The people's voice of reason
The people's voice of reason
If you find yourself feeling feverish and coming down with a cough, congestion, or a runny nose, you might reach for a quick, over-the-counter (OTC) fix. But with so many products to choose from in the cold and flu aisle, it’s easy to feel overwhelmed.
OTC cold and flu medicines won’t cure an infection. But they can help make symptoms more manageable. GoodRx, a platform for medication savings, explains how to determine which OTC medicines are the best for colds and flus.
The best OTC cold and flu medicine is one that targets specific symptoms. And it shouldn’t interfere with other medications or health conditions.
Marketing aside, there are just a handful of active ingredients found in cold and flu medicines. But which ones are best for which symptoms? Common symptoms are broken down in the table and subsequent sections below.
There are two OTC options to help bring down a fever: acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin, Advil). Both can provide relief for headaches and achy muscles, too.
Aspirin is also an NSAID option, but it should be avoided by people under age 19. That’s because it’s linked to a dangerous condition called Reye’s syndrome.
These medications are available on their own for fever and minor aches. They can also be found in a variety of combination products for multisymptom relief. Both acetaminophen and ibuprofen have dosage instructions for children based on their body weight. Multiple dosage forms are available for each medication, including capsules and tablets, liquids, and suppositories.
Acetaminophen takes about 15 to 60 minutes to kick in, depending on the product. Ibuprofen can take about 20 minutes to 2 hours, with the liquid-filled gel capsules working the fastest. There is also the option to alternate products. This means if acetaminophen doesn’t provide relief, for example, a dose of ibuprofen can be taken a few hours later. Aspirin takes about 15 minutes to start working.
Keep in mind that taking too much Tylenol can result in liver damage. If taking a few different products for your symptoms, check to make sure not to double up. The same is true with NSAIDs like ibuprofen, which can cause kidney damage and stomach ulcers if a person takes too much.
Tylenol and NSAIDs aren’t safe for everyone. Those who take medications or have other health conditions should check with a healthcare professional first.
Dextromethorphan (Delsym) and guaifenesin (Mucinex) are common go-to remedies for cough. There isn’t much evidence that they work, but some people find relief from taking them.
Dextromethorphan is a cough suppressant. It’s thought to work by blocking cough reflexes. This may be helpful for a dry, hacking cough that doesn’t produce mucus. Dextromethorphan usually starts working within 15 to 30 minutes of taking it.
Guaifenesin is an expectorant. It’s supposed to loosen up and thin the mucus in the airways of those with a wet cough. This can help make coughing up the mucus easier. But drinking water can have a similar effect. Guaifenesin can start kicking in within 30 minutes.
Both dextromethorphan and guaifenesin are available on their own and in combination products. Sometimes they can be found together, as with Mucinex DM.
Keep in mind that OTC cough medications can have serious side effects in young children under age 4. So, it’s best to check with their pediatrician about your options. Medication-free alternatives, such as honey (after 12 months old) or a cool-mist humidifier, may be a good place to start.
There are a few options for a stuffy nose. First, consider nonprescription oral and nasal decongestants.
Decongestant nasal sprays typically kick in the fastest — within 2 to 10 minutes. But they shouldn’t be used for more than three days because symptoms could come back worse and be tougher to treat.
Pseudoephedrine works better of the two oral options. It typically starts working within 30 minutes. But it is kept behind the pharmacy counter. It can also cause sleeping problems if taken in the evening. Oral phenylephrine is commonly found in combination products, but it has been found to be ineffective. So even though it’s still on pharmacy shelves, it may not help symptoms.
Keep in mind that decongestants can make certain health conditions, such as high blood pressure, worse. Check with a healthcare professional before taking one.
Antihistamines may be helpful for drying up sinuses for those who have a runny nose. One option is azelastine (Astepro Allergy), an OTC antihistamine nasal spray that starts working within 15 to 30 minutes. Azelastine may help clear out sinuses if the congestion is caused by allergies.
Older oral antihistamines, such as diphenhydramine (Benadryl) and doxylamine (Unisom), may provide some relief and start working in a similar amount of time. But they can cause side effects, such as drowsiness and dry mouth. Nondrowsy antihistamines, such as loratadine (Claritin), won’t help symptoms.
Certain oral antihistamines may not be safe for older adults. Some of these medications can have risks in young children, too. Check with a healthcare professional before taking one.
When feeling sick and trying to go to sleep, the last thing anyone wants is something that will keep them awake. But certain ingredients in cold and flu medicines may do just that.
As a general rule, avoid taking daytime cold and flu medications at night. They may include ingredients that are stimulating and can interfere with sleep. Examples include decongestants such as pseudoephedrine and phenylephrine.
“Nighttime” products, on the other hand, may contain ingredients that make you sleepy. For those who are having difficulty sleeping, this can be a welcome side effect. Examples include antihistamines such as diphenhydramine and doxylamine. Dextromethorphan can also cause drowsiness. Keep in mind that some products contain alcohol, which may not be ideal for certain people.
Pharmacists can be a good resource for those who are unsure of when to take a specific product.
So far, this story has covered some of the basics to help navigate the best OTC cold and flu medicine options. But there are a few more things to know before making a purchase.
As mentioned earlier, there are just a handful of ingredients found in OTC cold and flu medications. This may be surprising given how many different products are found on pharmacy shelves. What’s more, many products are the same or very similar to each other.
For example, Mucinex Fast-Max Cold, Flu, & Sore Throat contains the exact same active ingredients as Mucinex Fast-Max Cold & Flu (All-in-One). If someone is judging the product on the label alone, they might pick one over the other based on how it’s named. Taking different products with the same ingredient could result in the person taking too much of that particular medication.
When selecting a product, try to pay less attention to the marketing. Look at the OTC medication label instead. It’ll list the active ingredients, amounts, and symptoms the product is intended to treat. This can help avoid duplicating ingredients. And the shopper may even find a better deal for the same combination of medications.
Generic medication names like dextromethorphan and diphenhydramine aren’t always commonly known. People may be more familiar with their branded products — Delsym and Benadryl. But when people buy the brand, they’re really just paying for the name.
Generics work just as well as their brand-name counterparts. Store-brand (also called private-label) versions are also a great option. And they can save some money, too.
For those who are not familiar with the generic names, ask a pharmacist. They can help select the right product to meet needs.
It’s best to avoid throwing the kitchen sink at cold or flu symptoms. Especially with OTC combination products, people may end up taking more medication than they actually need.
For example, people may keep a combination product like NyQuil Cold and Flu on hand for when they get sick. It contains acetaminophen, as well as medications for cough and a runny nose. But if someone doesn’t have a fever or aches, they’ll end up taking acetaminophen — even though they don’t need it.
Combination products can be convenient. But taking unnecessary medications can increase the risk of side effects, interactions, and more. Be sure to check product ingredients first.
It’s also important to know when to skip OTC cold and flu medicines altogether. In some cases, people are better off speaking to their primary care provider or another healthcare professional. A prescription may be needed for cold and flu medications. Or more targeted treatments, such as flu antivirals, that aren’t available OTC, may be necessary.
People should talk to a healthcare professional about their symptoms if:
Which cold and flu medicines should people avoid taking together?
Cold and flu medicines that contain the same ingredients or ingredients that belong to the same drug class together shouldn’t be combined. For example, diphenhydramine and chlorpheniramine shouldn’t be taken together since they’re both antihistamines. This is also the case for taking multiple NSAIDs, such as ibuprofen and naproxen (Aleve, Naprosyn).
Which cold medications work the fastest?
Which cold medications work the fastest depends on which symptoms are being treated. For congestion, decongestant nasal sprays work the fastest. For a fever, there isn’t a significant difference between acetaminophen, ibuprofen, and aspirin. And for a runny nose, nasal spray antihistamines, such as azelastine, usually start working faster than oral antihistamines.
When dealing with cold and flu symptoms, over-the-counter (OTC) remedies may help provide some relief. Fever reducers, cough suppressants, and decongestants are common options to consider. They can be found on their own and in combination products.
Check a product’s ingredients before purchasing, since it’s best to avoid taking unnecessary medications. Also consider generics and store brands over brand-name products to help save money. Pharmacists can help navigate these options.
This story was produced by GoodRx and reviewed and distributed by Stacker.
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