Is Heart Palpitation a Side Effect of Cold Medicine?

Could you please clarify if this is considered a side effect?

Hello, doctor.
I apologize for the inconvenience, but I have discarded my prescription.
I would like to ask about a previous experience.
I went to a clinic to get cold medication, and after taking the first packet, I experienced palpitations.
When I returned, the pharmacist advised me to cut one of the pills in half.
Last week, I went to the same clinic for cold medication again.
Initially, I had no issues, but after two days, I suddenly felt palpitations again.
Is this possible? Some medications can cause palpitations upon first use, while others may trigger reactions after reaching a certain dosage.
However, I have not experienced these side effects with cold medications from other clinics.
Thank you.

Zi Zi, 30~39 year old female. Ask Date: 2018/10/15

Dr. Hou Fangmin reply Pharmacology

Hello,
1.
Some combination cold medications contain caffeine, antihistamines, anti-inflammatory pain relievers, medications for allergic rhinitis, and ephedrine, which is a bronchodilator.
The side effects of ephedrine and bronchodilators include dizziness and irregular or rapid heartbeat, known as palpitations.
Therefore, it's important to check if the cold medication you are taking contains bronchodilators or ephedrine.
2.
Sometimes, palpitations can be caused by interactions between cold medications and other drugs.
In other cases, certain medications may cause side effects due to individual sensitivities.
It is crucial to inform your physician about any drug allergies so they can note them on your health insurance card to prevent the prescription of allergenic medications in the future.
3.
For some allergies, simply discontinuing the medication may be sufficient.

Finally, I wish you peace and good health.

Reply Date: 2018/10/15

More Info

Heart palpitations can indeed be a side effect of certain cold medications. Many over-the-counter (OTC) cold medications contain ingredients that can stimulate the heart or affect blood pressure, leading to sensations of heart racing or palpitations. The most common culprits are decongestants, such as pseudoephedrine and phenylephrine, which are often included in cold and allergy medications. These substances work by constricting blood vessels to reduce nasal congestion, but they can also increase heart rate and blood pressure, especially in sensitive individuals.

When you first took the cold medication and experienced palpitations, it could have been due to one of these active ingredients. The fact that the pharmacist suggested halving the dose indicates that the medication might have been too strong for you, or that your body was particularly sensitive to it. It’s not uncommon for individuals to react differently to medications, even if they are the same type. Some people may experience side effects upon first use, while others may develop them after taking the medication for a few days, as you described.

Additionally, other ingredients in cold medications, such as caffeine or certain antihistamines, can also contribute to feelings of palpitations. Caffeine is a stimulant that can increase heart rate, and some antihistamines can have a paradoxical stimulating effect in certain individuals, leading to increased heart rate or anxiety.

It's also worth noting that if you have any underlying health conditions, such as anxiety disorders, hyperthyroidism, or pre-existing heart conditions, you may be more susceptible to experiencing palpitations as a side effect of these medications.
If you have taken cold medications from other pharmacies without experiencing these side effects, it could be due to differences in the formulations or the specific ingredients used in those products. Some cold medications may be formulated without decongestants or stimulants, which could explain why you did not experience palpitations with those alternatives.

Given your experience, it is advisable to consult with a healthcare professional before taking any new medications, especially if you have a history of heart palpitations or other cardiovascular concerns. They can help you identify which specific ingredients to avoid and may recommend alternative treatments for your cold symptoms that are less likely to cause palpitations.

In summary, yes, heart palpitations can be a side effect of cold medications, particularly those containing decongestants. If you experience this side effect, it is important to discuss it with your healthcare provider to find a safer alternative that effectively manages your cold symptoms without causing discomfort. Always be cautious with any medication, and don’t hesitate to seek professional advice when you have concerns about side effects.

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