Good medicine for cough and runny nose

We can send a man to the moon, but we can’t find a cure for the common cold. Still, there are plenty of meds to make waiting it out a little less miserable. In fact, there are so many over-the-counter medications available to treat cold symptoms that sifting through them all can feel overwhelming.

The best place to start? Identify your key symptoms: Is your cold making you congested? Do you have a runny nose? Are you dealing with a fever as well?

From there, you’ll probably be able to figure out which of these categories of over-the-counter cold medications is right for you.

Oral decongestants

When you’re feeling blocked up and stuffy from a cold or a sinus infection, the tissues and blood vessels of your nasal passages and sinuses swell up. “Decongestants work by shrinking the swelling inside your nose, helping you breathe better, says Benjamin Tweel, MD, an otolaryngologist at The Mount Sinai Hospital. There are two main types of decongestants. The first being oral decongestants—including pills and syrups—which typically utilize the ingredients phenylephrine and pseudoephedrine.

Regular Sudafed relies on pseudoephedrine to narrow the swollen blood vessels in your sinuses and nasal passageways. This non-drowsy formula offers temporary relief, and adults can take two tablets every four to six hours. You will have to ask a pharmacist for regular Sudafed from behind the pharmacy counter, since pseudoephedrine is tightly regulated by the FDA. You can buy Sudafed PE straight from the shelf, since it only contains phenylephrine (it doesn’t have as strong of an effect, though).

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Topical decongestants

Topical decongestants, on the other hand, come in the form of nose drops and nasal sprays. The most common ingredients you’ll find are oxymetazoline and phenylephrine. Topical treatments work faster and are stronger than their oral counterparts, but generally shouldn’t be used for more than three days because of the risk of rebound nasal congestion, which makes things worse.

Just like oral decongestants, Vicks Sinex works by shrinking swollen nasal membranes. But thanks to the direct contact of the active ingredient, oxymetazoline, relief lasts longer: 10 to 12 hours. As it starts to work, it may cause temporary stinging, burning, or sneezing—but you’ll be breathing more comfortably in no time.

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Expectorants

Expectorants, most often in the form of a drug called guaifenesin, work by thinning and loosening mucus in the chest, allowing you to more easily cough it up.

Using an extended-release form of guaifenesin, Mucinex tablets offer up to 12 hours of relief from chest congestion. It works mainly by thinning and loosening mucus in the chest so that you can cough it up, but can aid nasal congestion as well.

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Essentially a Walgreens version of Mucinex, Wal-Tussin also works by using guaifenesin to loosen and thin mucus in the chest. The main difference is that Wal-Tussin is available in liquid form. Plus, it’s non-drowsy and alcohol-free.

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Cough suppressants

Rather than help you expel phlegm from your lungs, cough suppressants target the part of your brain responsible for coughing, working to stop coughing altogether. Dr. Tweel explains the most common active ingredient in over-the-counter cough suppressants is dextromethorphan, abbreviated as “DM” at the end of many brand names.

Available in various flavors, this oral suspension liquid medication both soothes your throat and uses an active ingredient called dextromethorphan to stop you from coughing. As the name suggests, relief should last for 12 hours. The formulation is alcohol-free, but contains sodium metabisulfite, which some people are allergic to.

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Delsym is another great extended-release liquid cough suppressant and comes in flavors like orange and grape. It also uses dextromethorphan to offer cough relief for 12 hours. Unlike Robitussin, Delsym is free of sulfites. It’s also alcohol-free.

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General pain relievers and fever reducers

Standard pain relief medication, like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), can help with the body aches and potential fevers that your cold may bring.

Aleve is a NSAID that can relieve minor body aches and pains, temporarily reduce fever, and reduce inflammation (perhaps in the case of any sore throat that may come along with your cold). One capsule will last you 12 hours. Just don’t overdo it; heavy use of NSAIDs can be tough on the stomach.

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Using acetaminophen to soothe pain and reduce fever, Tylenol can be easier on the stomach than a NSAID, and the rapid-release formulation will get to work quicker. Note that it does not treat inflammation, and will need to be taken more frequently: two gelcaps every six hours.

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Combination drugs

If you don’t feel like you can neatly classify your symptoms into one category, know that many cold medicines serve multiple purposes. For example, you can buy a combination decongestant and expectorant, or a combination cough suppressant and fever-reducer. There’s usually a drug to match all your symptoms.

“As simple as it sounds, when I have a patient who has an upper respiratory infection, if I’m not concerned about a bacterial sinus infection (which would require antibiotics), I’ll usually just ask them to go to the pharmacy to find the box that matches their symptoms,” says Dr. Tweel.

Robitussin DM contains both dextromethorphan (a cough suppressant) and guaifenesin (an expectorant). “The expectorant thins mucus and promotes clearance of secretions, helping with the appropriate removal of excess mucus [through coughing],” says Dr. Tweel. “If there’s mucus that needs to be brought up, you’ll still cough. If there’s no mucus but your body is overreacting, the cough suppressant will suppress this overreaction.”

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If nasal congestion is paired with a fever or sore throat, you’re going to want a drug that can pull off double duty. These Advil tablets use phenylephrine (the decongestant you don’t have to ask a pharmacist for) to help you breathe better and ibuprofen to reduce fever and relieve any pain. You can take one tablet up to every four hours.

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A note on antihistamines

While antihistamines like chlorpheniramine and diphenhydramine can treat sneezing, runny nose, and watery eyes, they’re intended to treat those symptoms when they’re caused by allergies. “If you have a cold or a sinus infection, antihistamines may make it more difficult to treat,” says Dr. Tweel. “I haven’t found them to be significant in my practice. Plus, there’s a teaching you shouldn’t use antihistamines for a cold.”

Sometimes, above all, you just need a good night’s sleep. NyQuil packs a powerful punch, using dextromethorphan to keep coughing at bay and acetaminophen to soothe sore throat, headache, and/or fever. While antihistamines generally aren’t recommended to treat cold symptoms, in this case, the drowsy effect will help get you to sleep.

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Anisa Arsenault is a New York City-based writer and editor covering health, lifestyle, and parenting news.