Cold & Flu Medication Guide

Accord­ing to the Cen­ters for Dis­ease Con­trol and Pre­ven­tion (CDC), approx­i­mate­ly eight to ten per­cent of the Unit­ed States pop­u­la­tion will become sick with an influen­za (flu) virus year­ly. The aver­age Amer­i­can will also catch between two to three colds per year. A cold and the flu are both caused by viral infec­tions and pro­duce var­i­ous unpleas­ant symp­toms. Colds are often accom­pa­nied by nasal con­ges­tion and/​or a run­ny nose, sneez­ing, cough­ing, and a sore throat. Flu virus­es can cause sim­i­lar symp­toms: fatigue, fever, head and body aches, and, for some, diar­rhea and vom­it­ing. While there is no cure for either ill­ness, sev­er­al over-the-counter med­ica­tions and home reme­dies may offer symp­tom relief.

There are more over-the-counter (OTC) options than ever before, and it can be dif­fi­cult to decide which is best for you. Cer­tain health con­di­tions may also impact your decision.

Talk with a provider before tak­ing OTC cold and flu med­i­cines if you:

• Have a chron­ic med­ical condition
• Take pre­scrip­tion medications
• Are preg­nant or breastfeeding
• Are choos­ing med­i­cine for a young child

Our pri­ma­ry care team shares tips on select­ing the best OTC medication(s) to man­age your symp­toms and which to avoid, if necessary.

Antibi­otics

When cold and flu symp­toms strike, it can be tempt­ing to ask your pri­ma­ry care physi­cian to pre­scribe an antibi­ot­ic. Not only will antibi­otics not alle­vi­ate your symp­toms, but antibi­otics are also effec­tive in killing bac­te­ria, not the virus­es respon­si­ble for cold and flu bugs. When overused, your body begins to build up tol­er­ance to them. This caus­es antibi­otics to be less effec­tive when you actu­al­ly need them.

Anti­his­t­a­mines

When cold symp­toms include a run­ny nose, sneez­ing, or watery eyes, anti­his­t­a­mines can pro­vide relief by block­ing his­t­a­mine, a chem­i­cal your body releas­es in response to irri­tants. Com­mon OTC anti­his­t­a­mines include diphen­hy­dramine (Benadryl) and lorata­dine (Clar­itin). Old­er anti­his­t­a­mines like diphen­hy­dramine can cause drowsi­ness, mak­ing them suit­able for night­time use, while new­er options like lorata­dine or cet­i­rizine (Zyrtec) are non-drowsy alter­na­tives. If you have glau­co­ma, an enlarged prostate, or uri­nary reten­tion issues, con­sult your physi­cian before tak­ing anti­his­t­a­mines, as they can wors­en these con­di­tions. Keep in mind that while anti­his­t­a­mines effec­tive­ly man­age symp­toms, they may also thick­en mucus, poten­tial­ly mak­ing con­ges­tion worse for some people.

Cough sup­pres­sants

A cough is a com­mon, often frus­trat­ing cold symp­tom, espe­cial­ly if it is pre­vent­ing you from get­ting a good night’s sleep. If you devel­op a cough that lasts for sev­er­al days or are hav­ing dif­fi­cul­ty sleep­ing through the night, a cough sup­pres­sant can help. For the most relief, select one that con­tains the active ingre­di­ent dex­tromethor­phan (often list­ed as DM). Keep in mind that while it may be uncom­fort­able, cough­ing is an impor­tant part of your body’s heal­ing process. Cough­ing helps to clear mucus and oth­er irri­tants from your lungs. Sup­pres­sants may pre­vent this clear­ing from hap­pen­ing, keep­ing you sick longer, so try to use them sparingly.

Cough syrups and throat drops

Many peo­ple rely on cough syrups or throat drops to soothe their throat. While they can pro­vide tem­po­rary relief, many con­tain rel­a­tive­ly high amounts of sug­ar. If you are dia­bet­ic, be sure to select a sug­ar-free option to avoid rais­ing your blood sug­ar level.

Decon­ges­tants

Decon­ges­tants are often used to relieve a stuffy nose and reduce inflam­ma­tion with­in your nasal cav­i­ty. There are sev­er­al types avail­able, although not all decon­ges­tants are as effec­tive. For the most relief, select those that con­tain pseu­doephedrine and are avail­able behind the phar­ma­cy counter. When used appro­pri­ate­ly, pseu­doephedrine is con­sid­ered safe and effec­tive, but you will be required to show an ID to pur­chase it.

Con­di­tions That May Require Extra Caution

High blood pres­sure, heart dis­ease, or dia­betes: Oral decon­ges­tants can raise blood pres­sure and blood sug­ar. If you have any of these con­di­tions, your pri­ma­ry care provider or spe­cial­ist may rec­om­mend a spray-based decon­ges­tant or saline solu­tion instead, which can relieve symp­toms with­out enter­ing the bloodstream.

Enlarged prostate (benign pro­sta­t­ic hyper­pla­sia, BPH): Decon­ges­tants can tight­en the mus­cles in the prostate and blad­der, which may wors­en uri­nary symp­toms. Depend­ing on your symp­toms, it may be best to avoid oral decon­ges­tants and use a saline spray instead.

If you’re unsure which option is right for you, your pri­ma­ry care provider can help guide that deci­sion based on your symp­toms and health history. 

Find a provider near you >

Echi­nacea

Echi­nacea is a pop­u­lar herbal sup­ple­ment thought to help boost your immune sys­tem and pre­vent ill­ness and infec­tions. While its exact effec­tive­ness is still unclear, some research has found that it may slight­ly decrease your odds of catch­ing a cold. It should not be tak­en long-term (no more than 10 con­sec­u­tive days) and is most effec­tive if tak­en when your symp­toms first appear.

If you suf­fer from sea­son­al aller­gies, espe­cial­ly if you are sen­si­tive to rag­weed, you should avoid Echi­nacea. It is a plant-based sup­ple­ment that is close­ly relat­ed to the rag­weed fam­i­ly. This increas­es your risk of devel­op­ing a vari­ety of side effects, includ­ing stom­ach upset and skin rashes.

Expec­to­rants

Often, dur­ing a cold, the mucus in your nasal cav­i­ty will begin to drain, caus­ing you to cough and irri­tate your throat. Expec­to­rants, such as Mucinex, are often used to thin mucus, mak­ing it eas­i­er to cough up and keep air­ways clear. While expec­to­rants are an effec­tive way to relieve symp­toms, you can often achieve sim­i­lar results with­out med­ica­tion. Try increas­ing your water intake, tak­ing a hot show­er or using a humid­i­fi­er instead.

Pain reliev­ers

When you expe­ri­ence head and body aches or a fever, pain reliev­ers, includ­ing aceta­minophen or ibupro­fen, are often the first thing you reach for. If you are pre­scribed blood thin­ners and have heart dis­ease or diges­tive issues, includ­ing ulcers, you should avoid anti-inflam­ma­to­ry med­ica­tions (ibupro­fen and naprox­en). Anti-inflam­ma­to­ry med­ica­tions can cause your body to retain flu­id and affect your kid­ney func­tion, which caus­es your blood pres­sure to rise. Instead, stick to aceta­minophen prod­ucts, like Tylenol, for pain relief.

Gin­seng

Gin­seng is a pop­u­lar nat­ur­al rem­e­dy for cold pre­ven­tion and treat­ment. Research has shown it can be effec­tive in sup­port­ing a healthy immune sys­tem over time, which may also help short­en the dura­tion of a cold. Before tak­ing gin­seng (or any oth­er sup­ple­ment), check with your physi­cian to ensure it will not inter­act with any med­ica­tions you may be tak­ing — blood thin­ners, dia­bet­ic med­ica­tions or anti­de­pres­sants — or have any oth­er adverse health impli­ca­tions. If you have an autoim­mune dis­or­der, have had an organ trans­plant or if you are preg­nant, you should not take gin­seng sup­ple­ments. In gen­er­al, gin­seng should not be tak­en long-term. If you want to take gin­seng for a short peri­od of time (no more than 12 weeks) to help pre­vent a cold, your intake should not exceed 300 mg/​day.

Vit­a­min C

Many cold and flu prod­ucts fea­ture high dos­es of vit­a­min C, how­ev­er, there is very lit­tle research to sup­port that large amounts of vit­a­min C is an effec­tive way to com­bat the cold or flu. In fact, vit­a­min C is water-sol­u­ble, so any amount over your body’s dai­ly require­ment (90 mg/​day for men and 75 mg/​day for women) is removed from your body when you uri­nate. A bet­ter way to keep your immune sys­tem strong is by eat­ing foods rich in vit­a­min C such as bell pep­pers, broc­coli, kiwi or strawberries.

Zinc

Zinc is a min­er­al com­mon­ly found in OTC cold sup­ple­ments, like Zicam or Cold-eeze. While research sug­gests that it can help alle­vi­ate cold symp­toms and slight­ly reduce the dura­tion of your cold, there are a few things you should be aware of. First, it is impor­tant to under­stand that zinc helps to alle­vi­ate symp­toms, not pre­vent colds. For best results, you should begin tak­ing zinc sup­ple­ments the day your symp­toms start. After you have been exposed to a virus, zinc works to pre­vent it from mul­ti­ply­ing. Ensur­ing you are tak­ing the prop­er dose is also impor­tant. In order for it to be effec­tive, prod­ucts should con­tain between 13 – 23 mil­ligrams of zinc. Be care­ful not to take too high of a dose because too much zinc can sup­press your immune sys­tem. Adults should lim­it their dai­ly intake to 40 mg/​day or less.

Using Com­bi­na­tion Cold and Flu Prod­ucts Safely

Many OTC cold and flu prod­ucts com­bine mul­ti­ple active ingre­di­ents into a sin­gle med­ica­tion. While these prod­ucts can be con­ve­nient, it’s impor­tant to read labels care­ful­ly to avoid tak­ing more than you intend. 

Always check labels to avoid:

• Tak­ing more than one prod­uct that con­tains acetaminophen
• Dou­bling up on decon­ges­tants or cough suppressants

If you’re unsure which prod­ucts can be tak­en togeth­er, your pri­ma­ry care provider can help guide you.

Cold and Flu Treat­ment Dur­ing Pregnancy

If you devel­op a cold or the flu and are preg­nant, many OTC med­ica­tions may be off-lim­its. To help relieve symp­toms safe­ly, con­sid­er the fol­low­ing sup­port­ive care options:

• Get­ting plen­ty of rest
• Increas­ing your flu­id intake
• Drink­ing hot tea, suck­ing on ice chips, or gar­gling salt water for sore throats
• Using a humid­i­fi­er, tak­ing warm show­ers, and keep­ing your head ele­vat­ed to alle­vi­ate congestion

Some OTC med­ica­tions are safe for you and your baby, includ­ing aceta­minophen (Tylenol), vapor rubs and cer­tain cough sup­pres­sants and decon­ges­tants. You should con­sult with your OB/GYN before begin­ning any cold or flu med­ica­tions. If you have ques­tions about what’s safe to take dur­ing preg­nan­cy, reach out to your provider for guidance.

Under­stand­ing What These Med­ica­tions Actu­al­ly Do

Over-the-counter cold and flu med­ica­tions help man­age symp­toms like con­ges­tion, cough, fever, and body aches. They can make you more com­fort­able while your body fights off the virus, but they don’t cure the ill­ness or make it go away faster.

Most cold and flu symp­toms improve on their own with­in a week or two. But some­times what you’re expe­ri­enc­ing needs more than symp­tom relief. If symp­toms aren’t get­ting bet­ter after a few days, are wors­en­ing instead of improv­ing, or feel more severe than a typ­i­cal cold or flu, it’s worth check­ing in with a provider.

You should seek care if you’re deal­ing with a high or per­sis­tent fever, trou­ble breath­ing, chest pain, symp­toms last­ing longer than expect­ed, or if you have a chron­ic con­di­tion that puts you at high­er risk. If you’re preg­nant or car­ing for a young child and some­thing feels off, trust that instinct and reach out to your provider.

When it comes cold and flu treat­ment, Inter­nal Med­i­cine provider Dr. Peter Makar explains, ​“My approach when patients ask me ques­tions relat­ed to this top­ic is to lis­ten close­ly to their con­cerns and take the time to devel­op effec­tive treat­ment plans which include a wide range of over-the-counter med­ica­tions and inter­ven­tions that are avail­able to my patients. In gen­er­al, it is bet­ter for patients to be eval­u­at­ed in the office so I can best tai­lor their care based on my eval­u­a­tion how­ev­er I am hap­py to do vir­tu­al vis­its to accom­mo­date busy sched­ules. My patients can reach out to me any­time to sched­ule an appoint­ment if they have any ques­tions or con­cerns.“

Sched­ule a same-day or next-day appoint­ment with Dr. Makar or anoth­er Duly pri­ma­ry care provider today.