There's still no cure for the common cold. Cold medicines seek to relieve symptoms rather than cure the illness or make it go away faster. Over-the-counter (OTC) medicines and self-care may help you rest and reduce discomfort while your body heals. If your symptoms are serious or your doctor thinks something else is causing them, they might recommend a prescription medicine.
Most people don't need any kind of treatment for mild cold symptoms. But if you do take cold medications, always check the label for side effects and carefully follow the instructions for use. Make sure they won't interact with any other medications you're taking and are OK to use with any other health problems you have. Ask your doctor or pharmacist if you’re not sure.
Cold Medicines for Stuffy Nose
Congestion or stuffiness is a common symptom of colds, allergies, sinusitis, the flu (influenza), or hay fever. Some medications and devices may ease it or help you feel better when you have it.
Nasal decongestants
By curbing swelling in your nose and sinuses, nasal decongestants temporarily clear stuffy noses and make breathing easier.
Some common nasal decongestant ingredients are:
- Oxymetazoline
- Phenylephrine
- Pseudoephedrine
Nasal decongestants come alone or mixed with other medicines such as pain relievers or antihistamines. In fact, doctors examples include:
- Acetaminophen + guaifenesin + pseudoephedrine
- Cetirizine + pseudoephedrine
- Ibuprofen + pseudoephedrine
- Loratadine + pseudoephedrine
Oral decongestants. These are pills and liquids you take by mouth. Pseudoephedrine is considered one of the most effective decongestant ingredients. However, OTC products containing it are kept locked up or behind the counter at stores. That's because it can be used to produce the illegal drug methamphetamine. You'll need to ask an employee for these products and show them a photo ID.
Many other oral decongestants contain phenylephrine instead. But an FDA advisory panel found that it doesn’t work to clear congestion when taken by mouth, and has proposed removing it from oral OTC cold products. It may still work in nasal sprays.
Topical decongestants. You apply topical decongestants inside your nose as nasal sprays, drops, or gels. They work quickly to shrink blood vessels. You can find over-the-counter topical decongestants under many different brands and generic names. The active ingredients in most are oxymetazoline and phenylephrine.
Don't use topical decongestants for more than three days. You may have a "rebound effect" in which you end up more congested than ever and so keep using the spray more and more often. That could lead to rhinitis medicamentosa, a condition that makes the nasal passages red and swollen.
Sinus relief devices
Some devices use sound or electricity to help ease congestion, sinus pressure, inflammation, and pain without side effects like drowsiness.
The FDA has reviewed a couple of these devices that are available without a prescription:
ClearUP Sinus Pain Relief. This small device uses gentle electrical pulses to stimulate nerves around your sinuses. This may help with sinus pain and stuffy nose from allergies, colds, or the flu. The FDA has approved its use for nasal congestion.
Sonu. It uses sound vibrations to help clear your stuffy nose. Humming-like vibrations may reduce congestion, increase airflow, and reduce inflammation in the nasal passages. The FDA has granted it a "de novo" classification, used for certain low-risk devices.
Decongestant alternatives
Saline solution. A saltwater solution applied inside your nostril (a process called nasal irrigation) can break up hardened mucus and keep your nasal passages moist. While it may not work quickly to stop a stuffy nose, it’s free of side effects and won't cause a congestion relapse.
Nasal irrigation systems include:
- Neti pots: You use a teapot-shaped container to pour saline into your nostrils.
- Squeeze bottles: These are flexible bottles you use, like a nasal spray, to clean your nostrils with saline solution.
- Powered irrigators: They use battery power to send saline solution into your nasal passages.
All nasal irrigation systems are equally effective, so choose the one that feels most comfortable and easy for you to use.
Mentholated ointments. While they're not decongestants, menthol ointments you rub under your nose or on your chest have a cooling effect and strong odor that can mask feelings of congestion. This could make you feel like you're breathing better.
Nasal dilators. These small devices fit inside your nose to widen your nostrils. By increasing airflow, they may improve breathing when you're congested.
Sinus massagers. Manual and electronic massagers apply gentle pressure around the nose and forehead. Some people think they promote sinus drainage and blood flow and help with pain and pressure relief, though there's little research to back this up.
Humidifiers. Humidifiers add moisture to the air and soothe irritated nasal passages.
Cold Medicines for Runny Nose, Watery Eyes, and Sneezing
Antihistamines stop allergy symptoms because they block histamine, chemicals your body makes that are linked to sneezing, runny nose, and watery eyes.
While antihistamines may have short-term benefits when you have a cold, researchers have found that they're ineffective in the mid to long term. Over-the-counter antihistamines, such as chlorpheniramine and diphenhydramine, may relieve these cold symptoms for one or two days, experts say.
A combination of antihistamines and decongestants may work better. Some common combinations are:
- Cetirizine with pseudoephedrine
- Fexofenadine with pseudoephedrine
- Loratadine with pseudoephedrine
Cough and Cold Medicine
A cough is not always bad. It helps your body clear airways and fight off germs. But if your cough lasts more than one or two weeks or comes with a fever or other symptoms, you might need to see a doctor.
Types of OTC cough medicines
Many OTC cough medicines are available. But research has shown that most are no more effective than using cough drops, sucking hard candy, or taking a spoonful of honey to soothe your throat.
If you use one, choose a type that's right for the kind of cough you have and the time of day you're taking it.
Antitussives (cough suppressants). These may help you stop coughing when you have a dry cough, the type that doesn't produce any mucus. Dextromethorphan is a common ingredient.
Expectorants. These help thin and loosen mucus, making it easier to cough up when you have a wet cough, the type that brings up mucus. Guaifenesin is a common ingredient.
Combination cough and cold medicines. Some medicines mix ingredients such as antihistamines, decongestants, and/or pain relievers with cough medicine. Options include:
- Acetaminophen with dextromethorphan
- Acetaminophen with dextromethorphan and guaifenesin
Check whether your OTC cold medicine has an AM/daytime or PM/nighttime version. The daytime medicine might not make you sleepy, but it won't necessarily help keep you awake. Some might have caffeine to help you stay alert.
Nighttime medicines have ingredients that make you sleepy. Antihistamines such as diphenhydramine or doxylamine can cause drowsiness, so they’re best for nighttime use.
Dextromethorphan, a common cough suppressant, may make some people drowsy. Guaifenesin is a nondrowsy expectorant. However, some medicines mix guaifenesin with sleep aids, which can cause drowsiness.
Cold and Flu Medicine for Fever, Aches, and Sore Throat
Fever can be a good thing. It helps your body fight infection by hindering the growth of bacteria and viruses and activating your immune system. Doctors no longer recommend fighting fever for most people, except perhaps for the very young, the very old, and those with certain medical conditions such as heart disease or lung disease. But if you feel bad and can’t rest, it's safe for most people with colds to take OTC medicines such as aspirin, acetaminophen, ibuprofen, or naproxen to ease pain and lower fever.
Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce inflammation, pain, and fever. Health care providers use them to treat various symptoms, including headaches and fever.
Who should avoid NSAIDs?
People with the following conditions should avoid NSAIDs:
- Kidney disease
- Stomach ulcers or gastrointestinal bleeding
- Liver disease
- Gastroesophageal reflux disease (GERD), or chronic acid reflux
- Crohn's disease
- Ulcerative colitis
- Diabetes that's not under control
- High blood pressure
- Heart failure
- A history of stroke or heart attack
Drinking lots of fluids and gargling with salt water (made by mixing a cup of warm water and a teaspoon of salt) can often ease the pain of a sore throat. Some medicated lozenges or sprays can also temporarily soothe the pain.
But don't use lozenges, sprays, or gargles for more than a few days. They could mask the signs of strep throat, a bacterial infection that should be treated with antibiotics.
Combination Cold Medicines
Many OTC cold and flu medicines contain a mix of ingredients to treat multiple symptoms at once. These combination products may include:
- Decongestants such as pseudoephedrine or phenylephrine
- Cough suppressants such as dextromethorphan
- Expectorants such as guaifenesin to loosen mucus
- Pain relievers/fever reducerssuch as acetaminophen or ibuprofen
- Antihistaminessuch as diphenhydramine or chlorpheniramine
While combination medicines are convenient, they increase the risk of side effects or accidental overdose, especially if you take multiple medications at the same time.
To stay safe:
- Check the ingredients to avoid doubling up on the same drug. Acetaminophen is in many cold medicines, and exceeding the daily limit could cause liver damage.
- Be mindful of side effects. Some ingredients can cause drowsiness, increase blood pressure, or interact with other medications.
- Talk to a doctor or pharmacist before using multiple OTC medications, especially if you have existing health conditions, take prescription drugs, or are pregnant or nursing.
Prescription Cold and Flu Medicines
There are prescription-strength versions of many of the OTC medications used to treat cold symptoms. But you're not likely to need prescription medication unless you have serious symptoms or something besides a cold is causing them.
Some prescription medicines that might be used for a cold or other illnesses with similar symptoms are:
Nasal inhalers. Ipratropium bromide (Atrоvent) is more commonly used for allergies but may also relieve sneezing and a runny nose when you have a cold.
Antiviral medications. These don't work for colds but can be effective if you're coming down with the flu or COVID-19. If you take them within 48 hours after symptoms start, they can shorten the illness. For flu, they include baloxavir (Xofluza), oseltamivir (Tamiflu), peramivir (Rapivab), and zanamivir (Relenza). Antivirals for COVID include nirmatrelvir with ritonavir (Paxlovid) and molnupiravir (Lagevrio).
Antihistamine/decongestant combination. Doctors may prescribe a combination of antihistamines and decongestants to help relieve allergy and cold symptoms.
Cough suppressants. Your doctor can prescribe the cough syrup benzonatate (Tessalon Perles, Zonatuss) for coughs caused by colds or the flu. Opioid cough medications, such as codeine or hydrocodone, can treat a long-lasting (chronic) cough but aren't often prescribed because of side effects and addiction risk.
Antibiotics. Colds are caused by viruses, not bacteria; so, antibiotics don't work for colds. These drugs can also trigger side effects, and you can overuse them. That means they won't work well when you truly need them. Antibiotics help only if your symptoms are caused by a bacterial infection such as pneumonia or strep throat. Sometimes, you can develop pneumonia when your immune system is weakened by a cold.
Is It Safe to Take Cold Medications During Pregnancy?
If you're pregnant, it's especially important to talk to your doctor about whether any medicine you're considering is safe.
Occasional use of antihistamine and decongestant combinations during pregnancy is generally considered low risk. But using cold medicines in high doses or for long periods may increase your chances for complications.
These ingredients can be risky:
- Alcohol. Some cold medicines contain alcohol, which, if overused during pregnancy, may lead to birth defects.
- Phenylephrine. No research has confirmed its safety during pregnancy.
- Promethazine.This antihistamine has been linked to jaundice, muscle tremors, and blood clotting issues in newborns when taken late in pregnancy.
- Pseudoephedrine.While no human studies have confirmed this, animal research suggests that high doses may slow fetal growth and bone development.
What cold medicines can I take while pregnant?
Your doctor may approve some of these OTC medicines:
- Acetaminophen for pain and fever
- Certain antihistamines, such as chlorpheniramine and diphenhydramine, for runny nose
- Cough suppressants containing dextromethorphan
Cold medicine safe for breastfeeding
It's best to avoid decongestants in pill, powder, or liquid form if you're nursing. Some research suggests that nasal sprays or drops may be safer, but this may not always be the case.
Antihistamines and decongestants can pass into breast milk and may cause fussiness in babies. They may also reduce milk supply.
Potential Side Effects of Cold Medicines
While cold medicines can sometimes cause have side effects, most are mild.
Side effects of decongestants
Decongestants make some people hyper or keep them awake. Some could make you feel sleepy.
Other possible side effects include:
- Headaches
- Rash
- An irritated nose (for nasal sprays)
- Dry mouth
- Nausea
They can also increase your blood pressure, heart rate, and chances of a heart attack or stroke. If your blood pressure is well-controlled with medication, decongestants should be safe as long as you monitor your blood pressure. This may not be true with certain types of blood pressure drugs, so check with your doctor or pharmacist.
Decongestants can interact with medicines you take for other conditions, especially those for:
- Diabetes
- High blood pressure
- Overactive thyroid gland (hyperthyroidism)
- Enlarged prostate
- Liver, kidney, heart, or circulation problems
- Glaucoma
- Depression
Side effects of antihistamines
OTC antihistamines can make you sleepy and dry out your eyes, nose, and mouth. They can also thicken your nasal secretions, which can be a problem for people with asthma.
Some may also cause:
- Headaches
- Dizziness
- Blurry vision
- Trouble peeing or pooping
- Low blood pressure
- A sore throat
- Belly pain
- Nausea and vomiting
Side effects of cough medications
Possible side effects of cough medications include:
- Dizziness
- Sleepiness
- Fatigue
- Headache
- Rash
- Constipation
- Nausea or vomiting
- Confusion or hallucinations
- An allergic reaction
Side effects of fever and pain medications
If you take too many, or use them too often, OTC painkillers (analgesics) could cause:
- Upset stomach, heartburn, or nausea
- Constipation or diarrhea
- Ulcers
- Ringing in your ears
- Kidney or liver damage
- Heart problems
- Blood clotting issues
Tips to Take Cold Medicine
To stay safe when you use cold medicine:
- Check the label. Make sure you understand the dosage, side effects, and warnings.
- Follow the correct schedule. Don't take it more often than is recommended or for longer than the label suggests.
- Consider your other conditions. Ask your doctor about safe options if you have existing health conditions.
- Consult your doctor or pharmacist. They can help you choose the best medicine for your symptoms.
- Be especially careful with combination medicines. Many cold medicines have multiple active ingredients, like acetaminophen, which can be dangerous in high doses.
- Don't overdo it. Don't use more than one OTC cold medication at a time without talking to your doctor first since many have similar ingredients.
- Keep a list. Write down all medications, OTC drugs, and supplements you take so you can keep track. You can also share it with your doctor.
Best Supplements for Cold
It is unclear whether supplements such as vitamin C, echinacea, and zinc can help prevent colds or relieve symptoms.
Vitamin C hasn't been found to stop colds, but taking it before symptoms start might help shorten them.
Echinacea research has had mixed results. Some studies show it reduces symptoms and helps you recover faster if taken early, but others have found it doesn't help. It's generally safe for healthy adults. But it can interact with some medications, so check with your doctor first.
Zinc studies have also had varying results. Some found it could shorten a cold by about a day if you take it within two days after symptoms start. But zinc could cause you to lose your sense of smell, perhap permanently, if you take it by nose (intranasally). Don't use it without talking to your doctor.
When to Contact Your Doctor
Most of the time, the best thing to do for a cold is to rest and stay hydrated while it runs its course. But see your doctor if:
- Your symptoms last more than two weeks.
- Your symptoms get worse, or new ones appear. This could be a sign of another infection.
- You have a sore throat or a fever over 100 F that lasts more than three days.
- You're short of breath or having trouble breathing.
- You have serious chest pain.
Takeaways
Most people don't need medications for a cold. But if your symptoms are bothersome, you can try over-the-counter decongestants, antihistamines, pain relievers, or cough suppressants. Remedies such as saline solution and mentholated ointment may also help you feel better. If your cold symptoms last more than two weeks, or you have other symptoms like a high fever or trouble breathing, see a doctor.
Cold Medicine for Adults FAQs
What is the best medicine to stop a cold fast?
No medication can cure a cold. But some therapies may be effective for symptom relief:
- A combination of antihistamines and decongestants for nasal symptoms
- Acetaminophen, aspirin, ibuprofen, or naproxen for fever and aches
Rest, hydration, and saline nasal irrigation or gargles may also help you feel better.
Which is the best cold medicine for high blood pressure?
You may want to avoid decongestants such as pseudoephedrine. Safer options might include loratadine for congestion and acetaminophen for pain. However, always check with your doctor.
What cold medicine is safe for pregnant women?
Among the treatments your doctor may approve are:
- Acetaminophen for pain
- Saline sprays for congestion
- Chlorpheniramine or diphenhydramine, in moderation
Avoid pseudoephedrine and phenylephrine, especially in the first trimester. Always consult your doctor.
