K Health Guide to the Best Cold & Flu Medicines

By Edo Paz, MD
Medically reviewed checkmarkMedically reviewed
September 29, 2019

As soon as summer comes to an end and stores start putting out their fall displays, it’s only a matter of time before winter arrives, ushering in cold and flu season. The average adult will suffer from 2-3 colds per year, so we will review which over-the-counter (OTC) medicines to have on hand when illness inevitably strikes.

What Is a Cold vs. Flu?

Both the flu and the common cold are viral infections that affect the respiratory system. They are caused by different viruses, but have similar symptoms so it can sometimes be hard to tell if you are suffering from just a common cold or the more severe flu.

Symptoms of both the cold and flu may include fever, chills, runny nose, congestion, cough, sore throat, sinus pain, headache, and other aches and pains. Cold symptoms are usually milder, and almost always include either a runny or stuffy nose. In addition to being more severe, flu symptoms tend to come on more abruptly. While colds are unlikely to cause any major complications, the flu can be dangerous, particularly for the elderly and people with compromised immune systems. In extreme cases, the flu can result in pneumonia and other severe medical issues.

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OTC Treatment Options for Cold and Flu Symptoms

Whether you have a simple cold or the flu, chances are that you feel pretty unwell and want to get better as quickly as possible. Luckily, there are plenty of OTC medicines that will get you back to your normal healthy self in no time.

Following is a guide to the best cold and flu medicine to take, depending on which symptom(s) you are experiencing. You might find it useful to first download the K Health app and chat with a doctor in order to better understand the options.

The main symptoms for which I will share treatment options are:

Note that it’s important to carefully follow the instructions on the labels of any medication you take. Many cough and cold medicines contain the same active ingredients so you also want to avoid “double dosing.”


There are two different categories of cough medicines. The first, called antitussives, works by stopping the cough reflex and therefore preventing you from coughing. The other type is expectorants, which thin the mucus in your lungs and make it easier to cough up and remove from your body.


The most common antitussive is dextromethorphan and it’s found in medicines like Triaminic Cold and Cough, Robitussin Cough, and Vicks 44 Cough and Cold. Studies show mixed data about whether or not cough suppressants are actually effective, and because coughing is a natural reflex and the body’s way of removing something that doesn’t belong in the lungs, some say it is preferable not to take these medicines. Among those who do recommend antitussives, many suggest taking it at night, so you can sleep without waking up from coughing.


The most common expectorant is called guaifenesin and it’s found in Mucinex and Robitussin Chest Congestion. Expectorants are used if you have significant congestion in your chest and are having difficulty coughing it up. By thinning the mucus in your lungs, they make your coughs productive so that you can clear your congestion.

Nasal Congestion

Phenylephrine and pseudoephedrine are the main ingredients in decongestants and come in either liquid or pill form, or as a nasal spray. Decongestants work by narrowing the blood vessels, reducing the amount of blood that flows through a given area. This shrinks the swollen tissue inside the nose so that air can pass through more freely and you can breathe easier.


This is the active ingredient in medications such as Sudafed. While effective at relieving congestion, it can cause uncomfortable side effects including insomnia, nervousness, and irritability. Women who are pregnant and people with high blood pressure should avoid this type of decongestant.


This is found in Sudafed PE and Triaminic and may have similar side effects to pseudoephedrine. The same precautions apply.

While some studies have shown that pseudoephedrine is more effective than phenylephrine in clearing up nasal congestion, there has been a move by some drug companies to use phenylephrine instead of pseudoephedrine in medications. Pseudoephedrine can be used to make methamphetamine, a highly addictive drug, and so as part of an effort in the United States to prevent the production of methamphetamine, drugs containing pseudoephedrine are kept behind the counter in pharmacies. While no prescription is required, you do need to show identification in order to obtain it.

Nasal spray

Oxymetolazine is another decongestant that comes in the form of a nasal spray under the brand name Afrin. Should you choose to use a nasal spray, limit the use to three days to avoid developing a dependency. If your body does become dependent on nasal decongestants, you may experience what is known as the “rebound effect,” in which your nose will feel increasingly stuffed up and congested when you stop using the spray.

Runny Nose


We all know how annoying it is when your nose is constantly running! One way to treat this symptom is by using an antihistamine. Histamine is a chemical produced by the body in response to a perceived threat, and causes blood vessels to expand as a means of protection. For people with allergies, the “threat” is actually something benign, and the histamine produced in response brings with it a runny nose, rash, and sneezing. Antihistamines block the action of this chemical, and the same antihistamines that are used to stop or prevent allergy attacks can also be useful in stopping a runny nose caused by a cold or flu.

First Generation vs. Second Generation Antihistamines

There are two types of antihistamines known as ”first generation” and “second generation.” The newer, second generation antihistamines do not cross the blood-brain barrier and therefore do not cause sedation in the same way that first generation drugs do.

One common first-generation antihistamine is diphenhydramine, which is the active ingredient in Benadryl. It is important to keep in mind that diphenhydramine can cause fatigue or drowsiness, and you should take extra caution if you are doing something that requires you to be alert, such as driving or operating machinery. In some cases, it can also impact cognitive functioning and memory. Common second-generation antihistamines include loratadine, the active ingredient in Claritin, and cetirizine, the active ingredient in Zyrtec.

Sinus Pain

A cold or flu can cause sinus pain, which you may experience as pressure across your face and forehead. Sometimes, this can turn into full-fledged sinusitis which may require antibiotic treatment, but often OTC medications will be able to ease the pain.

The best OTC medicines for sinus pain include:

Saline Nose Spray: You can spray saline into your nose several times a day to clear out your nasal passages and minimize discomfort.

Nasal corticosteroids: These are also nasal sprays that contain medication that prevents and treats inflammation. One common nasal corticosteroid is fluticasone, the active ingredient in Flonase.

Decongestants: The same decongestants as described above can be used for sinus congestion.

Pain relievers: Acetaminophen (commonly known as Tylenol), ibuprofen (the active ingredient in Advil or Motrin), and aspirin are all good options of OTC medications that can reduce sinus pain. Some of these pain relievers can be found in combination with a decongestant in products specifically designed to combat sinus pressure and pain such as Advil Cold & Sinus and Tylenol Sinus.

Mucolytics: Medicines such as guaifenesin (the active ingredient in Mucinex) work to thin and reduce mucus allowing the sinuses to drain and relieve the pressure.

Fever, Aches, & Pains

When suffering from a cold or the flu, it is par for the course to have a fever, sore joints, headache, sore throat, and just a general achy feeling. The best thing to do for fever or any sort of pain is to take an analgesic (pain reliever). The most common pain relievers are acetaminophen (Tylenol), ibuprofen (Advil), or naproxen (Naproysn). It is important to follow the dosing instructions on the package and to be careful when combining pain relievers with other OTC cold and flu medications as you do not want to overdose on the active ingredients.

Multi-Symptom Medications

Most of the time when you are suffering from a cold or the flu, you will have a myriad of symptoms and you may want to take one medication that can address them all. There are many different options including:

  • Tylenol Cold: Combines acetaminophen, dextromethorphan, and phenylephrine, and therefore helps with fever, aches, cough, and congestion.
  • Aleve Cold and Sinus: Contains naproxen and pseudoephedrine to relieve fever, aches, and congestion.
  • Vicks DayQuil: A mixture of acetaminophen, dextromethorphan, and phenylephrine to combat pain, fever, cough, and nasal congestion.

The cold and flu aisle at your local pharmacy is likely to have a huge assortment of potential remedies for you. Now that you know the names of the active ingredients and the symptoms each one treats, you can check the labels on different medications and choose the one that suits your needs. If you have questions, feel free to download the K Health App and discuss with a doctor.

In general, there are few severe consequences for otherwise-healthy adults when it comes to taking cold or flu medications. There are cases when OTC cold or cough medicines can have life-threatening side effects for children, so it is very important that you consult with your child’s pediatrician before giving them medicine.

For adults, the most important things to remember are:

  • Follow the dosage instructions and do not take more than recommended.
  • Check with your doctor if you take any prescription medications to make sure that they won’t negatively interact with OTC cold or flu medicine.
  • Do not take more than one medication with the same active ingredient at the same time.

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When Are Antibiotics Necessary?

The truth is that most colds and flus are caused by viruses not bacteria, so antibiotics will not help. If you are diagnosed with the flu, your doctor may prescribe an antiviral medication such as Tamiflu. This will not cure you, but it can make the symptoms less severe and help you recover more quickly. This type of medication is most effective if you can take it within the first 48-hours of experiencing symptoms.

If a cold or flu is accompanied by sinus pain that ends up being a bacterial sinus infection—diagnosed by a nasal swab and/or physical exam—you will be prescribed antibiotics. You would most likely be given amoxicillin or a combination that includes amoxicillin (found in brands like Moxatag or Augmentin). Remember that with antibiotics, it is important that you finish the entire course of treatment even if you are feeling better.

Natural Remedies for Cold and Flu

If you do not want to take traditional medications for your cold or flu symptoms, there are many natural remedies proven to be just as effective. Check out our article on natural cold and flu remedies.

Cold and Flu Prevention

Of course the ideal way to get through cold and flu season is to avoid getting sick to begin with. While there are no guarantees, there are a few basic steps you can take:

  • Avoid the spread of germs by washing your hands often with soap.
  • Boost your immune system by eating healthy, exercising, and getting enough sleep.
  • When you cough or sneeze, do it into the inside of your elbow instead of your hand.
  • Regularly clean common-area surfaces such as tables, toys, door handles, and bathrooms.

While there is no vaccine to prevent the common cold, it is recommended to get the flu vaccine each year, particularly for people who are pregnant, have compromised immune systems, or work with children. The vaccine, available either as a shot or a nasal spray, helps your body to respond by building antibodies that will protect you from the flu. Because there are different strains of the flu, even getting the vaccine is not a 100% guarantee of protection, but studies show that it can reduce the risk by 40-60%.

When to See a Doctor

Usually a cold or even the flu will go away on its own after 7-10 days, but if you experience any of the following more serious symptoms, you should contact your doctor as they may indicate the need for medical intervention:

  • A fever above 102° F (38.9°C) alongside fatigue and body aches
  • Symptoms that last for more than 7-10 days
  • Difficulty breathing
  • Chest pain or pressure
  • Fainting
  • Confusion or disorientation
  • Persistent vomiting
  • Severe sinus pain
  • Swollen glands in neck or jaw

How K Health Can Help

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K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Edo Paz, MD

Edo Paz is the VP of Medical at K Health. Dr. Paz has two degrees in chemistry from Harvard and earned his medical degree from Columbia University. He did his medical training in internal medicine and cardiology at New York-Presbyterian. In addition to his work at K Health, Dr. Paz is a cardiologist at White Plains Hospital, part of the Montefiore Health System. 

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