Our expert pharmacist advises how to find over-the-counter cold and flu medications that are safe for your diabetes.

Searching for relief for your runny nose, sore throat, or cough? Many over-the-counter cough, cold, and flu remedies list diabetes as an underlying condition that may indicate you should leave the medication on the shelf. The warnings are clear: "Ask a doctor before use if you have: heart disease, high blood pressure, diabetes." Unfortunately, your doctor is not along for the trip to the pharmacy.

Because illness causes your body to release stress hormones that naturally raise blood glucose, you'll want to be sure that over-the-counter medications won't increase blood glucose levels, too.

Simple Is Best for Cold Medicines

Keep it simple by choosing an over-the-counter medication based on the types of ingredients proven to relieve your particular symptoms. Often a medication with just one ingredient is all you need to treat your symptoms rather than agents with multiple ingredients. "To choose the correct medication, take time to speak to a pharmacist," says Jerry Meece, R.Ph., CDE, of Gainesville, Texas. "The proper remedies may not only make you feel better, but also cut the length of the illness and possibly save you a trip to the doctor."

Oral cold and flu pills are often a better choice than syrups with the same ingredients because the pills may contain no carbohydrate. If you decide to use a syrup, look for one that is sugar-free. If you can't find one, the small amount of sugar in a syrup will likely affect your blood sugar less than the illness itself, Meece says.

Safe OTC Cold Medicines

Various over-the-counter medications are designed to treat specific symptoms. Many pharmacists recommend these products for people with diabetes.

Symptom: Cough

Best option: Anti-tussive dextromethorphan (Delsym, Diabetic Tussin NT [includes acetaminophen, diphenhydramine])

Symptoms: Congestion, mucus in sinus passages

Best options: Decongestant pseudoephedrine (Sudafed); phenylephrine; phenylpropalamine

Symptoms: Phlegm, mucus in respiratory tract

Best option: Expectorant guaifenesin (Mucinex, Robitussin)

Symptoms: Pain and/or fever

Best options: Analgesic acetaminophen (Tylenol); aspirin

For fever and pain relief, look to analgesics, including aspirin and acetaminophen. Both are safe for most people and commonly available. The analgesic class of nonsteroidal anti-inflammatory drugs (NSAIDS), which includes ibuprofen and naproxen, may increase blood pressure and is not a good choice for people with kidney problems. Note: Be sure to call your doctor if your temperature rises above 103 degrees Fahrenheit.

Symptoms: Runny nose, itchy eyes

Best option: Antihistamine

Less-sedating options: certirizine (Zyrtec); loratadine (Claritin)

More-sedating options: chlorpheniramine (Chlortrimeton); diphenhydramine (Benadryl)

For a stuffy nose, oral decongestants (pseudoephedrine, phenylephrine, phenylpropalamine) can increase both blood glucose and blood pressure and therefore are not usually recommended. "The occasional use of a decongestant should be the rule," says Robert Busch, M.D., an endocrinologist from Albany, New York. You'll have to sign the pharmacy register for over-the-counter remedies containing pseudoephedrine. Federal law limits pseudoephedrine purchases because the drug can be used to make illegal methamphetamine.

All oral antihistamines are effective for sneezing, runny nose, nasal or eye itching, postnasal discharge, conjunctivitis, and allergic rhinitis.

Reminder: Get your flu shot! The American Diabetes Association recommends an annual flu shot (typically in September or October) for people with diabetes. The vaccine doesn't guarantee you will avoid influenza, but it reduces your risk of illness.