1 Principle of cold and flu drug formulation Cold and flu medication is mainly for colds and flu caused by headache and fever, cough and tear, nasal congestion and runny nose, throat congestion, general body aches and pains, fatigue and other symptoms, in order to alleviate the pain and shorten the duration of the disease and to prevent complications. It is mainly composed of antipyretic and analgesic anti-inflammatory drugs, antihistamines, decongestants, cough suppressants and expectorants to cover all the symptoms of colds, so it is also known as multi-symptom reliever for colds and coughs, also known as cold and cough joint compound. Some of them also contain antiviral medicines or Chinese medicines that clear away heat and relieve symptoms, clear away heat and detoxify the toxin. Zhou Ping, Department of Dermatology and Venereology, Beijing Century Forum Hospital, and Xue Xingyang, Department of Thoracic Surgery, Affiliated Cancer Hospital of Guangzhou Medical College, Henan Provincial People’s Hospital, and Zhuang Health, Department of Rehabilitation Medicine, Henan Provincial People’s Hospital, formed a series of cold and flu medicines by combining several types of medicines, including antipyretic and analgesic anti-inflammatory medicines, antihistamine medicines, decongestant medicines, and antipyretic medicines, as well as some selective formulas. There are complete formulas containing antipyretic and anti-inflammatory drugs, decongestants and expectorants, and selective formulas containing some relievers. 2.1 Antipyretic, analgesic and anti-inflammatory drugs Acetaminophen, ibuprofen, benoate, diclofenac, etc. Relieve headache, fever and generalized acidity. Relieve the symptoms of headache, fever and generalized pain. 2.2 Antihistamines Chlorpheniramine maleate (Paracetamol), Diphenhydramine hydrochloride, Terfenadine, Triprolidine hydrochloride, Isoprinosine etc. They are used to eliminate or reduce symptoms such as itchy, runny nose, sneezing, itchy and watery throat and eyes. 2.3 Decongestants Pseudoephedrine, methylephedrine. Reduce congestion of the nasal mucosa, relieve nasal or sinus obstruction (nasal congestion) caused by allergic reactions or colds, and ear obstruction caused by inflammation or infection. 2.4 Cough suppressants Dextromethorphan hydrobromide, codeine, clofazimine (CoughPeace), and propoxyphene dioxide (CoughMin) are used to relieve coughing symptoms in colds. 2.5 Expectorants Guaifenesin, Carbocistein, etc., to relieve cough in colds. It is often used in combination with cough suppressants to relieve cough and phlegm in colds. 2.6 Other ingredients Artificial oxalis (antipyretic and antitussive, synergistic effect of antipyretic and analgesic), caffeine (synergistic effect of antipyretic and analgesic, and reduce the side effect of drowsiness of antihistamines), amantadine (used in Asian influenza A-II, with antipyretic effect), zinc gluconate (inhibit the effect of viral replication and improve the body’s ability to fight against viruses) and so on. 3 Classification and Introduction of Cold and Flu Medicines by Components (See Table 1-9) 3.1 Complete Compounding of Antipyretic and Analgesic Anti-inflammatory Drugs, Antihistamines, Decongestants, and Cough-suppressing and Expectorant Drugs This category of grouping is a complete grouping of the four classes of drugs used in the symptomatic treatment of cold and flu to cover the symptoms used in cold and flu. It can reduce the congestion of mucous membrane of upper respiratory tract, clear the pre-cold symptoms such as nasal congestion, runny nose, itchy eyes and nose, sneezing, tearing, etc., and also treat the middle and late symptoms such as headache, fever, cough, limb ache, muscle pain, general malaise, etc. caused by cold. Table 1 Antipyretic and analgesic anti-inflammatory drugs, antihistamines, decongestants, cough and expectorant drugs compound preparations drug name ingredients Phenmetrazine (Tylenol, New Parc) tablets, capsules: each tablet (capsule) containing acetaminophen 325mg, pseudoephedrine hydrochloride 30mg, dextromethorphan hydrobromide 15mg, chlorpheniramine maleate 2mg Phenmetrazine (Mepomorphyrin) (children’s Tylenol, Aldo, Kilpepsin) Oral Liquid: Each 5ml contains 160mg of Acetaminophen, 15mg of Pseudoephedrine Hydrochloride, 5mg of Dextromethorphan Hydrobromide, 1mg of Chlorpheniramine Phenmetrazine Granules (Tylenol) Each sachet contains 650mg of Acetaminophen, 60m of Pseudoephedrine Hydrobromide, 30mg of Dextromethorphan Hydrobromide, 4mg of Chlorpheniramine Maleate Phenmetrazine (PAD) Each Tablet contains 500mg of Acetaminophen, 500mg of Pseudoephedrine Hydrobromide and 2mg of Phenmetrazine Maleate. 500mg, Pseudoephedrine Hydrochloride 30m, Dextromethorphan Hydrobromide 15mg, Chlorpheniramine Maleate 2mg Amphenol Pseudomedicine Menamin Tablets (Remonix) Each tablet contains Acetaminophen 325mg, Pseudoephedrine Hydrochloride 30m, Dextromethorphan Hydrobromide 15mg, Chlorpheniramine Maleate 2mg Mayphenol Pseudomedicine Tablets (White Plus Black) Daily Tablets: Each tablet contains Acetaminophen 500 or 325mg Pseudoephedrine Hydrochloride 30mg, Dextromethorphan Hydrobromide 15mg Nighttime Tablets: Daytime Tablets + Diphenhydramine Hydrochloride 25mg Amphetamine Tablets (Nick) Daytime Tablets: Each Tablet Contains Acetaminophen 500 or 325mg, Pseudoephedrine Hydrochloride 30mg, Dextromethorphan Hydrobromide 15mg Nighttime Tablets: Daytime Tablets + Diphenhydramine Hydrochloride 10mg Bisabolol Tablets (Daytime Tablets)/Medipropomofetil (Night) (Day & Night Pepsodone Tablets) (Night Tablets) (Day and Night Pepcid) Day Tablets: Each tablet contains acetaminophen 500mg, pseudoephedrine hydrochloride 30mg, dextromethorphan hydrobromide 15mg Night Tablets: Day Tablets + chlorpheniramine maleate 2mg Phenamine Pseudoephedrine Tablets Day Tablets: Each tablet contains pseudoephedrine hydrochloride 30mg, acetaminophen 500mg Night Tablets: Day Tablets + benadryl hydrochloride 25mg Table 2 Antipyretic and Analgesic, Decongestant and Coughing Agents Antipyretic, decongestant and antitussive and expectorant compound preparations Drug Name Ingredients Dual pseudoephedrine (Haiwang Yindefei, Zelik) Each tablet (10 ml) contains acetaminophen 325 mg or 500 mg, pseudoephedrine hydrochloride 30 mg, dextromethorphan hydrobromide 15 mg phenolmepseudomaltaicum (Darnell) Each tablet contains acetaminophen 325 mg or 500 mg, pseudoephedrine hydrochloride 30 mg, dextromethorphan hydrobromide 30 mg phenolmepseudomaltaicum (Danuo) Each tablet contains acetaminophen 325 mg or 500 mg, phenolmepseudoephedrine hydrochloride 30 mg, dextromethorphan hydrobromide 30mg Phenol meiheguai pseudo-ma (Runton Pepsi) per 10ml containing acetaminophen 200mg, ephedrine hydrochloride 30mg, dextromethorphan hydrobromide 15mg, guaiac glycerol ether 100mg Table 3 antihistamines, decongestants and antitussive expectorant compound preparations Drug Name Ingredients meiheguai pseudo-ma tablets, capsule: each tablet (capsule) containing dextromethorphan hydrobromide 10nmg, pseudoephedrine hydrochloride 30mg, guaiac glycerol ether 100mg 30mg, Guaifenesin 100mg Mephenol pseudoephedrine (Mephedrone) (Redenta, Lizucel) Tablets, oral solution: each tablet (per 10ml) contains Dextromethorphan Hydrobromide 15nmg, Pseudoephedrine Hydrochloride 30mg, Guaifenesin 100mg Mephenol Pseudoephedrine Solution (Sangkeling) for adult use, containing Pseudoephedrine Hydrobromide 30mg, Dextromethorphan Hydrobromide 10mg, Clobenamin Maleate 2mg for every 5ml. Chlorpheniramine 2mg per 5ml for children contains Pseudoephedrine Hydrochloride 15mg, Dextromethorphan Hydrobromide 5mg, Chlorpheniramine Maleate 1mg Compound Codeine Oral Solution (Fiducial Cough Syrup, Neotelocin) contains Codeine Phosphate 5mg, Ephedra 7mg and Pirilipramine (Tropridium) 0.7mg per 5ml Compound Dextromethorphan Syrup (Mekel Syrup) contains Dextromethorphan Hydrobromide 15mg, Dextromethorphan Hydrobromide 10mg per 10ml. Compound Dextromethorphan Syrup (Meco Syrup) contains 15mg of Dextromethorphan Hydrobromide, 1mg of Chlorpheniramine Maleate, 50mg of Guaiacol, 10mg of Mephedrone Hydrochloride per 10ml. For Adults: Dextromethorphan Hydrobromide, 60mg of Pseudoephedrine Hydrochloride, 4mg of Chlorpheniramine Maleate per 10ml. For Children: Dextromethorphan Hydrobromide, 10mg of Dextromethorphan Hydrobromide, 30mg of Pseudoephedrine Hydrochloride, 2mg of Chlorpheniramine Maleate per 10ml. 2mg Dr. Special Effect Cough Drops contains Codeine Phosphate 4mg, Pyrrolopyramine 1.25mg, Pseudoephedrine Hydrochloride 15mg, Phenylephrine 5mg, Keslan 0.04mg, Allium Sativum 0.01mg, Fenugreek 0.01mg Dr. Pediatric Cough Drops contains Dextromethorphan Hydrobromide 5mg, Pyrrolopyramine 0.6mg, Pseudoephedrine Hydrochloride 15mg, Pseudoephedrine Hydrochloride 15mg, Pseudoephedrine Hydrochloride 4.25mg. Pseudoephedrine 15mg, Guaifenesin 50mg, Onion 0.005mg, Feverfew 0.005mg per 5ml contains Methadone Hydrobromide 4.5mg, Chlorpheniramine Maleate 5mg, Ammonium Chloride 30mg, Sodium Citrate 60mg, Citrate 5mg, Guaihenyldene Oral Solution (Federal Pediatric Cough Drops) contains Isopropylzine Hydrochloride 4mg, Codeine 5mg, Cocaine 4mg, Cocaine 5mg, Cocaine 4mg, Cocaine 4mg, Cocaine 4mg, Cocaine 5mg, Cocaine 4mg, Cocaine 4mg, Cocaine 4mg, Cocaine 4mg per 5ml. 4mg, codeine 5mg, ephedrine hydrochloride 5mg and guaiacol sulfonic acid potassium 50mg Table 4 Antihistamines and decongestant compound preparations Drug name Ingredients Pseudoephedrine Capsules (Pulsatilla tablets) Capsules, tablets: each capsule contains 60mg of pseudoephedrine hydrochloride, chlorpheniramine maleate 4mg Compound Pseudoephedrine Extended-Release Capsules (NeoContact) Capsules: each capsule contains 90mg of pseudoephedrine hydrochloride, Chlorpheniramine maleate 4mg Table 5 Anti-cough, expectorant or antihistamine compound preparations Drug Name Ingredients Compound Codeine Phosphate Syrup (Keflex) Containing 20mg of Codeine Phosphate, 12.5mg of Isopromethazine Hydrochloride per 10ml Keflex Syrup Containing 10mg of Codeine Phosphate and 100mg of Guaifenesin per 5ml Guai Mei Tablets Containing 100mg of Guaifenesin and 15mg of Dextromethorphan Hydrobromide per Tablet Guaime capsule contains 100mg of guaifenesin and 10mg of dextromethorphan hydrobromide per capsule. Dextromethorphan hydrobromide syrup contains 30mg of dextromethorphan hydrobromide and 200mg of guaifenesin per 10ml. Table 6 Antihistaminic, decongestant and antipyretic and anti-inflammatory preparations: Name of the drug Ingredients: Aminophenolpseudoepileptic (diphasoneuropseudoepileptic) (Cynarol, Dijia, Nuonol) Tablets, Chewable tablets: each tablet contains Acetaminophen 500 or 325mg, Pseudoephedrine Hydrochloride 30mg, Chlorpheniramine Maleate 2mg Amphenol Pseudoephedrine Solution contains Acetaminophen 200mg, Pseudoephedrine Hydrochloride 30mg, Chlorpheniramine Maleate 2mg Phenol Pseudoephedrine Tablets (Danuo) contains Acetaminophen 325mg, Pseudoephedrine Hydrochloride 30mg, Diphenhydramine Hydrochloride 10mg per tablet. Each tablet contains Terfenadine 15mg, Pseudoephedrine Hydrochloride 15mg, Acetaminophen 162.5mg Amphenicol Tromethamine Tablets (Federated Fidelity) contains Acetaminophen 200mg, Pseudoephedrine Hydrochloride 30mg, Salicylamide 100mg, Triptolide Hydrochloride 1.2mg. 30mg, chlorpheniramine maleate 2mg Compound Phencopodium Pseudoephedrine Capsules (Lixu) Each capsule contains acetaminophen 150mg, caffeine 12.5mg, ephedrine hydrochloride 5mg, chlorpheniramine maleate 1.25mg, chlorpheniramine maleate 6mg, and bromelain 15.5 million IU Table 7 Compound Preparations of Antihistamines and Antipyretic Analgesic and Anti-inflammatory Drugs Drug Name Ingredients Compound Zinc Cloth (Zinc Kecon) ) Tablets, capsules, granules: each tablet (capsule or packet) contains ibuprofen 50mg, zinc gluconate 100mg, chlorpheniramine 2mg Zinc Cloth Granules (Chenkong Zaixin) Granules: each contains zinc gluconate 100mg, ibuprofen 150mg, chlorpheniramine maleate 2mg Compound Aminophenol Gluconate and Zinc Tablets (Kangbidai) Each tablet contains 150mg of acetaminophen, 35mg of zinc gluconate, Dioxopromethazine Hydrochloride 0.5mg, Banlangen Cream 125mg Compound Aminophenol Alkylamine (Quick, New Quick Cold & Flu Tablets) Each capsule contains Acetaminophen 250mg, Amantadine Hydrochloride 100mg, Artificial Oxalic 10mg, Caffeine 15mg, Chlorpheniramine 2mg Twin Puffs Oral Liquid per 10ml contains Acetaminophen 125mg, Chlorpheniramine Maleate 1.5mg, Caffeine 7.5mg and artificial oxalis 5mg Children’s antipyretic tablets: each tablet contains acetaminophen 120mg, chlorpheniramine 0.5mg phenol caffeine tablets containing acetaminophen 250mg, caffeine 32.5mg Table 8 Decongestant and antiemetic expectorant compound preparation drug name ingredients Guaixue Ziqi Pseudo-Ma tablets (Preparation) each tablet containing Guaixue Ziqi Pseudo-Ma 200mg and 30mg of pseudoephedrine hydrochloride Saffen Pseudoephedrine chewable tablets each containing dextromethorphan hydrobromide 15mg and pseudoephedrine hydrochloride 30mg Carboxypseudoephedrine tablets each containing dextromethorphan hydrobromide 15mg, carboxymetholestane 250mg and pseudoephedrine hydrochloride 30mg Table 9 Antipyretic and analgesic and decongestant compound preparations drug name composition of the distribution of Luo Pseudoephedrine (Aifeler, Yak, Der, Bershu) tablets, granules: each tablet (packet) containing ibuprofen Drops (Simei Pepcid) contain 80mg of acetaminophen and 7.5mg of pseudoephedrine hydrochloride per 0.8ml.4 Safe Use of Compounded Anti-cold and Flu Medicines 4.1 Selection of medicines according to the clinical symptoms of colds and flu 4.2 Most of the preparations of anti-cold and flu medicines have the same ingredients, so be sure to read and understand the instructions of the medicines in detail before use, to avoid duplication of medicines. 4.3 Cold remedies containing antihistamine ingredients, such as chlorpheniramine and diphenhydramine, have the side effect of causing drowsiness, and should not be taken by drivers, workers at height, or operators of fine work, at least not during the day. 4.4 Preparations containing pseudoephedrine, methylephedrine, ephedrine-sensitive pregnant women, elderly patients, patients suffering from heart disease, hypertension, hyperthyroidism, glaucoma, emphysema and other respiratory distress patients, patients with prostate hypertrophy with urinary difficulties and patients with mental depression should not be used. 4.5 The duration of the drug is 3~7d, if the symptoms are not relieved after application, the drug should be stopped promptly. 4.6 Pediatric patients should use children’s compound anticold medicines. 4.7 Pregnant women should be cautious to use cold and flu medicines in the first 3 months, and avoid the use of cold and flu medicines containing antiviral drugs during the whole pregnancy, because antiviral drugs may cause teratogenicity. 4.8 Do not drink alcohol or alcoholic beverages while taking cold remedies. 4.9 Reasonable use of proprietary Chinese medicines against colds. Chinese medicine practitioners categorize colds into wind-cold type, wind-heat type and summer-heat type according to the cause of the disease, and there are differences in the use of medicines. For wind-cold type colds, the treatment should be pungent, warm and symptomatic medicines to promote the lungs and disperse cold. ② wind-heat type of cold, it is appropriate to promote the lungs and clear heat, pungent and cool relief of the surface, can choose Yin Qiao detoxification pills, mulberry and chrysanthemum cold tablets, antelope cold tablets, or cold and clear heat punch orally. For summer-heat type colds, it is better to remove heat and clear the heat, use Huo Xiang Zheng Qi Punch or oral liquid.