Many over-the-counter (OTC) products can relieve cold and flu symptoms, such as a runny nose or a cough. However, the variety of products available can sometimes be overwhelming.

When choosing a cold medicine, people need to know which symptoms they want to relieve. Choosing the wrong medication for the symptoms will mean that the remedy does not help.

Cold medicines that address specific symptoms can be helpful. However, some may be unsuitable for people who are pregnant or have chronic health conditions and for young children. Some may also cause side effects.

This article reviews the best cold medicines for a runny or stuffy nose and for a wet or dry cough, as well as the best medicines for children. It also looks at cold medicine interactions and how to treat cold symptoms at home.

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People with a cold or flu may experience a runny nose, or rhinitis. OTC medicine is unlikely to help relieve a runny nose due to a cold.

Topical anticholinergics, such as ipratropium bromide nasal spray, may help reduce a runny nose. However, this medicine requires a prescription from a doctor.

  • For a cold: People aged 5 years and over can use ipratropium 0.06% nasal spray three or four times per day for up to 4 days.
  • For a seasonal allergy: People aged 5 years and over can use ipratropium 0.06% nasal spray four times per day for up to 3 weeks.
  • For year-round allergies: People aged 6 years and over can use ipratropium 0.03% nasal spray two or three times daily.

However, anticholinergics may not be safe for everyone to use. This includes people with some other health conditions, such as glaucoma, and those using certain other medications. A doctor can advise on whether these medicines are suitable for an individual.

Sometimes, a runny nose is a symptom of an allergic reaction. If this symptom is due to an allergy and not a cold, antihistamines may help.

Learn about some home remedies that may help with a runny nose.

Decongestants can help relieve a stuffy nose. OTC decongestants are available in oral, drop, and spray forms.

Pseudoephedrine, present in Sudafed, is an oral decongestant.

It is available without a prescription in many states, but there are restrictions on how much a person can buy because of the risk of dependency and adverse effects.

People need to show photo identification to purchase this drug, and pharmacies must keep people’s details for at least 2 years, according to the Food and Drug Administration (FDA). This medication is suitable only for those aged 6 years and over.

Phenylephrine, present in Sudafed PE, is effective for the short-term relief of nasal congestion and is available on the pharmacy shelf.

In some people, decongestants can cause adverse effects such as insomnia or increases in heart rate or blood pressure.

Topical nasal sprays offer quick relief but may cause rebound congestion with overuse. People should avoid using decongestants for longer than 3 consecutive days.

Some cold medicines contain other ingredients, such as antihistamines. People typically use antihistamines for allergies, but because they can cause drowsiness, manufacturers also add them to nighttime cold and flu formulations. This can help people if they have difficulty falling asleep while they have a cold.

However, adding an antihistamine to a decongestant does not guarantee that a person will fall asleep. Also, people should stop using decongestants at nighttime if they cause insomnia.

Get some tips here for better sleep.

When a person has a cold or flu, they may experience a cough. A “wet” or “productive” cough is one that produces mucus. Doctors do not recommend medicines that suppress cough for people with a wet cough.

People who have a wet cough may take guaifenesin. This is an expectorant that manufacturers claim can help loosen mucus and phlegm.

People with a dry cough — a cough that does not produce mucus — may take a cough suppressant. Dextromethorphan (DXM) is a cough suppressant present in many cold and flu medicines. It acts on parts of the brain to stop a person from coughing. However, taking too much can have adverse effects, including hallucinations.

Sometimes, manufacturers add DXM to combination cold and flu products, such as “all-in-one” medicines.

People must read the full ingredient list to ensure that the medicine fits their symptoms and will not interfere with drugs. A pharmacist can help a person choose a safe product. People should also avoid taking multiple medicines containing the same ingredient — such as acetaminophen — at the same time.

Codeine is present in many cough medications because it suppresses activity in the brain that leads to coughing.

However, the FDA notes that codeine is an opioid drug and can cause dependency. It can also lead to breathing difficulties in some people. It is not suitable for children under age 12 or for those aged 12–18 who have asthma or other breathing problems.

Always check with a doctor or pharmacist before using medicine containing codeine for cough, and follow the instructions on the package. Do not exceed the recommended dose or number of days for use.

People should also avoid mixing different cough suppressants. Both DXM and codeine can cause drowsiness. The side effects of different cough medicines can combine and cause severe fatigue or even respiratory failure.

Cold symptoms in toddlers under 2 years of age may seem alarming to parents and caregivers, but they typically disappear on their own with time. A cold will typically run its course within 1–2 weeks.

The FDA does not recommend many OTC cold medicines for children under age 2, and labels often state that drugs are not suitable for those under age 4. Medicines containing codeine are not suitable for those under age 12 or those aged 12–18 with breathing problems.

Acetaminophen is a fever- and pain-relieving medicine. Pediatric acetaminophen (Tylenol) is usually suitable for children under age 2 under a doctor’s supervision.

Pediatric ibuprofen is also likely safe for children under age 2, but only under a doctor’s supervision. It may cause adverse effects.

Avoid giving adult formulations to children of this age to ensure safe dosing. A pharmacist can help a person select a suitable medicine.

Like adults, children should never take two medicines containing acetaminophen at once.

Sometimes, doctors in neonatal intensive care units may administer ibuprofen to newborns. However, parents and caregivers must avoid giving OTC ibuprofen to babies under age 2 for safety reasons.

The sections below will look at how certain cold medicines can interact with drugs for other health conditions.

Diabetes

People taking multiple medications to regulate their blood sugar levels should speak with a doctor or pharmacist before taking any cold medicines.

Cough syrups often contain sugar. Before taking cough syrup, people with diabetes should read the label to ensure that the product is sugar-free.

High blood pressure

Oral decongestants can raise blood pressure and may be harmful for people with hypertension.

People who have high blood pressure and take blood pressure medications should speak with a doctor or pharmacist before taking cold medicines with a decongestant.

Pregnancy

The most popular pain and fever medicines are acetaminophen, ibuprofen, and aspirin. Ibuprofen and aspirin are nonsteroidal anti-inflammatory drugs (NSAIDs).

Acetaminophen is not an NSAID, and it can treat fever during pregnancy.

However, the FDA does not recommend NSAIDs from week 20 onward, as these medicines may lead to low amniotic fluid.

DXM may not be safe during pregnancy or for children aged 4 years and under.

During pregnancy, people should speak with a doctor before taking oral decongestants. Inhaled decongestants may be a good alternative with correct use.

Anyone who is pregnant or planning to become pregnant may wish to consider getting a flu vaccine. The CDC notes that flu vaccines are safe to receive during pregnancy.

Depression

DXM and decongestants may interact with certain antidepressants, such as monoamine oxidase inhibitors (MAOIs). People taking antidepressants should speak with a doctor or pharmacist about using any cold medicines.

A cold can be uncomfortable, but it will usually resolve on its own with time. OTC medicines may help ease symptoms but will not cure a common cold.

People can also try the following strategies:

  • resting
  • drinking plenty of fluids, especially water, to prevent dehydration
  • avoiding smoking or exposure to tobacco smoke

Some research suggests that honey can soothe coughs. Honey contains antioxidants and may have antibacterial and antiviral properties. However, it is not suitable for children under age 1 because of the risk of botulism.

Ginger can also ease the symptoms of a sore throat.

Learn more about home remedies for a common cold.

Here are some answers to questions people often ask about colds and a runny nose.

What ingredients should you look for to stop a runny nose?

OTC medications will not stop a runny nose, but a doctor may prescribe ipratropium nasal spray 0.06% for people aged 5 years and over with a cold or seasonal allergy. Ipratropium nasal spray 0.03% can help manage an allergy-related runny nose year-round.

How should I take these medications?

Medications for colds, runny noses, and congestion come as tablets, syrups, sprays, and drops. It’s essential to follow the instructions from the doctor or pharmacist and read any instructions that come with the medication.

When should I see a doctor?

People with a cold, flu, or runny nose or nasal congestion should seek medical advice if they have:

  • a high fever of 102.2°F (39°C) or over that does not reduce with ibuprofen or acetaminophen
  • chest pain
  • difficulty breathing
  • swollen lymph nodes
  • severe ear or sinus pain
  • symptoms that do not resolve within 3 weeks

Cold and flu medicines do not cure a common cold or flu, but some preparations may help relieve a runny nose, stuffy nose, and cough.

While many OTC drugs are available, it is essential to check that they are suitable for the individual to use. For instance, people with a dry cough should not take medications for a productive cough, as they may make symptoms worse.

Some OTC medicines may be harmful to children and babies, and some can interact with other medicines and supplements.

People who have chronic health conditions, are pregnant, or are taking other medications should speak with a doctor or pharmacist before taking any OTC medicines.