You have a lot of choices when it comes to over-the-counter (OTC) cold and flu medications. In part, that's because colds and influenza cause a lot of different symptoms. Show Taking stock of exactly which cold and flu symptoms are bothering you is the first step in figuring out which type of OTC medication is right for you. A single drug targeting a particular symptom may be fine. Or you may want a multi-symptom medication. Decongestants, for example, can help improve stuffiness, analgesics can reduce pain and fever, and other types of medications can help with problems like coughing and sneezing. This article walks you through the various options and how they work, so you can choose the best medication for your cold and flu symptoms.
DecongestantsCongestion 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. That means air can flow and mucus can drain. Decongestants come as pills, tablets, liquid, and nasal spray. Oral decongestants include:
Nasal sprays contain oxymetazoline. They deliver relief directly to the nasal passages. OTC brands include:
AnalgesicsAnalgesics are painkillers and fever reducers. Common OTC analgesics are:
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 every three hours. That's especially true if the fever comes back as the medication wears off. A note about acetaminophen: Taking too much acetaminophen can cause potentially fatal liver damage. Don't take more than 4,000 milligrams (mg) of acetaminophen per day. This drug is in dozens of OTC products. Read labels closely to make sure you don't take more than one product containing this drug. In children with a cold or other virus, aspirin or other salicylate medicines increase the risk of Reye's syndrome. Children under 18 shouldn't take aspirin unless specifically instructed to by a healthcare provider. Cough MedicineTreating a cough from a cold or flu is tricky. The type of cough determines the kind of medicine you need.
The time of day also matters. Antitussives quiet a cough so you can sleep. The generic antitussive dextromethorphanis in many OTC medicines, including:
During the day, you want your cough to clear mucus from your lungs. If the mucus isn't removed, it can lead to pneumonia or other lung infections. 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 guaifenesin is the only expectorant approved by the Food and Drug Administration (FDA). It's in multiple brand-name products, including:
OTC cold medicine isn't recommended for children under 4. And kids between 4 and 6 should only take cough medicine under a healthcare provider’s supervision. AntihistaminesMany people turn to antihistamines (allergy pills) for sneezing and a stuffy or runny nose. They may not be the right choice. Antihistamines block the chemical histamine. Your body releases that in response to an allergen, such as pollen or dust. Common antihistamines include:
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 in the first two days of a cold. They're less effective on day three or later. Some antihistamines have side effects including:
Are Antihistamines Safe for You?Talk to your healthcare provider before taking antihistamines if you have:
Multi-Symptom TreatmentsMulti-symptom formulas typically include a combination of:
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. SummaryKnowing 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. Antihistamines may help cold and flu symptoms somewhat. But they're better for allergies. 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. A Word From VerywellSome people turn to natural treatments or home remedies for cold and flu symptoms. But certain supplements can interact with OTC medications. Talk to your healthcare provider or pharmacist before using a supplement plus an OTC cold or flu product. Frequently Asked Questions
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
 By Kristina Duda, RN Thanks for your feedback! What is best for congestion and sore throat?To relieve a sore throat, gargle with warm salt water, use throat sprays, and suck on ice or lozenges. Try a saltwater nasal rinse. These can help with a stuffy or runny nose. Use petroleum jelly on your nose if it's irritated from constant blowing.
What overIbuprofen, acetaminophen, and aspirin can also ease the pain of a sore throat. Or you can suck on a lozenge or use a throat spray that contains a pain reliever such as benzocaine.
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Best over the counter medicine for sore throat and congestion
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