Max strength cold and flu pills are they worth the money?

Cold and flu gear fall into three broad camps: household names such as Lemsip and Sudafed; supermarket own-label alternatives; and single-ingredient medicines containing paracetamol or ibuprofen.

The difference in price can be striking.

A packet of 16 Lemsip All-In-One Max Strength tablets retails at £7.30, more than 20 times the £0.35 cost of paracetamol pills in some supermarkets.

Both contain 500mg of paracetamol, which doesn’t treat the underlying infection but does relieve pain and can bring down a fever.

The Lemsip version, along with many of its competitors, also contains the decongestant phenylephrine.

It’s meant to constrict leaky or swollen blood vessels in the nose which can cause congestion.

But Prof Lawrence says there is little evidence it works when taken as a tablet, rather than as a nasal spray, because much of the drug is broken down before it can reach the bloodstream.

In 2024, the US drug regulator said it wanted phenylephrine removed from all cold and flu pills, saying it was simply not effective, although that proposal has yet to be finalised.

Some cold and flu remedies contain a third active ingredient – guaifenesin – which is meant to loosen mucus in the airways.

That sits in more of a grey area: some studies report improvements in chest congestion, while others find little or no benefit.

A spokeswoman for Reckitt, which owns Lemsip and Nurofen, said the ingredients in its products are approved by regulators and formulated for multiple symptoms including fever, congestion and coughs.

Yet ingredients are only part of the story.

Bigger brands have more money to spend on in-store adverts and displays, according to a former manager at a large chemist chain.

Well-known names or premium own-label products are often positioned at eye level, while budget alternatives are tucked away on the bottom shelves.

“You are always going to promote the ones which are more expensive,” says the former manager, who doesn’t want to be named as she still works in the industry.

When it comes to medicines, some shoppers assume that paying extra means getting something more trusted or effective.

“Nine times out of ten, people would come in and ask for a certain brand,” she adds.

“Even if I explained there was little difference, and I was only trying to save them money, they would still want the big name.”

The PAGB, which represents the consumer healthcare sector, argues that “trusted and recognisable” brands can simplify choice and build confidence at a time when “health misinformation is widespread”.