About Non-prescription ("OTC") Cold Medicines

There are a variety of common upper respiratory conditions like the flu, COVID, and the common cold that share similar symptoms. For most people, these conditions are mild, resolve about a week, and can be treated with self-care, including over-the-counter (OTC, or non-prescription) medications to help relieve symptoms. These symptoms include:

• Runny or stuffy nose
• Sore or scratchy throat
• Cough
• Sneezing
• Body aches
• Headache
• Low grade fever (usually defined as less than 100.3F)

Non-prescription cold medicines contain different types of medications that help relieve cold symptoms. Here are the medication types commonly found in non-prescription cold medicines, what they do, examples of each type, and precautions to know. People with chronic health conditions, including high blood pressure and heart conditions, or taking other medications should check with the healthcare provider before starting new medications. It's important to carefully read and follow the recommended dosage instructions included with OTC medications, including the maximum dosages and when to contact the doctor if symptoms continue.

• Pain Relievers: Pain relievers (also called analgesics) help reduce body aches and headaches associated with the common cold. Common examples of analgesics found in non-prescription cold medicines are:
  • Acetaminophen (such as Tylenol)
  • Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (such as Advil) or naproxen (such as Aleve)
  • Aspirin: Aspirin-containing products should not be given to infants, children, and teenagers due to the risk of Reyes syndrome.
• Decongestants: These medications help unblock the nose and sinuses, reducing nasal congestion. Examples of decongestants include pseudoephedrine. Another decongestant in OTC cold medicines is phenylephrine. However, the FDA states that phenylephrine does not appear to be effective in providing congestion relief. It's also important to note that decongestants can raise blood pressure, so individuals with high blood pressure should consult their doctor before using them.
• Expectorants: These medications help loosen or thin mucus in the chest, making it easier to cough up. Guaifenesin is an example of an expectorant commonly found in non-prescription cold medicines. Drinking plenty of fluids can also help with mucus clearance.
• Cough suppressants: These medications work by blocking the cough reflex, making coughing less likely. Dextromethorphan is a common cough suppressant found in non-prescription cold medicines. However, it's important to note that cough suppressants should not be used if the cough is caused by smoking, emphysema, asthma, pneumonia, or chronic bronchitis because coughing helps clear the lungs.
• Antihistamines: Antihistamines are used in both allergy medications and some cold medicines because they can relieve symptoms like sneezing and runny nose. Examples of antihistamines found in non-prescription cold medicines include:
  • First-generation antihistamines: Examples are chlorpheniramine, diphenhydramine, and doxylamine. These older antihistamines can cause drowsiness, so it's important to be cautious when taking them, especially if driving or operating heavy machinery.
  • Non-sedating or second-generation antihistamines: Examples include cetirizine, loratadine, and fexofenadine. These newer antihistamines cause less drowsiness. Some people may still experience drowsiness, so it is important to be sure drowsiness doesn’t occur before driving.

It's important to remember that while these medications can provide relief from cold symptoms, they may not cure the underlying viral infection causing the cold symptoms. For certain conditions, such as flu and COVID, healthcare providers may recommend a prescription antiviral for people at higher risk of severe illness. Antibiotics are not effective for these conditions. If symptoms worsen, it is important to contact the healthcare provider to be diagnosed and for individualized advice.

Remember to carefully read and follow the instructions on the medication packaging for proper use and dosage information. If you have any questions or concerns about which medication is right for you or your child, dosing, or possible side effects, it's best to consult with a healthcare professional for personalized advice.