Best Cold and Flu Medicines—And What To Avoid - Health.com

There's no cure for a common cold, but some over-the-counter medicines may alleviate symptoms. The best cold and flu medicine depends on your symptoms. Pain medication, for example, can treat a sore throat, aches, and fever. Decongestants help alleviate a stuffy nose, while expectorants can treat a runny nose.

Various viruses may cause a cold, the most common being rhinoviruses. Influenza viruses, in contrast, cause the flu. Common cold and flu symptoms include a cough, runny or stuffy nose, body aches, fever, and sore throat.

It's no surprise people spend hundreds of millions of dollars on over-the-counter (OTC) cold and flu medicine annually. However, few cold and flu remedies are likely to influence the course of illness if you are already sick. That said, some actually work. Read on to learn about the best cold and flu medicines.

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The best cold and flu medicine will depend on your symptoms, including a runny or stuffy nose, body aches, cough, fever, or sore throat. The most effective options for getting rid of a cold include decongestants, cough suppressants, and pain relievers. Antivirals are also effective for getting rid of the flu fast. If you take them at the start of your illness, they help shorten the duration of the flu.

Aches

A pain reliever may be one of the first things you reach for when you come down with a common cold or the flu, and with good reason. Body and muscle aches often occur with the flu, while headache is a common cold symptom.

Tylenol (acetaminophen) can relieve painful symptoms. Non-steroidal anti-inflammatory drugs (NSAIDs) also treat discomfort and reduce inflammation. Common NSAIDs include Advil and Motrin (ibuprofen) or Aleve (naproxen).

NSAIDs may increase the risk of heart attacks or stroke and can lead to ulcers and bleeding. Long-term use can also lead to kidney damage.

Congestion/Stuffy Nose

Research has found that OTC decongestants are an effective way to treat a stuffy nose in adults. Decongestants narrow the blood vessels that line nasal passages, which reduces inflammation. Look for decongestants that contain pseudoephedrine, such as Sudafed. You'll have to ask for it at the pharmacy counter.

Pseudoephedrine may cause a number of side effects, including:

• Anxiety
• Difficulty sleeping
• Dizziness
• Nausea and vomiting

Pseudoephedrine may also slightly increase blood pressure. People with high blood pressure may want to consider spray-based decongestants, such as Afrin (oxymetazoline). Only use nasal decongestants for short periods. Chronic use can lead to rebound congestion, meaning your nose feels stuffier after you stop using it.

Cough

A hacking cough is one of the most common cold or flu symptoms. Suppressants that contain dextromethorphan (DM) may help a bit. Remember, a cough can be part of the healing process. Coughing helps clear your airways.

Fever

Pain relievers like Tylenol and NSAIDs can help reduce a fever. Try taking a fever reducer with a cup of tea or soup. These warm, soothing fluids will help soothe a sore throat.

Runny Nose and Sneezing

Antihistamines may provide temporary relief from a runny nose and sneezing. A study published in 2015 found that antihistamines help lessen the severity of overall cold symptoms at the start of a cold. The researchers did not find any benefit after the first two days of illness.

Common brand names include Benadryl (diphenhydramine), Claritin (loratadine), and Zyrtec (cetirizine). Claritin is not likely to tire you, but Benadryl and Zyrtec often cause drowsiness. However, it's important to get plenty of rest when you have a cold or the flu.

Expectorants like Mucinex (guaifenesin) help thin mucus that drains down the back of your throat. This makes it easy for you to cough it up.

Sore Throat

A sore throat causes your throat to feel painful or scratchy, which makes it hard to swallow. Pain relievers like Tylenol and NSAIDs can help alleviate a sore throat. Try sucking on throat lozenges, which are available over the counter, or hard candies. These help increase saliva and lubricate your throat.

People have touted several supplements as ways to protect against and treat a cold, but research is limited. Keep in mind that the Food and Drug Administration (FDA) minimally regulates supplements.

These supplements may or may not be suitable for you. Side effects vary from person to person and depend on many variables, including type, dosage, frequency of use, and interactions with current medications. Talk to a healthcare provider or pharmacist before starting any supplements.

Supplements that might help include:

• Astragalus: This is a common herb used in traditional Chinese medicine to treat upper respiratory infections like a cold. Oral astragalus is generally safe in doses of 60 grams (g) per day for four months.
• Echinacea: This flower is native to North America. Oral echinacea may reduce your risk of getting a cold, but it's unclear whether it treats symptoms. Although uncommon, you may be likely to develop a reaction to oral echinacea if you are allergic to ragweed.
• Elderberry: This dark purple berry, which grows in Asia, Europe, North America, and Northern Africa, is a common cold and flu remedy in folk medicine.
• Garlic: People worldwide have used garlic to protect against and treat colds and the flu, but there's not enough evidence to support its use.
• Ginseng: Some evidence suggests that ginseng may shorten the duration of colds if you take the herb consistently.
• Vitamin C: This vitamin can reduce the duration and severity of a cold if you take it before you get sick. Eat foods that are high in vitamin C, such as broccoli, oranges, strawberries, and tomatoes.
• Vitamin D: This vitamin may protect you against cold and flu viruses, but it's unclear whether it works if you are already sick. You can find vitamin D in eggs, fish, fortified foods, and natural sunlight. A balanced, nutrient-rich diet may be the best protection for your overall health.
• Zinc: This supplement may reduce the length of a cold if you take it within 24 hours after your symptoms begin. Zinc may cause nausea and, in high doses, copper deficiency.

Some medicines will not work against colds or may be harmful to some people. Antibiotics, for example, treat bacterial infections. Viruses cause colds, so antibiotics will not work.

If you have heart disease, you should avoid decongestants such as phenylephrine and pseudoephedrine. Decongestants narrow blood vessels to treat a stuffy nose, but this action can worsen heart problems. Narrow blood vessels can increase the risk of a heart attack, heart failure, and stroke.

NSAIDs can also increase the risk of heart attack and stroke, especially in people with high blood pressure. These medications decrease the sodium your body gets rid of through urine, increasing blood pressure.

Children's Cold and Flu Medicine 

You can safely give acetaminophen and ibuprofen—available in chewable, liquid, and tablet forms—to children older than 2. Make sure you read the instructions and give the correct amount based on your child's age and weight. Talk to a healthcare provider before giving these medicines to children younger than 2.

Do not give OTC cold and flu medicine to infants and children younger than 6. These medicines may result in harmful side effects in young children.

Other ways to treat cold and flu symptoms in children include:

• Breathing in steam from a hot shower
• Elevate your child's head when they are lying down
• Spraying non-medicated saline drops into the nose
• Staying hydrated
• Using a humidifier to add moisture to the air
• Visiting a healthcare provider if they have a wheezing cough

Cold and Flu Medicine During Pregnancy

Medicines that you take during pregnancy can cross the placenta and reach the fetus. It's essential to know what's safe and what to avoid, as well as what some natural remedies are if you are sick while pregnant.

The safest cold and flu medicines for pregnant people include:

• Anesthetic throat lozenges to relieve a sore throat
• Most cough drops to help ease a cough and lubricate a sore throat
• Tylenol for aches, fevers, and headaches

Avoid pain relievers, such as aspirin, ibuprofen, and naproxen, and herbal remedies like echinacea. Afrin and other non-steroidal nasal decongestant sprays that contain oxymetazoline may also be unsafe during pregnancy.

Talk to a healthcare provider or pharmacist before using cold and flu medicines to make sure they are safe. Some healthcare providers may advise avoiding all drugs—whether OTC or prescription—during the first trimester.

Here are other tips for taking cold and flu medicines:

• Avoid or limit combination products, especially ones that contain acetaminophen, like Dayquil. These drugs increase the risk of liver damage if you take too much.
• Be careful of combining multiple medications.
• Follow directions for dosing and timing in adults and children.
• Talk to a healthcare provider or pharmacist
• before taking medication or giving it to children if you are unsure whether it's safe.

There are some natural cold remedies in addition to OTC medications and supplements. Make sure you consult a healthcare provider or pharmacist before trying one of these remedies:

• Defend: This homeopathic remedy fights multiple cold symptoms, including hacking, rattling, or tickling cough. There's little to no evidence that any homeopathic products work. The FDA does not regulate these remedies as tightly as other medicines.
• Oscillococcinum: This is a homeopathic remedy made from heart and liver extract from the muscovy duck. The muscovy duck is native to Mexico, Central America, and South America.
• Sambucol: This natural cold remedy consists of extracts from the black elderberry plant, but more research is needed. A 2016 study of 312 air travelers found that elderberry extract reduced the length of illness and severity of symptoms compared to a placebo. 

You cannot always prevent a cold or the flu, but you can reduce your risk. Here are ways to prevent a cold or the flu:

• Choose small daycare classes, where viruses commonly spread, if you have young children
• Cover your coughs and sneezes with a tissue or the crook of your elbow
• Disinfect commonly touched surfaces (e.g., countertops and door knobs)
• Do not share personal items (e.g., cups, towels, and utensils)
• Get an annual flu shot
• Opt for disposable paper towels instead of cloth towels
• Regularly wash your hands with soap and water for at least 20 seconds
• Stay home if you are sick
• Use hand sanitizer with at least 60% alcohol if soap and water are not available

Most people recover from a cold or the flu at home with plenty of rest and fluids. Speak to a healthcare provider if your symptoms do not get better after 10 days or worsen. Let them know if you have the flu and are at risk of developing complications.

Other signs to contact a healthcare provider include:

• A fever that lasts more than four days
• Chest or stomach pain
• Confusion or dizziness
• Dehydration
• Lack of urination
• Seizures
• Severe muscle pain
• Shortness of breath or trouble breathing
• Symptoms improve but then come back or worsen
• Underlying health conditions that worsen with illness

Some cold and flu medicines may reduce the length and severity of symptoms. Keep in mind that some of these remedies are not guaranteed to be foolproof, or they might not work if you are already feeling ill. 

You can use antihistamines, decongestants, expectorants, and pain relievers if you currently have a bout of illness to feel better. Just remember not to go overboard on a single ingredient like acetaminophen. Make sure these medications are safe if you are pregnant or before giving them to a child.

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