Best Cold Medicine: OTC Treatments for Your Symptoms

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.

Taking stock of exactly which cold and flu symptoms you have is the first step in figuring out the best cold medicine 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.

woman looking at medication in store aisle
 SDI Produtions / Getty Images
Cold/Flu Symptom Ingredient to Look For Drug Type
Body aches Acetaminophen, aspirin, ibuprofen, naproxen Analgesic
Cough (dry) Dextromethorphan Antitussive
Cough (wet or productive) Guaifenesin Expectorant
Fever Acetaminophen, aspirin, ibuprofen, naproxen Analgesic
Headache Acetaminophen, aspirin, ibuprofen, naproxen Analgesic
Runny nose, sneezing, congestion Cetirizine, chlorpheniramine, desloratadine, diphenhydramine, fexofenadine, hydroxyzine, levocetirizine, loratadine Antihistamine
Congestion Oxymetazoline, phenylephrine, pseudoephedrine Decongestant

Decongestants

Congestion 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:

  • Sudafed (pseudoephedrine): It's available in regular and extended-release tablets and liquid, and also in combination products. It's OTC but kept behind the pharmacy counter. Quantities are limited and you may need to show ID to buy it. 
  • Sudafed PE (phenylephrine): It's available as a tablet, liquid, and quick dissolve strip, and also in combination cold medicines. It's in the cold and flu aisle in the grocery store or drug store. In 2023, a Food and Drug Administration (FDA) panel determined phenylephrine isn't effective when taken by mouth, but for now, it's still included in many products.

Nasal sprays contain oxymetazoline. They deliver relief directly to the nasal passages. OTC brands include:

  • Afrin
  • Anefrin
  • Dristan
  • Mucinex
  • Vicks Sinex
  • Zicam

Analgesics

Analgesics are painkillers and fever reducers. Common OTC analgesics include: 

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 Medicine

Treating a cough from a cold or flu is tricky. The type of cough determines the kind of medicine you need.

  • For a dry cough, choose an antitussive (cough suppressant).
  • For a wet, productive cough, choose an expectorant.

The time of day also matters. Antitussives quiet a cough so you can sleep. The generic antitussive dextromethorphan is in many OTC medicines, including:

  • Delsym
  • Robitussin DM
  • Mucinex DM
  • Tussin DM

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. For this reason, it's best to only take cough medicine when your cough is too painful.

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 FDA. It's in multiple brand-name products, including:

  • Robitussin Chest Congestion
  • Mucinex 
  • Tussin Chest
  • Kids-EEZE

OTC cold medicine isn't recommended for children under 4 years of age. And kids between 4 and 6 should only take cough medicine under a healthcare provider’s supervision.

Antihistamines

Many 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:

  • Benadryl (diphenhydramine)
  • Chlor-Trimeton (chlorpheniramine)
  • Atarax, Vistaril (hydroxyzine)
  • Zyrtec (cetirizine)
  • Allegra (fexofenadine)
  • Clarinex (desloratadine) 
  • Claritin, Alavert (loratadine)
  • Xyzal (levocetirizine) 

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 during the first two days of a cold. They're less effective on day three or later.

Some antihistamines have side effects including:

  • Drowsiness
  • Dizziness
  • Dry mouth
  • Irritability
  • Constipation

Are Antihistamines Safe for You?

Talk to your healthcare provider before taking antihistamines if you have: 

  • Glaucoma
  • Enlarged prostate
  • Epilepsy
  • Overactive thyroid
  • Heart disease
  • High blood pressure
  • Diabetes


Multi-Symptom Treatments

Multi-symptom formulas typically include a combination of:

  • Analgesics
  • Decongestants
  • Antihistamines
  • Expectorants and/or cough suppressants

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.

If you are already taking prescription medication, call your provider and ask if it is okay to use an OTC medication for your cold as well.

Interactions With Home Remedies

Some 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.

Tips for Taking Cold Medicine

In addition to reading ingredient lists carefully, there are a few other tips to consider when treating a cold with OTC medicine.

First, never give cold medicine to a child who is younger than 6. Cold medicine will not help them and could result in dangerous side effects.

Keep in mind that even the best cold medicine will not cure the cold itself; cold medicines only relieve your symptoms while your immune system fights the virus.

So, while taking cold medicine may be helpful, it's important to also provide your immune system with the support it needs by:

  • Getting ample rest
  • Drinking plenty of water, herbal teas, broth, and other clear fluids
  • Avoiding smoking and staying away from secondhand smoke

When to Call Your Healthcare Provider

Always take the proper dose of a medication, which should be listed on the medication's label. If you feel that you need a stronger dose than what is listed, or you need to take the medication more frequently, call your healthcare provider.

Most cold symptoms go away within about a week. If your symptoms get worse or do not get better within 10 days, call your provider. Your provider may wish to test you for sinus infection, allergies, or another illness.

Should you experience any of the following symptoms, call 911 or go to the emergency room right away:

  • Difficulty breathing
  • Sudden chest pain
  • Sudden abdominal pain
  • Sudden dizziness
  • Hallucinations, out-of-body sensations, or other strange behaviors
  • Severe vomiting that doesn't go away

Summary

Knowing 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.

Frequently Asked Questions

  • What is the difference between Mucinex and Dayquil?

    Mucinex and Dayquil are both over-the-counter cold medications, but the similarities end there. Mucinex contains the expectorant guaifenesin, which helps to loosen chest congestion so your cough will be more productive. Dayquil is a combination medicine that contains the fever-reducer acetaminophen, the decongestant phenylephrine, and the cough suppressant dextromethorphan. 

  • What is the best cough medicine?

    It depends on your symptoms. If you have a wet or productive cough, use an expectorant. An antitussive is your best bet for a dry cough or at night. Guaifenesin—the medication in Mucinex—is an expectorant. It is also found in Robitussin, Tussin, and other brands. Dextromethorphan is an antitussive or cough suppressant. It works to quiet a cough by turning down the cough reflex. Cough medications that contain DM in the name contain dextromethorphan.

  • What medicine gets rid of a cold fast?

    Multi-symptom cold medicines can help to quickly relieve a cold for several hours, but they won’t get rid of the cold. There is some evidence that the mineral zinc can help to shorten the duration of a cold. Zinc is the main ingredient in Zicam, a homeopathic medication marketed to end colds faster. 

15 Sources
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.
  1. National Center for Biotechnology Information, U.S. National Library of Medicine: InformedHealth.org. Treating acute sinusitis. Updated October 18, 2018.

  2. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Pseudoephedrine.

  3. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Phenylephrine.

  4. Food and Drug Administration. FDA clarifies results of recent advisory committee meeting on oral phenylephrine.

  5. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Oxymetazoline nasal spray. Updated September 15, 2016.

  6. Wong T, Stang AS, Ganshorn H, et al. Combined and alternating paracetamol and ibuprofen therapy for febrile childrenCochrane Database Syst Rev. 2013;2013(10):CD009572. doi:10.1002/14651858.CD009572.pub2

  7. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Acetaminophen.

  8. National Institute for Neurological Disorders and Stroke. Reye's syndrome information page.

  9. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Dextromethorphan.

  10. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Guaifenesin. Updated February 15, 2018.

  11. American Academy of Pediatrics: HealthyChildren.org. Coughs and colds: Medicines or home remedies?.

  12. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Antihistamines for allergies.

  13. De Sutter AI, Saraswat A, van Driel ML. Antihistamines for the common cold. Cochrane Database Syst Rev. 2015;(11):CD009345. doi:10.1002/14651858.CD009345.pub2

  14. Mount Sinai. Common cold - how to treat at home.

  15. Wang MX, Win SS, Pang J. Zinc supplementation reduces common cold duration among healthy adults: A systematic review of randomized controlled trials with micronutrient supplementation. Am J Trop Med Hyg. 2020 Jul;103(1):86-99. doi:10.4269/ajtmh.19-0718

By Kristina Herndon, RN
Kristina Herndon, BSN, RN, CPN, has been working in healthcare since 2002. She specializes in pediatrics and disease and infection prevention.