How to Choose Over-the-Counter Cold and Flu Meds

Medically Reviewed by Neha Pathak, MD on July 10, 2023
3 min read

Most cold and flu drugs attack symptoms, not the specific viruses that cause the illnesses. They aren't a cure, but they can make you feel better or shorten your illness.

There's no one right way to treat a cold or the flu. But here are some questions you can ask your pharmacist to get the correct over-the-counter medication for you.

This depends on your symptoms. If you have nasal or sinus congestion, then a decongestant can help. If you have drainage -- either a runny nose or postnasal drip or itchy, watery eyes -- then an antihistamine could work.

Over-the-counter antihistamines could make you drowsy. Decongestants might make you hyper or keep you awake. Antihistamines can thicken mucus, which can be a problem for people with asthma.

Both of these medications may mix poorly with other drugs, like those that treat heart disease, and they may worsen some conditions, like high blood pressure. Ask your doctor or pharmacist which one is best for you.

This type of medicine can increase blood pressure and heart rate, and raise the risk of heart attacks and strokes.

Pseudoephedrine is the main decongestant taken by mouth that's available. In general, if your blood pressure is well controlled with medications, then a decongestant shouldn't be a problem as long as you closely watch your BP. This may not be true with certain types of blood pressure drugs, so check with your doctor or pharmacist about what may be best for you.

Nasal decongestants work fast to open your airways. But if you use them for more than 3 days in a row, you may end up more stuffy than you were at the start.

Some doctors suggest using a saline spray instead of a medicated spray. It may take longer to work, but you won’t have problems down the line.

An occasional cough clears the gunk from your lungs. But one that goes on and on needs treatment.

On the shelf you'll find tons of cough medicines with a zillion combinations of decongestants, antihistamines, analgesics/antipyretics, cough suppressants, and expectorants. Ask your pharmacist which, if any, would be right for you.

A fever can be a good thing. It kick-starts your immune system and helps your body fight off an infection by torching bacteria and viruses.

Doctors no longer suggest you try to lower it, except for people who are very young or old, and those with certain medical conditions such as heart disease or lung disease. If you're uncomfortable, though, it's fine to take a fever-reducer medication.

Young people, including those in their early 20s, should avoid aspirin. Medicines with acetaminophen and ibuprofen are best. Each type has its own set of risks, so talk to your doctor or pharmacist about which is best for you.

Be careful not to overdose. These drugs are often mixed in with cough and cold and flu remedies. Read the labels, and don't take a separate pain remedy if your cough or cold medicine includes one. If you’re not sure what’s in it, talk to your pharmacist before you take it.

Drink lots of fluids, and use a salt-water gargle for relief. To make it, mix a cup of warm water and a teaspoon of salt. Some medications you take by mouth like acetaminophen, medicated lozenges, and gargles can also temporarily soothe a sore throat.

Get your doctor's OK before you take anything, even over-the-counter drugs. Don't use lozenges or gargles for more than a few days. The drugs could mask signs of strep throat, a bacterial infection that should be treated with antibiotics.