen
  • Three or more alcoholic drinks a day while using Theraflu® products

Please ensure you dispose of any expired medicine appropriately. Incorrect disposal can result in a potentially lethal threat to young children and pets, and/or damage to the environment. For more information on how to properly dispose of unused medicine, speak to your healthcare professional.

What’s the purpose of the different ingredients in different Theraflu® products?

Each ingredient has a role to play in easing flu symptoms and cold symptoms. Not every Theraflu® product contains the ingredients below:

Acetaminophen

Pain reliever and fever reducer

Chlorpheniramine maleate

Antihistamine: Relieves hay fever and common cold symptoms like sneezing, runny nose, and itchy, watery eyes

Pheniramine

Antihistamine: Relieves hay fever and common cold symptoms like sneezing, runny nose, and itchy, watery eyes

Diphenhydramine hydrochloride

Antihistamine and cough suppressant: Relieves hay fever and common cold symptoms like sneezing, runny nose, itchy, watery eyes and a dry cough

Dextromethorphan hydrobromide

Cough suppressant: Relieves a dry cough

Guaifenesin

Expectorant: Helps clear mucous secretions in the chest by thinning them so they can be coughed up

Phenylephrine hydrochloride

Nasal decongestant: Helps clear your sinuses by reducing swelling and restricting mucous production

Pseudoephedrine

Nasal decongestant: Helps clear your sinuses by reducing swelling and restricting mucous production

Do not use Theraflu® products with any other product containing acetaminophen – a common ingredient in cold, flu and pain medications.

How long is the shelf life of Theraflu® products?

Please check the expiration date on the package.

Can I use Theraflu® products past the expiration date?

No. You should not use any medicine after the expiration date marked on the package. You should appropriately dispose of any expired products. For more information on how to properly dispose of unused medicine, please visit:

FDA, “How to Dispose of Unused Medicines”, http://www.fda.gov/forconsumers/consumerupdates/ucm101653.htm, 8/13

The flu vaccine (flu shot)

Who should get the flu vaccine?

The following groups are recommended to get a yearly flu vaccine:

All persons aged 6 months and older should be vaccinated annually; especially people who:

  • Are 50 years of age and older
  • Have chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, neurologic hematologic, or metabolic disorders (Including diabetes mellitus)
  • Are immunosuppressed
  • Are or will be pregnant during the influenza season
  • Are household contact and caregivers of children aged younger than 5 years and adults aged 50 years and older

CDC, “Preventing the Flu: Good Health Habits Can Help Stop Germs”, http://www.cdc.gov/flu/protect/habits.htm, 8/13

Is there a cold vaccine?

No. It’s a common mistake that people refer to the flu vaccine as a cold vaccine. There are no vaccines for the common cold. Flu vaccines often give you protection against different strains of the influenza virus but don’t cover common cold viruses.

The main reason for this is that there are a large number of viruses that cause the common cold and they can mutate, so any vaccine would most likely be out of date by the time it was distributed among the population.

When should I get the flu vaccine?

Even though it's better to get vaccinated in October or November, influenza vaccinations still offer benefits when given later in the season (December or later).

CDC, "Key Facts about Influenza (Flu) & Flu Vaccine”, http://www.cdc.gov/flu/keyfacts.htm, 8/13

What is the flu vaccine?

There are two kinds of flu vaccine available in the United States:

  • The "flu shot" — an inactivated vaccine (containing killed virus) that is given with a needle. The flu shot is approved for use in people older than 6 months, including healthy people and people with chronic medical conditions.
  • The nasal-spray flu vaccine — a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for "live attenuated influenza vaccine"). LAIV is approved for use in healthy people 5 years to 49 years of age who are not pregnant.

About two weeks after vaccination, antibodies develop that protect against influenza virus infection. Flu vaccines will not protect against flu-like illnesses caused by other non-influenza viruses.

CDC, "Key Facts about Influenza (Flu) & Flu Vaccine”, http://www.cdc.gov/flu/keyfacts.htm, 8/13

How effective is the flu shot?

With the flu shot, when the "match" between vaccine and circulating strains is close, the vaccine prevents influenza in about 70%-90% of healthy persons younger than age 65 years. Among elderly persons living outside chronic-care facilities (such as nursing homes) and those persons with long-term (chronic) medical conditions, the flu shot is 30%-70% effective in preventing hospitalization for pneumonia and influenza. Among elderly nursing home residents, the flu shot is most effective in preventing severe illness, secondary complications, and deaths related to the flu. In this population, the shot can be 50%-60% effective in preventing hospitalization or pneumonia and 80% effective in preventing death from the flu.

CDC, "Seasonal Flu Shot”, http://www.cdc.gov/flu/about/qa/flushot.htm, 8/13

Why do I need to get a flu vaccine every year?

Flu viruses change from year to year, which means two things. First, you can get the flu more than once during your lifetime. The immunity (natural protection that develops against an infection after a person has had that infection) that is built up from having the flu caused by one flu virus strain doesn't always provide protection against newer strains of the flu. Second, a vaccine from the previous year may not protect against the newer viruses. That is why the flu vaccine is updated to include current viruses every year. Another reason to get the flu vaccine every year is that after vaccination, protection from the flu strains in the vaccine decreases over the year. Because of these reasons, a new flu vaccine is needed each year.

CDC, "Vaccine Effectiveness – How Well Does the Flu Vaccine Work?”, http://www.cdc.gov/flu/about/qa/vaccineeffect.htm, 8/13

Are there any flu shot side effects?

Most people who receive the influenza vaccine do not develop serious problems; however, all vaccines can have side effects. The most common side effects of influenza vaccine include local reactions and mild symptoms such as:

  • Soreness, redness, or swelling where the shot was given
  • Fever (low grade)
  • Aches

Some people should not be vaccinated without first consulting a physician. They include:

  • People who have a severe allergy to chicken eggs.
  • People who have had a severe reaction to an influenza vaccination in the past.
  • People who have developed Guillain-Barré (GBS) within 6 weeks of getting an influenza vaccine previously.
  • Children less than 6 months of age (influenza vaccine is not approved for use in this age group).
  • People who have a moderate or severe illness with a fever should wait to get vaccinated until their symptoms lessen.

CDC, "Seasonal Flu Shot”, http://www.cdc.gov/flu/about/qa/flushot.htm , 8/13

What should I do if I have a serious reaction to influenza vaccine?

If you have a serious reaction to influenza vaccine:

  • Call a doctor, or get to a doctor right away.
  • Tell your doctor what happened, the date and time it happened, and when you got the flu shot.

Ask your doctor, nurse, or health department to file a Vaccine Adverse Event Reporting System (VAERS) form, or call VAERS at 1-800-822-7967.

CDC, "Seasonal Flu Shot”, http://www.cdc.gov/flu/about/qa/flushot.htm , 8/13

Can I get the flu from the injected vaccine?

No. Injectable influenza virus vaccines are made from influenza viruses that have been inactivated (killed) - an inactivated virus cannot give you the flu.

CDC, "Preventing the Flu: Good Health Habits Can Help Stop Germs”, http://www.cdc.gov/flu/protect/habits.htm, 8/13