You feel the telltale symptoms of a cold or flu coming on — maybe it’s a cough, runny nose, sneezing and stuffy nose and head. You want to choose the best medication to help you feel better. But the choices in the cold and flu aisle in the pharmacy or at the pharmacy counter are overwhelming. All kinds of medicines claim to control some or all your symptoms. How do you choose a cold vs. flu medication?
To start, you want to figure out whether you have a cold, flu or another infection. “A lot of times, they all start with the same types of symptoms — fever, runny nose, overall fatigue and sometimes headaches,” said Kelly Erdos, PharmD, a clinical pharmacist with Banner Health. “But one of the biggest differences is the intensity. Colds are usually not as intense. With the flu, people say they feel like they got hit by a bus.”
With cold viruses, you usually start to feel better within a day or two. If you aren’t, Erdos recommends making an appointment with your PCP, calling the nurses’ line at their office or visiting an urgent care center. You may be able to schedule a virtual visit so you can see a health care provider without leaving your home.
Before you choose medication to treat symptoms of a cold or the flu, consider your medical history and pre-existing conditions. Since some cold and flu medicines can interact with other medications, consulting with a health care provider is crucial.
With that in mind, consider what has worked for you in the past. “The most important thing is to take something that works for you. And that may be very different from what works for other people,” Dr. Erdos said.
Over-the-counter (OTC) medications
You can choose over-the-counter cold and flu medications to help treat symptoms. “You aren’t necessarily going to speed up how quickly you get better, but you can make yourself more comfortable during that healing process,” Dr. Erdos said.
Options include:
- Decongestants, including decongestant nasal sprays, can help reduce the congestion you might have in your sinuses or chest, or help a stuffy nose.
- Antihistamines, which help treat a runny nose or itchy, watery eyes.
- Pain relievers, which can relieve body aches and headaches and may also work as fever reducers.
- Cough medicines, which may suppress a cough. Many OTC options aren’t very effective, however, so a prescription drug might be a better choice.
Be sure to look at the label to see what active ingredients are in the medication. “There are a ton of cold and flu products that people buy thinking there is only one ingredient, but it may be a combination product. Taking the lowest dose and least amount of medications is key,” Dr. Erdos said. If you have a sore throat and a runny nose, you don’t need to take a medication that controls a cough, for example.
Prescription medicines
One of the reasons it’s essential to see a health care provider for diagnosis is that you sometimes need prescription antiviral medication to treat the flu. But you need to begin taking this medication within 48 hours of when your symptoms start, so getting care quickly is vital.
Also, it's important to note that antibiotics are not effective against viral infections like the cold or flu. Antibiotics are specifically designed to treat bacterial infections, not viruses. Taking antibiotics unnecessarily or for viral infections can contribute to antibiotic resistance, which is a serious public health concern. If you're unsure about whether you need antibiotics, consult your health care provider for guidance.
Natural remedies and home treatments
When you’re under the weather due to a cold or the flu, some home treatments can help you feel better. “Even though you often need medications to get relief from a cold or flu, don’t underestimate the power of sleep and proper nutrition,” said Dr. Erdos. “When you are feeling sick, be sure to take time to rest and stay hydrated.”
It helps to move around a little, too. Spending the whole day in bed can make muscle aches worse. Even stretching in bed or walking to the kitchen for a glass of water can make a difference. And warm tea with honey can be soothing, especially if you have a sore throat.
Some people try supplements to help boost immunity. But they aren’t likely to have much effect once you have a cold or flu. “It’s probably more effective to choose a well-rounded diet and focus on hand washing, not touching your face and getting a flu shot,” Dr. Erdos said. If you’re thinking about trying any alternative treatments, talk to your health care provider first.
Choose age-appropriate medications
If you’re selecting medication for children or older people, you want to make sure you’re making the right choices.
Children’s bodies are still developing, and their metabolisms and immune systems are different than adults. And some medications haven’t been studied enough in children, so we don’t know if they are safe. Therefore, some medicines aren’t right for them. The American Academy of Pediatrics does not recommend cough or cold medicine in children under age 4. Some experts say to avoid them in children younger than age 6.
Choose medications that are designed for children or have dosages meant for children. Be sure to read the label carefully to make sure the dose is accurate. Children are more sensitive to medication – with the wrong amount, they might have side effects or not get the treatment they need.
You may want to select medications designed for children, since they often come in syrups or chewable tablets in kid-friendly flavors. Be sure to store these medications out of reach. Don’t give medication intended for adults to children (or vice versa) unless a health care provider recommends it.
Older people can have changes in their overall health, metabolism, immunity and organ function that affect how their bodies process medication. They might also be taking medication for other health conditions, so you need to be careful about interactions.
In children and older people, it’s especially crucial to watch for any side effects or interactions. Talk to your doctor or pharmacist if you have any concerns.
Medical conditions
If you have certain health conditions, you’ll want to consider them when choosing medication to treat cold symptoms. Here are some to pay attention to:
- Aspirin allergies: If you’re allergic or sensitive to aspirin, read the ingredients list carefully to make sure you don’t choose a medication that contains it.
- Respiratory conditions: Be careful when choosing medicine if you have conditions like asthma or COPD (chronic obstructive pulmonary disease). Some, such as decongestants for cold and flu, can make breathing more difficult or interact with other respiratory medications.
- Cardiovascular conditions: Some medications for cold and flu could contain ingredients that raise blood pressure or interact with drugs prescribed for these conditions. People with high blood pressure, heart disease or a history of stroke need to select medications that don’t impact heart health.
- Immune disorders: You might have more severe flu symptoms if you have HIV/AIDS, or you are undergoing chemotherapy or taking immunosuppressive drugs. So you might need prescription antiviral medications.
- Diabetes: Cold and flu infections can affect blood glucose levels. If you have diabetes, you’ll want to choose medications that don’t interfere with your treatment. Also be sure to check the sugar content on cough drops so you’re not impacting your blood sugar with too many of them.
- Liver and kidney problems: Some cold and flu medications are metabolized by the liver or filtered through the kidneys. If you have liver or kidney problems, you may need to adjust the dose of your medicine or choose different types.
- Pregnancy or nursing: Some over-the-counter (OTC) medications may not be good choices if you’re pregnant or breastfeeding, since they can affect the baby.
If you have any of these conditions, talking to your health care provider about the best medicine for flu and cold symptoms is especially important.
Side effects and interactions
Flu and common cold medications can sometimes cause side effects. If you take other medications or have health conditions, talking to a pharmacist or health care provider about possible interactions is especially important.
Keep in mind that it’s not just prescription drugs that can cause interactions. You need to be careful with herbal supplements and OTC medicines as well.
Here are some possible side effects and interactions:
- Decongestants may make you feel nervous and restless. You could find it hard to sleep. They can also raise your heart rate and blood pressure. It’s vital to be careful with decongestants if you have cardiovascular conditions, high blood pressure, glaucoma or thyroid problems.
- Antihistamines can cause drowsiness, dry mouth, blurred vision, dizziness and constipation. You shouldn’t drive or operate heavy machinery if you’re taking antihistamines that cause drowsiness.
- Pain relievers like acetaminophen (Tylenol) and NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen (Advil, Motrin) can cause upset stomach, gastrointestinal irritation and liver or kidney problems. Don’t drink alcohol if you’re taking medications containing acetaminophen, which can lead to liver damage.
- Cough suppressants may cause dizziness, drowsiness or constipation. Do not take them if you have a productive cough (coughing up phlegm). Productive coughs are your body’s natural way of clearing your airways.
- Antiviral medications such as oseltamivir (Tamiflu) may cause nausea, vomiting, headache and dizziness. Some people are allergic to these medications and can develop a rash, itching or swelling.
- Combination cold and flu medications can have overlapping side effects due to their various ingredients. They may cause drowsiness, dry mouth, upset stomach and other effects. Be careful about taking multiple medications at the same time since that puts you at higher risk of overdosing on certain ingredients or having adverse reactions. Watch out for overlaps if you’re taking one type of medication in the day and another at night.
- Natural remedies such as herbal supplements or essential oils can have side effects, interact with other medications or cause allergic reactions.
Not everyone will have side effects, and when they occur, they could be more severe in some people and less severe in others. If you notice any adverse reactions or have concerns about side effects, contact your health care provider right away for guidance. They can help you adjust your treatment plan.
Steer clear of the germs that cause colds and flu
Good overall health can help you avoid catching the next cold or flu. “Going into cold and flu season, the best thing you can do to stay healthy is to wash your hands regularly and to keep your body strong with proper activity, nutrition and rest,” Dr. Erdos said.
This year and every year, one of the most important things you can do to stay healthy is get a flu shot.
The bottom line
When you’re trying to find the best medicine for cold or flu symptoms, medication options can feel overwhelming. Talking to a health care provider, remembering what worked for you in the past, choosing the lowest dose of only the ingredients you need and avoiding interactions with other drugs can lead you to the best choice for symptom relief. If you need to connect with a health care provider to evaluate your symptoms, reach out to Banner Health.
