Because there is no cure for the common cold, the best thing you can do is ease the symptoms. Over-the-counter (OTC) drugs can help with many different symptoms. However, you likely won’t experience all possible symptoms of a cold during every cold you have, so the drug that you choose will depend on your symptoms.
Nasal decongestants help unclog a congested nose. They work by narrowing the blood vessels in the lining of your nose so the swollen tissue shrinks. Air can then pass through more easily. These drugs can also help dry up postnasal drip.
Nasal decongestants are available as pills, nasal sprays, and liquid drops. Generally, they aren’t recommended for children who are 3 years or younger.
Active ingredients used in OTC nasal decongestants include:
- oxymetazoline nasal (Afrin, Dristan 12-Hour Nasal Spray, Duramist Plus)
- phenylephrine nasal (Neo-Synephrine 12-Hour Spray, Nostril, Rhinall)
- phenylephrine oral (Sudafed PE, Triaminic)
Coughing actually protects the body by expelling unwanted mucus, microbes, and air. However, the urge to cough is a reflex and can sometimes be triggered unnecessarily.
Cough suppressants can help if a cough is interfering with your daily life or sleep. This is why some doctors recommend you take cough suppressants mostly at bedtime. These drugs work by blocking the nerve impulse that causes your cough reflex. They can help give short-term relief from coughing.
The most common over-the-counter cough suppressant is dextromethorphan. It’s the active ingredient in Triaminic Cold and Cough, Robitussin Cough, and Vicks 44 Cough and Cold.
Expectorants help thin and loosen mucus so you can cough it up more easily. This can help your body rid itself of excessive mucus more quickly.
The active ingredient in OTC cough expectorants is guaifenesin. It is found in Mucinex and Robitussin Chest Congestion.
Antihistamines block the release of histamine, which is a natural substance our bodies release when we’re exposed to allergens. Antihistamines may provide some relief of symptoms related to the release of histamine in your body. These can include:
- itchy ears and eyes
- watery eyes
- nasal discharge
Active ingredients in OTC antihistamines include:
- brompheniramine (Dimetane)
- chlorpheniramine (Allerest, Sudafed Plus)
- clemastine (Tavist)
- diphenhydramine (Benadryl)
- doxylamine (Aldex AN)
Antihistamines are often found only in nighttime or PM formulations of cold drugs because they can cause drowsiness. Some healthcare providers advise against using these drugs to treat colds. The drying effect of antihistamines may make it more difficult for your body to remove the virus causing the cold.
Pain relievers help reduce the different types of pain brought on by the common cold, such as:
- muscle aches
- sore throat
The common active ingredients in pain relievers include:
- acetaminophen (Tylenol)
- naproxen sodium (Aleve)
- ibuprofen (Advil, Motrin)
Warnings for use in children
Use caution when giving OTC cold drugs to children. It can be easy to give a child too much, and some OTC cold drugs can have serious side effects. Accidental overdoses can sometimes be fatal. When in doubt about the safety of a cold drug for your child, always talk to your child’s doctor or pharmacist.
Children who are younger than 7 years should never give themselves nasal decongestant sprays. Saline nasal drops are a child-safe alternative that can help ease congestion. Ask your doctor for guidance.
Also, never give aspirin to children. Aspirin has been linked to a rare but life-threatening illness called Reye’s syndrome in children. Instead, try ibuprofen. It’s a safe pain reliever for children who are 6 months or older.
Cold drug precautions
You should always use cold drugs only according to the product recommendations or your healthcare provider’s advice. This helps you use them safely. However, certain cold drugs deserve special consideration:
If you have high blood pressure, talk to your doctor before using nasal decongestants. These drugs can increase your blood pressure level.
Don’t use decongestant nasal sprays or drops for more than five days. These drugs become less effective after this period. Using them longer may cause chronic inflammation of your mucus membranes as a rebound effect.
Acetaminophen can lead to liver damage if you take too much too often over an extended period. Acetaminophen is a standalone drug (such as in Tylenol), but it’s also an ingredient in many OTC drugs. It’s important to read the ingredients of your OTC drugs before taking them together to make sure you don’t take more acetaminophen than is safe.
Is it safe to combine different cold medicines to address all of my symptoms?
Yes, it can be safe to combine different cold medicines to address different symptoms. However, many cold products contain multiple ingredients, so it’s easier to use too much of a single ingredient when you combine these drugs. Talk with your pharmacist or doctor about specific products that are safe to combine to address your symptoms.Philip Gregory, PharmD, MSAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.