The Best Cold and Flu Medicine to Always Have Handy
When the cold and flu strikes, the last thing you want to do is schlep to the store in search of relief. These are the best medications to keep at the ready the next time a cold or flu knocks you down.
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Common cold or the flu?
From a sore throat and stuffy nose to coughing and body aches, the common cold and the flu share similar symptoms. “Sometimes, it is difficult to determine which you have,” says Steven Sperber, MD, chief of infectious diseases at Hackensack University Medical Center. With the flu, you often have a fever and feel wiped out and physically sick, while a cold has a slower onset with less intense symptoms. According to the U.S. Centers for Disease Control and Prevention, the flu can lead to hospitalization and even death, especially among young children, those with chronic medical conditions, and older adults. While both are often treated with similar over-the-counter medications, it’s important to understand the different types that are available so you can find the best cold and flu medicine to relieve your symptoms.
Over-the-counter pain medications
A fever, body aches, and chills are common early symptoms of the flu. The best way to treat them is with non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aspirin, or naproxen. They are one of the best over-the-counter medications for tackling fever and reducing aches and pains, but NSAIDs do have contraindications. “People with liver problems should not take some of these medications,” says Dr. Sperber. According to the U.S. Food and Drug Administration, NSAIDs may also increase the chance of heart attack or stroke, especially if you have heart disease or risk factors for heart disease, like smoking, high blood pressure, high cholesterol, or diabetes. Acetaminophen (Tylenol) can also treat fever and body aches, too.
Dr. Sperber also cautions that a high fever may be a sign that you should see a physician. “If the fever becomes high, and you feel that what you have is more than just a cold, it’s worth putting in a call to your doctor.” Don’t miss these habits doctors use to avoid getting a cold and the flu.
Available in oral pills or as a nasal spray, antihistamines go after histamine, a chemical that your body produces during an allergic reaction. Antihistamines—Benadryl is a common example—are often used to treat allergies or to combat an allergic reaction to a bee sting, explains Dr. Sperber. They are also good for treating symptoms of the cold and flu. In pill form, antihistamines reduce mucus production and improve the symptoms of itchy/watery eyes, sneezing, and runny nose. As a nasal spray, they help with congestion, postnasal drip, or an itchy or runny nose. “Antihistamines are good if you have a runny nose and you want to dry up secretions,” says Dr. Sperber, “but sometimes they can dry you out too much, making it difficult to breathe or talk.” Antihistamines can be sedating, and they can also interact with certain medications, antidepressants (like MAOIs), and seizure medications. Chronic use of certain types of antihistamines among older adults may be linked to increased risk for dementia. As with all medications, consult with your doctor or pharmacist before taking them. Here’s how to tell the difference between allergies and a cold.
Coughing is a symptom of both the cold and the flu. Staying hydrated, raising your head while sleeping, and sucking on lozenges can help ease your cough, but the best cold and flu medicine to suppress a cough contains dextromethorphan (DM), an ingredient that works to block the cough reflex. Dextromethorphan is a fairly common ingredient in cough and cold preparations, says T. Jann Caison-Sorey, MD, senior medical director at Blue Cross Blue Shield of Michigan, but she cautions that consumers of these medications should be mindful of other ingredients that can interfere with blood pressure control. It can also interact with medications such as MAOIs, and research shows it can lead to memory loss if taken in high doses. “Dextromethorphan, when used within recommended dosage guidelines, is an effective cough suppressant, but it also presents a risk of dissociative anesthetic properties that can occur as a side effect,” says Caison-Sorey. “If abused, it can result in dizziness, blurred vision, and impaired speech, among other complications.” Avoid those side effects with these natural homemade cough remedies.
The opposite of the cough suppressant is the expectorant. “Expectorants are not good to take at night when you need to sleep, but they are good for clearing the lungs because if mucus sits in the lung, it can lead to pneumonia,” Dr. Sperber says. Productive, wet, throaty coughs are a normal symptom of the cold and flu. The most common ingredient found in expectorants, like Mucinex and Robitussin, is guaifenesin, which thins and loosens mucus in the lungs and airways, making it easier to cough and get rid of the mucus. Make sure you don’t fall for these mistakes that can actually make your cold or flu worse.
Oral decongestants (such as Sudafed) contain phenylephrine, an active ingredient that works to relieve congestion caused by a common cold, the flu, or sinusitis. The medication shrinks the blood vessels, which reduces the amount of blood flowing through the area and the swollen tissue inside the nose to let air pass through more easily. While oral decongestants are effective, they come with bothersome side effects, such as dizziness, sleeplessness, and nervousness. They can also cause heart palpitations and raise your blood pressure. “Oral decongestants put up a big red flag for patients with high blood pressure,” says Emily Shafer, a doctor of pharmacy and manager of clinical programs and quality at Walgreens. “If you are working to lower your blood pressure, taking an oral decongestant can counter the effects.” These are 14 foods that will make you feel better when you have a cold.
When your nose is stuffy and congested from having a cold or the flu, a powerful nasal spray can offer quick relief, but they should only be used in the short term. Decongestant nasal sprays such as Afrin contain oxymetazoline hydrochloride, an ingredient that shrinks the blood vessels in the nose to help you breathe. However, using them for extended periods of time can actually be counterproductive. “If you use them for more than three days, they will begin to cause congestion,” says Shafer. Other forms of nasal sprays contain saline, which can help provide moisture to the area, especially if your sinuses are dry. “They won’t open up the nasal passages, but they can be soothing to patients,” says Shafer. Nasal steroid sprays (Flonase and Nasacort) may be helpful for cold symptoms as well. She also recommends Neti pots, which help clean out nasal passages with a saline solution and Breathe Right nasal strips, which can help open nasal passages.
It’s not uncommon for patients to go the pharmacy in search of one pill that will serve as the best cold and flu medicine to fix multiple symptoms, says Shafer. “We are so used to buying one medication, but we don’t always need all of the medications that come in the combination treatments.” If you are down-and-out with the cold and flu, products such as Theraflu and Vicks NyQuil are available in liquid or pill form and contain several active ingredients to address multiple symptoms, from body aches and pain to coughs, congestion, fever, runny nose, and sneezing.
“It’s important to check with your pharmacist to make sure you are treating a symptom that you actually have and to ensure it won’t interact with other medications you may be taking,” says Shafer. Many combo products contain acetaminophen, which can be harmful when taken in excess (so don’t use Tylenol in addition to these products). Additionally, avoid taking more than one combination medication at a time due to the risk of duplicating ingredients.
Also, tailor specific medications to the time of day you are taking them, Dr. Sperber suggests, especially since some treatments can make you drowsy. Check out these silent signs that indicate your medication could be making you sick.
While many people prefer to use natural products, like zinc and vitamin C, to treat cold symptoms and speed up recovery time, according to the National Institutes of Health, there is no strong scientific evidence that any natural product is useful against the flu. “These options provide more of a soothing effect, and they are much safer than their chemically manufactured counterparts,” says Dr. Caison-Sorey. “But these medicines are created to reduce the symptoms associated with colds and the flu, not treat the underlying cause.” Oral zinc (in the form of lozenges such as Cold-Eeze and Zicam) has been shown to reduce the length of colds when taken within 24 hours after symptoms start, but intranasal zinc should be avoided as it has been linked to a loss of the sense of smell. Here are some home remedies for head colds actually worth trying.
Vicks VapoRub, the soothing mentholated salve, has been a household staple for more than 100 years. The salve suppresses coughs and reduces pain with its mixture of camphor, eucalyptus oil, and menthol. “Mentholated vapors, whether as a chest rub or in a vaporizer, can help with breathing,” says Shafer. “A small dab of mentholated salve on your chest and neck helps to open breathing passages.” The salve also has mild numbing ingredients, which can help with pain.
Cough drops and throat lozenges
Cough drops and throat lozenges come in a variety of flavors and strengths, all geared toward helping soothe sore throats, quell coughs, and even fight off the first hint of the common cold. “Cough drops are soothing, and some contain menthol, which is numbing on the throat and can also help with a stuffy nose by opening up your nasal passages so you breathe better,” says Shafer. Strong cough drops such as Fisherman’s Friend can help with coughs, sore throats, and clogged nasal passages. Other lozenges, like Ricola, rely on herbs and honey. While they don’t contain the medications found in cough suppressants, cough drops and lozenges are an effective and inexpensive way to help keep the throat moist and reduce the coughing that leads to a sore throat. That said, the relief you need may be found in your kitchen, not your bathroom. Check out these natural remedies for the cold and flu that really work.
- Psychopharmacology: "Double-blind comparison of the two hallucinogens psilocybin and dextromethorphan: effects on cognition"
- JAMA Internal Medicine: "Cumulative Use of Strong Anticholinergics and Incident Dementia"
- U.S. Food and Drug Administration: "FDA Drug Safety Communication: FDA strengthens warning that non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) can cause heart attacks or strokes"
- Centers for Disease Control & Prevention: "Flu Symptoms & Complications"
- Mayo Clinic: "Monoamine oxidase inhibitors"
- Steven J. Sperber, MD, Hackensack University Medical Center, Hackensack, New Jersey
- T. Jann Caison-Sorey, MD, senior medical director at Blue Cross Blue Shield of Michigan, Detroit, Michigan
- Emily Shafer, PharmD, manager of clinical programs and quality at Walgreens, Deerfield, Illinois
- National Institutes of Health, National Center for Complementary and Integrative Health: "5 Tips: Natural Products for the Flu and Colds: What Does the Science Say?"