UK HealthCast: What over-the-counter medications are best for colds?

UK HealthCast is a podcast series featuring interviews with UK HealthCare experts on a variety of health-related topics.

Cold and flu season is here, and for many households, that means an inevitable wave of sniffles, coughs, fevers and misinformation.

While cold and flu viruses differ, they share one major trait: they spread easily. Dr. Michael Hall sees this firsthand as the parent of three school-aged children; viruses come home from classrooms and can quickly affect the whole family. 

Dr. Hall, a family medicine physician, joined UK HealthCast to discuss effective ways to slow the spread of viruses, which over-the-counter medicines to use and avoid depending on your symptoms, and when you should consider seeking help from a provider.

Watch Dr. Hall’s conversation below or continue reading for key takeaways from that conversation.

Myths about cold and flu medications

Good hand hygiene remains one of the simplest and most effective ways to slow transmission. Clean surfaces, wash hands thoroughly, and cover sneezes or coughs with your elbow to limit droplets that can spread illness.

But all the precautions in the world can’t guarantee you or a loved one won’t get sick, so it’s good to know how you can treat common illnesses at home.

One of the biggest issues Dr. Hall sees is confusion about what people are actually taking. Many “cold and flu” combo products include multiple ingredients — such as Sudafed, acetaminophen, ibuprofen, antihistamines or cough suppressants — and people often don’t realize what’s in them. That leads to accidental doubling-up on medications or using the wrong product for your symptoms.

Brands can also be misleading. For example, Mucinex and Robitussin both contain guaifenesin, an expectorant that thins mucus, even though one sounds like a chest product and the other like a cough syrup. 

Is there an OTC treatment for the flu?

While vitamins like C, D, and zinc may support immune health, Dr. Hall emphasizes that true flu treatments are prescription-only. Tamiflu, taken for five days, shortens symptoms by about a day. 

XOFLUZA is a one-dose option that brings improvement within 24 hours, though it can be more expensive

Which OTC medications work for colds?

According to Dr. Hall, the first step is understanding whether your cold symptoms are sinus-related, chest-related or systemic (symptom such as fever, aches and fatigue).

• For sinus congestion and drainage: Products that “dry up” the sinuses can help. Antihistamines and certain decongestants reduce mucus and ease the post-nasal drip that leads to nighttime coughing. Nasal sprays that reduce inflammation can also provide relief but be cautious with sprays like oxymetazoline, which can cause rebound symptoms if used too long.
• For chest congestion and bronchitis-like symptoms: Avoid drying medications. Chest congestion requires the opposite approach: thinning the mucus, not stopping it. Guaifenesin (e.g., Mucinex) helps loosen chest mucus so it can be cleared out, preventing more serious complications like pneumonia.
• For cough: Dextromethorphan is one of the more effective OTC cough suppressants. It’s the “DM” in Mucinex DM and appears in many cough formulations.
• For fever or body aches: Ibuprofen and other NSAIDs tend to work slightly better than acetaminophen, though both are useful.

Early symptom management can make you feel better while your body fights a cold virus. Hydration, nutrition and rest are essential no matter what else you take. OTC products help ease discomfort and prevent mucus buildup that can lead to sinus infections or pneumonia.

Steam, either from a shower or a humidifier, can also loosen mucus and soothe irritated airways. Dr. Hall personally likes menthol or eucalyptus steam for temporary relief.

When to see a doctor

While most colds and even many flu cases resolve on their own, certain symptoms signal the need for medical care:

• Fever lasting longer than 2-3 days
• Trouble staying hydrated or loss of appetite
• Persistent dizziness, especially when standing
• Shortness of breath or worsening chest symptoms
• Thick, discolored mucus that doesn’t improve
• Symptoms lasting more than 7-10 days (possible bacterial infection)

Trust your instincts, Dr. Hall says. If something doesn’t feel right, especially with children or older adults, it’s better to get checked.