Compare Sudafed vs. Acetaminophen / dextromethorphan / doxylamine / phenylephrine

Sudafed (pseudoephedrine) and Alka-Seltzer Plus Severe Cold and Flu (acetaminophen/chlorpheniramine/dextromethorphan/phenylephrine) are both over-the-counter medications used to relieve symptoms of the common cold, but they have different uses and ingredients. Sudafed is a decongestant that works by narrowing blood vessels to reduce nasal and sinus congestion. It is available in both immediate-release and extended-release forms. On the other hand, Alka-Seltzer Plus Severe Cold and Flu is a combination medication that includes an analgesic (acetaminophen), an antihistamine (chlorpheniramine), a cough suppressant (dextromethorphan), and a decongestant (phenylephrine). This combination helps relieve a wider range of symptoms, including pain, fever, and cough. Studies show oral phenylephrine is not an effective decongestant. For this reason, Alka-Seltzer Plus Severe Cold and Flu may not be the best option to relieve congestion. Sudafed can cause side effects like anxiety and difficulty sleeping, while Alka-Seltzer Plus can cause drowsiness and dry mouth. Additionally, Sudafed is restricted and must be purchased at the pharmacy counter, whereas Alka-Seltzer Plus is more readily available on store shelves. Both medications should not be taken with monoamine oxidase inhibitors (MAOIs), such as selegiline (Zelapar), and have specific age restrictions for children.