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What Is The Best Cold And Flu Medicine?

There's no cure for a common cold, but some over-the-counter medicines may alleviate symptoms. The best cold and flu medicine depends on your symptoms. Pain medication, for example, can treat a sore throat, aches, and fever. Decongestants help alleviate a stuffy nose, while expectorants can treat a runny nose.

Various viruses may cause a cold, the most common being rhinoviruses. Influenza viruses, in contrast, cause the flu. Common cold and flu symptoms include a cough, runny or stuffy nose, body aches, fever, and sore throat.

It's no surprise people spend hundreds of millions of dollars on over-the-counter (OTC) cold and flu medicine annually. However, few cold and flu remedies are likely to influence the course of illness if you are already sick. That said, some actually work. Read on to learn about the best cold and flu medicines.

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The best cold and flu medicine will depend on your symptoms, including a runny or stuffy nose, body aches, cough, fever, or sore throat. The most effective options for getting rid of a cold include decongestants, cough suppressants, and pain relievers. Antivirals are also effective for getting rid of the flu fast. If you take them at the start of your illness, they help shorten the duration of the flu. Aches A pain reliever may be one of the first things you reach for when you come down with a common cold or the flu, and with good reason. Body and muscle aches often occur with the flu, while headache is a common cold symptom. Tylenol (acetaminophen) can relieve painful symptoms. Non-steroidal anti-inflammatory drugs (NSAIDs) also treat discomfort and reduce inflammation. Common NSAIDs include Advil and Motrin (ibuprofen) or Aleve (naproxen). NSAIDs may increase the risk of heart attacks or stroke and can lead to ulcers and bleeding. Long-term use can also lead to kidney damage. Congestion/Stuffy Nose Research has found that OTC decongestants are an effective way to treat a stuffy nose in adults. Decongestants narrow the blood vessels that line nasal passages, which reduces inflammation. Look for decongestants that contain pseudoephedrine, such as Sudafed. You'll have to ask for it at the pharmacy counter. Pseudoephedrine may cause a number of side effects, including: Anxiety Difficulty sleeping Dizziness Nausea and vomiting Pseudoephedrine may also slightly increase blood pressure. People with high blood pressure may want to consider spray-based decongestants, such as Afrin (oxymetazoline). Only use nasal decongestants for short periods. Chronic use can lead to rebound congestion, meaning your nose feels stuffier after you stop using it. Cough A hacking cough is one of the most common cold or flu symptoms. Suppressants that contain dextromethorphan (DM) may help a bit. Remember, a cough can be part of the healing process. Coughing helps clear your airways. Fever Pain relievers like Tylenol and NSAIDs can help reduce a fever. Try taking a fever reducer with a cup of tea or soup. These warm, soothing fluids will help soothe a sore throat. Runny Nose and Sneezing Antihistamines may provide temporary relief from a runny nose and sneezing. A study published in 2015 found that antihistamines help lessen the severity of overall cold symptoms at the start of a cold. The researchers did not find any benefit after the first two days of illness. Common brand names include Benadryl (diphenhydramine), Claritin (loratadine), and Zyrtec (cetirizine). Claritin is not likely to tire you, but Benadryl and Zyrtec often cause drowsiness. However, it's important to get plenty of rest when you have a cold or the flu. Expectorants like Mucinex (guaifenesin) help thin mucus that drains down the back of your throat. This makes it easy for you to cough it up. Sore Throat A sore throat causes your throat to feel painful or scratchy, which makes it hard to swallow. Pain relievers like Tylenol and NSAIDs can help alleviate a sore throat. Try sucking on throat lozenges, which are available over the counter, or hard candies. These help increase saliva and lubricate your throat. People have touted several supplements as ways to protect against and treat a cold, but research is limited. Keep in mind that the Food and Drug Administration (FDA) minimally regulates supplements. These supplements may or may not be suitable for you. Side effects vary from person to person and depend on many variables, including type, dosage, frequency of use, and interactions with current medications. Talk to a healthcare provider or pharmacist before starting any supplements. Supplements that might help include: Astragalus: This is a common herb used in traditional Chinese medicine to treat upper respiratory infections like a cold. Oral astragalus is generally safe in doses of 60 grams (g) per day for four months. Echinacea: This flower is native to North America. Oral echinacea may reduce your risk of getting a cold, but it's unclear whether it treats symptoms. Although uncommon, you may be likely to develop a reaction to oral echinacea if you are allergic to ragweed. Elderberry: This dark purple berry, which grows in Asia, Europe, North America, and Northern Africa, is a common cold and flu remedy in folk medicine. Garlic: People worldwide have used garlic to protect against and treat colds and the flu, but there's not enough evidence to support its use. Ginseng: Some evidence suggests that ginseng may shorten the duration of colds if you take the herb consistently. Vitamin C: This vitamin can reduce the duration and severity of a cold if you take it before you get sick. Eat foods that are high in vitamin C, such as broccoli, oranges, strawberries, and tomatoes. Vitamin D: This vitamin may protect you against cold and flu viruses, but it's unclear whether it works if you are already sick. You can find vitamin D in eggs, fish, fortified foods, and natural sunlight. A balanced, nutrient-rich diet may be the best protection for your overall health. Zinc: This supplement may reduce the length of a cold if you take it within 24 hours after your symptoms begin. Zinc may cause nausea and, in high doses, copper deficiency. Some medicines will not work against colds or may be harmful to some people. Antibiotics, for example, treat bacterial infections. Viruses cause colds, so antibiotics will not work. If you have heart disease, you should avoid decongestants such as phenylephrine and pseudoephedrine. Decongestants narrow blood vessels to treat a stuffy nose, but this action can worsen heart problems. Narrow blood vessels can increase the risk of a heart attack, heart failure, and stroke. NSAIDs can also increase the risk of heart attack and stroke, especially in people with high blood pressure. These medications decrease the sodium your body gets rid of through urine, increasing blood pressure. Children's Cold and Flu Medicine  You can safely give acetaminophen and ibuprofen—available in chewable, liquid, and tablet forms—to children older than 2. Make sure you read the instructions and give the correct amount based on your child's age and weight. Talk to a healthcare provider before giving these medicines to children younger than 2. Do not give OTC cold and flu medicine to infants and children younger than 6. These medicines may result in harmful side effects in young children. Other ways to treat cold and flu symptoms in children include: Breathing in steam from a hot shower Elevate your child's head when they are lying down Spraying non-medicated saline drops into the nose Staying hydrated Using a humidifier to add moisture to the air Visiting a healthcare provider if they have a wheezing cough Cold and Flu Medicine During Pregnancy Medicines that you take during pregnancy can cross the placenta and reach the fetus. It's essential to know what's safe and what to avoid, as well as what some natural remedies are if you are sick while pregnant. The safest cold and flu medicines for pregnant people include: Anesthetic throat lozenges to relieve a sore throat Most cough drops to help ease a cough and lubricate a sore throat Tylenol for aches, fevers, and headaches Avoid pain relievers, such as aspirin, ibuprofen, and naproxen, and herbal remedies like echinacea. Afrin and other non-steroidal nasal decongestant sprays that contain oxymetazoline may also be unsafe during pregnancy. Talk to a healthcare provider or pharmacist before using cold and flu medicines to make sure they are safe. Some healthcare providers may advise avoiding all drugs—whether OTC or prescription—during the first trimester. Here are other tips for taking cold and flu medicines: Avoid or limit combination products, especially ones that contain acetaminophen, like Dayquil. These drugs increase the risk of liver damage if you take too much. Be careful of combining multiple medications. Follow directions for dosing and timing in adults and children. Talk to a healthcare provider or pharmacist before taking medication or giving it to children if you are unsure whether it's safe. There are some natural cold remedies in addition to OTC medications and supplements. Make sure you consult a healthcare provider or pharmacist before trying one of these remedies: Defend: This homeopathic remedy fights multiple cold symptoms, including hacking, rattling, or tickling cough. There's little to no evidence that any homeopathic products work. The FDA does not regulate these remedies as tightly as other medicines. Oscillococcinum: This is a homeopathic remedy made from heart and liver extract from the muscovy duck. The muscovy duck is native to Mexico, Central America, and South America. Sambucol: This natural cold remedy consists of extracts from the black elderberry plant, but more research is needed. A 2016 study of 312 air travelers found that elderberry extract reduced the length of illness and severity of symptoms compared to a placebo.  You cannot always prevent a cold or the flu, but you can reduce your risk. Here are ways to prevent a cold or the flu: Choose small daycare classes, where viruses commonly spread, if you have young children Cover your coughs and sneezes with a tissue or the crook of your elbow Disinfect commonly touched surfaces (e.G., countertops and door knobs) Do not share personal items (e.G., cups, towels, and utensils) Get an annual flu shot Opt for disposable paper towels instead of cloth towels Regularly wash your hands with soap and water for at least 20 seconds Stay home if you are sick Use hand sanitizer with at least 60% alcohol if soap and water are not available Most people recover from a cold or the flu at home with plenty of rest and fluids. Speak to a healthcare provider if your symptoms do not get better after 10 days or worsen. Let them know if you have the flu and are at risk of developing complications. Other signs to contact a healthcare provider include: A fever that lasts more than four days Chest or stomach pain Confusion or dizziness Dehydration Lack of urination Seizures Severe muscle pain Shortness of breath or trouble breathing Symptoms improve but then come back or worsen Underlying health conditions that worsen with illness Some cold and flu medicines may reduce the length and severity of symptoms. Keep in mind that some of these remedies are not guaranteed to be foolproof, or they might not work if you are already feeling ill.  You can use antihistamines, decongestants, expectorants, and pain relievers if you currently have a bout of illness to feel better. Just remember not to go overboard on a single ingredient like acetaminophen. Make sure these medications are safe if you are pregnant or before giving them to a child.

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Medications To Treat Pollen Allergies

You're already doing your best to avoid pollen, but you still might need medication to ease your seasonal allergies. A few types can help.

Check with your doctor before you start taking any of these medicines, even if you don't need a prescription. That way, your doctor can make sure you're taking what you need and watch for any side effects.

These are drugs you spray into your nose. They are the first choice of treatment for allergic rhinitis. They relieve congestion, a runny or itchy nose, sneezing, and other symptoms. Nasal steroids are often the first treatment doctors recommend.

Some steroid sprays require a doctor's prescription, but three of them, budesonide (Rhinocort Allergy), fluticasone (Flonase), and triamcinolone (Nasacort Allergy 24HR), do not. It's best to start using them before pollen season begins and to keep taking them as long as it lasts. It may take up to a week before your symptoms get better.

Steroids you take by mouth (oral steroids) are only used in rare cases to treat nasal allergies.

These drugs work against the chemical histamine. Your body makes histamine during an allergic reaction, and it causes the symptoms that make you miserable.

Antihistamines are available in pills and nasal sprays. The pills target itching, sneezing, and runny nose. The nasal sprays work on congestion, an itchy or runny nose, and postnasal drip.

Some over-the-counter pills can fight your symptoms for longer. Be careful, as they can also make you drowsy:

Others can make you feel drowsy, such as:

You'll need a prescription to get other types of antihistamines in a nasal spray, including

These drugs unclog your stuffy nose. You can take some types as pills or liquids, like phenylephrine and pseudoephedrine. Others come in a nasal spray, like oxymetazoline and phenylephrine.

Don't use the decongestant nasal sprays for more than 3 days in a row, or you might get rebound congestion, which means you get congested all over again.

Remember that decongestants can also cause problems, including increased heart rate and blood pressure. If you have heart problems or high blood pressure, you shouldn't take them. If you have a prostate problem that makes it hard to urinate, these drugs can make it worse. It's a good idea to talk to your doctor first to see if a decongestant will work for you.

Cromolyn sodium (NasalCrom)  is a nasal spray that keeps certain cells in the body called mast cells from releasing chemicals that cause allergy symptoms. It's available without a prescription and helps a runny/itchy nose, sneezing, and congestion.

Nasal ipratropium is a prescription nasal spray that can help if you have a runny nose because of your allergies.

Some products include more than one kind of drug. Allegra-D, Claritin-D, and Zyrtec-D have both an antihistamine and the decongestant pseudoephedrine.

You call them allergy shots. Your doctor calls it "immunotherapy." By either name, the goal is the same: Retrain your immune system so it doesn't go into allergy mode.

When you get allergy shots, your doctor gives you small, gradually increasing amounts of the pollens that are causing your symptoms. Over time, your body builds up a resistance to them. The shots are a long-term commitment, likely taking 3 to 5 years. After that, your doctor will see if you still need them.

Instead of getting shots at the doctor's office, there are also under-the-tongue tablets that you can take at home. The FDA has approved three of these products: Grastek, Oralair, and Ragwitek. They work the same way as shots. The goal is to boost your tolerance of allergy triggers.

The tablets can cause an allergic reaction in some people, so you will need to take your first one at your doctor's office to make sure it's safe for you. Even if you don't have a reaction, you may feel itching or burning in your mouth or lips or have stomach troubles. These problems usually go away after a few days.

A Complete Guide To Allergy Treatments

With tree pollen counts already hitting peak levels in some parts of the United States, now is the time to start preparing for — and treating — your spring allergy symptoms.

But before you head to a pharmacy, consider some measures you can take at home. And if you do need to resort to medication, here's what to know about the various pills, sprays and shots available.

Your first-line defense

Doctors recommend first trying to limit your exposure to whatever is triggering an allergic response — for example, tree pollen in the spring.

You can monitor local pollen levels on weather or allergy apps or on sites such as the National Allergy Bureau's. When counts are high, doctors recommend keeping your windows closed, wearing a well-fitting mask outside and showering and changing your clothes when you get home. Pets can also bring in pollen from the outdoors, so keep them out of your bedroom and wash them regularly. When you come inside, you can also rinse out your nose with a saline spray or neti pot.

"It's laborious, but the people who do this stuff find it really helpful," said Dr. Neeta Ogden, a New Jersey based allergist.

Nasal sprays

Dr. John Mafi, a primary care physician at UCLA Health who often treats patients with allergies, said that for those with moderate or severe seasonal allergies, the most effective treatment is typically a nasal corticosteroid spray.

These include fluticasone (Flonase), budesonide (Benacort), triamcinolone (Nasacort) and mometasone (Nasonex).

Allergens trigger inflammation in the nose, eyes, throat and, sometimes, the airway. "A local steroid is calming that area of inflammation," Mafi said. Because nasal sprays are not absorbed systemically the way steroid pills are, they are considered low-risk, he added.

Spray with the nozzle pointed out toward the ears to get the greatest benefit and to avoid side effects like nose bleeds. The steroids can take several days to take effect, so doctors recommend using them from a week or two before pollen season until pollen counts decline.

Antihistamines

Antihistamines reduce the itchiness and inflammation produced by histamine, a chemical your immune cells release when triggered by an allergen. They can be taken as pills, nasal sprays or eye drops. They work quickly and are most effective if taken as needed, such as on days when your symptoms are particularly bad.

"It can be like a rescue therapy," said Dr. Farah Khan, an allergist and immunologist at Nationwide Children's Hospital in Columbus, Ohio.

For itchy, watery eyes, antihistamine eye drops — often in conjunction with a nasal spray — tend to work best, Mafi said.

An oral antihistamine can be beneficial when you have multiple symptoms, like itchy eyes, a stuffy nose and hives, said Dr. Rita Kachru, chief of clinical allergy and immunology at UCLA Health.

In 2020, a task force of physicians that issues allergy treatment guidelines recommended against using "first-generation" oral antihistamines, such as diphenhydramine (Benadryl), for allergic rhinitis, especially on a chronic basis. The group cited negative side effects, including sedation, performance impairment and increased risk of dementia.

Doctors said the "second-generation" oral antihistamines loratadine (Claritin), cetirizine (Zyrtec) and fexofenadine (Allegra) won't make most people drowsy, though patients are least likely to experience drowsiness with fexofenadine, Kachru said. These pills can cause side effects, including dry eyes or mouth and constipation.

If an antihistamine produces unpleasant side effects or stops working well, doctors suggest trying another one.

Decongestants

Some antihistamines, such as Claritin-D and Allegra-D, come combined with pseudoephedrine (Sudafed). Doctors don't recommend products that contain pseudoephedrine for children at all, or for adults for more than a few days in a row because the ingredient can increase heart rate and blood pressure.

Kachru also warned against using the decongestant nasal spray oxymetazoline (Afrin). Though it might provide relief, she said, over time you need more medication to get the same response. And stopping the medication can cause inflammation that can make it hard to breathe through your nose, she said.

Immunotherapy

Doctors recommend consulting a board-certified allergist if your symptoms are getting worse, interfering with daily life or causing other health problems, and medications aren't helping. Ogden said patients often come to her when they can no longer tolerate taking medications for months on end.

"And then we have a talk about starting allergy shots," she said.

Allergy shots deliver progressively higher doses of the protein you're allergic to, teaching your immune system to tolerate it. The therapy, which has been approved by the Food and Drug Administration and is usually covered by insurance, has been shown to significantly reduce symptoms and medication use, and the effects can last for several years after treatment ends.

Another option is sublingual immunotherapy, in which you place a tablet containing the allergen under your tongue. The FDA has approved tablets for ragweed, grasses and dust mites.

Both forms of immunotherapy require a substantial investment of time, usually three to five years. Scientists are studying other options. With climate change and air pollution making allergy symptoms worse, Ogden said, "I think immunotherapy is where we're going to end up."

Agrawal is a freelance writer. This article appeared in The New York Times.

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