Best Cold Medicine: OTC Treatments for Your Symptoms (2024)

Best Decongestant for a Stuffy Nose

Congestion is a hallmark symptom of colds and flu. It's caused by swollen blood vessels in the nasal passages and airways.

Over the counter (OTC) decongestants narrow these blood vessels and decrease inflammation. This helps air flow and mucus drain.

Decongestants come as pills, tablets, liquid, and nasal spray. Oral decongestants include:

• Sudafed (pseudoephedrine): This medication is available in regular and extended-release tablets and liquid. It's also found in combination products. Pseudoephedrine is OTC but kept behind the pharmacy counter. Quantities are limited and you may need to show ID to buy it.
• Sudafed PE (phenylephrine): This medication is available as a tablet, liquid, and quick dissolve strip. It's also available in combination cold medicines.Phenylephrine can be found in the cold and flu aisle in grocery stores and drug stores.In 2023, a Food and Drug Administration (FDA) panel determined that phenylephrine isn't effective when taken by mouth, but for now, it's still included in many products.

Nasal sprays contain oxymetazoline. They deliver relief directly to the nasal passages. OTC brands include:

• Afrin
• Anefrin
• Dristan
• Mucinex
• Vicks Sinex
• Zicam

Best Analgesics for Aches, Pain, and Fever

Analgesics are painkillers and fever reducers. Common OTC analgesics include:

• Tylenol (acetaminophen)
• Advil (ibuprofen)
• Aleve (naproxen)
• Asprin (acetylsalicylic acid)
  

Aspirin and acetaminophen may work better for fevers and headaches. Ibuprofen and naproxen may be better for body aches.

For fevers above 102 degrees, it may help to alternate between acetaminophen and ibuprofen. Adults may alternate between these two medications every three hours. That's especially true if the fever comes back as the medication wears off.

Always check labels to see what the active ingredients are, especially if you are planning to take more than one medication at a time. Combining cold medications can cause you to take too much of one or more active ingredients, which can lead to dangerous side effects.

Best Medicine for a Cough

The best medicine for a cough depends on your symptoms and the type of cough you have.

• For a dry cough, choose an antitussive (cough suppressant).
• For a wet, productive cough, choose an expectorant.

The time of day also matters. If you need to quiet a cough so you can sleep, an antitussive medication is a good choice.

Dextromethorphan is an antitussive. It works to quiet a cough by turning down the cough reflex. Cough medications that contain DM in the name contain dextromethorphan, including:

• Delsym (acetaminophen and dextromethorphan)
• Robitussin DM (guaifenesin and dextromethorphan)
• Mucinex DM (guaifenesin and dextromethorphan)
• Tussin DM (guaifenesin and dextromethorphan)
  

During the day, you cough to clear mucus from your lungs. If the mucus isn't removed, it can lead to pneumonia or other lung infections. For this reason, it's best to only take cough medicine if your cough becomes painful and you're having trouble clearing mucus on your own.

An expectorant loosens chest congestion and thins mucus so it can drain. It doesn't stop a cough; it helps your cough remove mucus better.

The expectorant guaifenesinis the only expectorant approved by the FDA. It's in multiple brand-name products, including:

• RobitussinChest Congestion
• Mucinex
• Tussin Chest
• Kids-EEZE

Best Multi-Symptoms Cold Medicine

Multi-symptom formulas typically include a combination of:

• Analgesics
• Decongestants
• Antihistamines
• Expectorants and/or cough suppressants

These treat many different cold and flu symptoms in one dose. But they should be used with caution.

Always read the ingredients list. Make sure the product only includes drugs that treat symptoms you have.

Don't take other medications or you could risk an accidental overdose or drug interactions. For example, if a medicine contains acetaminophen, don't also take Tylenol, Midol, or Excedrin, because they also contain acetaminophen.

Also, don't take cough syrup with multi-symptom products that contain dextromethorphan or guaifenesin. You may get a dangerous double dose of those drugs.

If you are already taking prescription medication, call your provider and ask if it is okay to also use an OTC medication for your cold.

Can Antihistamines Help With Cold Symptoms?

Antihistamines don't provide significant relief for cold symptoms. They work by blocking the chemical histamine, which your body releases in response to an allergen, such as pollen or dust.

Common antihistamines include:

• Benadryl (diphenhydramine)
• Chlorpheniramine
• Atarax, Vistaril (hydroxyzine)
• Zyrtec(cetirizine)
• Allegra(fexofenadine)
• Clarinex(desloratadine)
• Claritin, Alavert (loratadine)
• Xyzal (levocetirizine)

Antihistamines relieve congestion related to allergies. But their effect on the common cold is questionable.

A review of 18 high-quality trials found antihistamines may help relieve congestion during the first two days of a cold. They're less effective on day three or later.

Some antihistamines have side effects including:

• Drowsiness
• Dizziness
• Dry mouth
• Irritability
• Constipation

Tips for Taking Cold Medicine

In addition to reading ingredient lists carefully, there are a few other tips to consider when treating a cold with OTC medicine.

First, never give cold medicine to a child who is younger than 6. Cold medicine will not help them and could result in dangerous side effects. Instead, try natural remedies such as lemon and honey (do not give honey to children under the age of 1 year).

You should also avoid taking cold medicine if you are pregnant.

Keep in mind that even the best cold medicine will not cure the cold itself; cold medicines only relieve your symptoms while your immune system fights the virus.

While taking cold medicine may be helpful, it's important to also provide your immune system with the support it needs by:

• Getting ample rest
• Drinking plenty of water, herbal teas, broth, and other clear fluids
• Avoiding smoking and staying away from secondhand smoke
  

When to Call Your Healthcare Provider

Always take the proper dose of a medication, which should be listed on the medication's label. If you feel that you need a stronger dose than what is listed, or you need to take the medication more frequently, call your healthcare provider.

Most cold symptoms go away within about a week. If your symptoms get worse or do not get better within 10 days, call your provider. Your provider may wish to test you for sinus infection, allergies, or another illness.

Should you experience any of the following symptoms, call 911 or go to the emergency room right away:

• Difficulty breathing
• Sudden chest pain
• Sudden abdominal pain
• Sudden dizziness
• Hallucinations, out-of-body sensations, or other strange behaviors
• Severe vomiting that doesn't go away

Summary

Knowing what cold and flu medicines do helps you choose the best medication for your symptoms. Decongestants help clear stuffed-up nasal passages and airways. Analgesics treat pain and fever.

Cough suppressants treat dry coughs. They also quiet a cough so you can sleep. Expectorants loosen up phlegm in your lungs and help it drain. They're good during the day for wet coughs.

With multi-symptom treatments, look for one with ingredients that match your symptoms. Read labels of everything you take to avoid doubling up on a drug.