Searching for the right over-the-counter medicine to treat your cold and flu symptoms can be challenging. There are so many choices – some medicines treat certain symptoms and others offer all-in-one relief. How do you know which is best?
“Choose a medicine that targets your specific symptoms and follow the directions on the label,” says Abigail Entz, M.D., a primary care physician at Henry Ford Health. “And check with your pharmacist to ensure that the medicine you choose won’t interact with any medications you’re taking for chronic medical conditions.”
What Are The Different Types Of Cold Medicine?
Colds and flu tend to last about three to seven days. But if you’re suffering from a sore throat, nasal congestion or body aches, the discomfort can make it seem longer. “Consider taking a cold medicine if you’re having difficulty doing your daily activities or sleeping at night,” says Dr. Entz.
Here’s a breakdown of the different over-the-counter medications:
- Antihistamines: These medications relieve symptoms caused by allergies, including itchy and watery eyes, sneezing, coughing and nasal congestion. Traditional antihistamines such as brompheniramine (Dimetapp®), diphenhydramine (Benadryl®) and doxylamine (Vicks® Nyquil) are effective but may make you drowsy. A newer generation of antihistamines available over the counter do not cause fatigue. These medications include cetirizine (Zyrtec®), fexofenadine (Allegra®) and loratadine (Claritin®).
- Cough suppressants: These medications provide short-term relief for a persistent cough by blocking the nerve impulse that causes coughing. Many cough suppressants contain the active ingredient dextromethorphan.
- Decongestants: There are a wide variety of pills, sprays and drops that relieve nasal congestion. These medications narrow blood vessels in your nose, reducing swollen tissue and decreasing mucous production. The two most popular are:
- Nasal sprays and drops: These sprays include oxymetazoline nasal (Afrin®) and phenylephrine nasal (Neo-Synephrine®), which quickly shrink swelling in your nose. You should limit the use of nasal decongestant sprays to three days, however. Extended use can cause a rebound effect of chronic inflammation of the mucous membranes in your nose.
- Pseudoephedrine: This oral decongestant also shrinks swollen, inflamed nasal tissue. Pseudoephedrine (sold as Sudafed®), is regulated to prevent misuse. You’ll need to request it from your pharmacist and present identification when purchasing it. Ask our doctor before taking pseudoephedrine if you’re pregnant, have heart disease, high blood pressure, kidney disease or liver disease.
- Expectorants: These medications help loosen mucous to make it easier to cough up and clear your airways. Most expectorants contain guaifenesin, which is an active ingredient in products like Mucinex® and Robitussin®.
- Pain relievers: Colds and flu can also cause aches in your head, throat and muscles along with a sore throat and fever. Pain relievers, also called analgesics, can help manage these symptoms. These medications include acetaminophen, (Tylenol®), ibuprofen (Advil®) and Naproxen (Aleve®).
Use Cold Medicine Safely
Dr. Entz offers these tips for choosing and safely taking cold medicine:
- Avoid alcohol: Alcohol combined with active ingredients in cold and allergy medications can cause fatigue and may impair your ability to drive or carry out other daily activities.
- Consult your pharmacist: If you take medications for a chronic health condition, you may need to avoid certain cold medicines. People with high blood pressure (hypertension) should not take nasal decongestants, which can increase blood pressure. Let your pharmacist know if you’re taking herbal supplements, which can also interfere with some cold medicines.
- Don’t combine cold medications: Some cold and cough medicines contain the same ingredients, and if taken together, you may take more than the recommended dosage. For example, some multi-ingredient cold medicines contain acetaminophen for pain relief. Because it’s important to limit acetaminophen to no more than 4,000 milligrams per day to avoid liver damage, you shouldn’t also take acetaminophen at the same time.
- Read and follow medication instructions: Never exceed the recommended daily dosage for any medication. Follow the recommended dosage schedule.
- Target your symptoms: Choose medications that target your specific symptoms. If you only have a sore throat, choose a pain reliever and avoid taking a combined cold medicine product with additional ingredients that you don’t need.
Other Steps To Care For Your Cold And Flu
While over-the-counter medications can reduce your cold and flu symptoms, don’t forget the cold and flu care basics, including:
- Get plenty of rest: Take time to get extra sleep to help your body recover from the infection.
- Stay hydrated: Drink liquids throughout the day. Try sipping hot liquids like chicken soup, warm apple juice or hot tea with honey to soothe a sore throat and relieve congestion.
- Use a cool-mist humidifier: The humid air will help reduce your nasal congestion, allowing you to get the rest you need. Change the water and clean the unit each day, following the manufacturer’s instructions.
- Try saline nose drops: Saline (in the form of nose drops, spray or neti pot) can help irrigate your nose, relieving nasal congestion and stuffiness.
“It’s also important to get your annual flu shot to protect yourself from a serious illness,” says Dr. Entz.
When To See Your Doctor
If rest, hydration and over-the-counter medications don’t bring you good relief, you may need a doctor. Dr. Entz recommends seeking medical care if you experience:
- Dizziness or fatigue
- Fever that does not go away after taking a pain reliever and lasts longer than 4 hours
- Ongoing nausea, vomiting and diarrhea
- Symptoms that go away for 2 to 3 days, then return and worsen
If you’re experiencing cold and flu symptoms or were around someone with these symptoms, Dr. Entz recommends getting a COVID-19 test. “Some of the newer variants of COVID-19 have similar symptoms to colds and flu,” she says. “Once you know the source of your infection, you can talk with your doctor regarding the best treatment, including which cold medicines may offer relief.”
Dr. Abigail Entz is an internal medicine physician who sees patients at Henry Ford Hospital in Detroit.