How Do You Treat a Cold or the Flu? Medications, Home Remedies, and Other Treatment Options

Colds are the main reason adults miss work and children miss school, according to the Centers for Disease Control and Prevention (CDC), with adults averaging two or three colds a year and kids even more.

While the impact of the flu varies year to year, it also has a significant effect on our collective daily life; it resulted in anywhere from 9 million to 45 million illnesses in the United States each year between 2010 and 2020, the CDC estimates.

“Most people can help ease their symptoms by getting plenty of rest and staying well-hydrated with fluids,” says Christopher Ohl, MD, a professor of infectious diseases at Wake Forest School of Medicine in Winston-Salem, North Carolina. “Allowing yourself to rest, especially while you have a fever, also gives your body the strength it needs to fight the virus.”

To prevent dehydration, opt for water, juice, and warm soups, and avoid caffeine and alcohol, the Mayo Clinic advises.

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Over-the-counter (OTC) pain and fever reducers or decongestants can lessen cold and flu symptoms, but they will not cure the underlying viral infection, according to the Cleveland Clinic. Nor can antibiotics, which are only effective against bacterial infections.

The following are some of the many nonprescription products available to ease cold and flu symptoms.

Analgesics (for Pain and Fever)

Acetaminophen (Tylenol) is a top choice. Other popular options are ibuprofen (Advil, Motrin) and naproxen (Aleve).

Be cautious about taking too much acetaminophen, as this can damage the liver. The daily dose should not exceed 4 grams (g) per day, and for people with liver issues, 2 g per day.

“Acetaminophen is included in multiple remedies for cold or sinus symptoms,” says Scott E. Glaser, MD, the president of Pain Specialists of Greater Chicago. “If an individual is not aware of this fact, they may unintentionally expose themselves to amounts of acetaminophen in the danger zone.”

Avoid aspirin. Its use to treat people with viral infections (particularly children and teens) has been linked to a rare condition called Reye’s syndrome, which can harm the brain and liver, notes the Mayo Clinic.

Antihistamines

Diphenhydramine (Benadryl, Sominex) can offer relief for a runny nose, but it can also make you sleepy. Loratadine (Alavert, Claritin) won’t make you drowsy, but it may not be as effective. Other OTC choices include fexofenadine (Allegra), cetirizine (Alleroff, Zyrtec), and levocetirizine (Xyzal).

Decongestants

OTC medications such as pseudoephedrine (Silfedrine, Sudafed) can help with a stuffy nose, but for some people, side effects of pseudoephedrine can include nervousness, insomnia, and irritability. People with uncontrolled high blood pressure should avoid pseudoephedrine, advises the Mayo Clinic.

Nasal Steroids

Over-the-counter medications used for seasonal allergies such as fluticasone can help relieve a runny nose or sinus pressure caused by a cold or the flu.

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Expectorants

Guaifenesin (Mucinex, Tussin) can help thin mucus and phlegm, making it easier to blow your nose or clear chest or throat congestion by coughing.

Cough Suppressants

Dextromethorphan (Robitussin, TheraFlu, Vicks) belongs to a category of medication called antitussives, which can ease coughs, per the Cleveland Clinic.

Sore Throat Treatments

Lozenges such as Cepacol are one OTC remedy.

Other Medications

Products such as NyQuil can help ease discomfort, notes the Cleveland Clinic. Be sure to read the labels to make sure the product matches your symptoms.

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While there isn’t a lot of research to support the effectiveness of herbal remedies for cold and flu, many people believe they can help.

The National Center for Complementary and Integrative Health offers this recap of research on a few popular natural products for cold and flu:

• Zinc Oral forms (lozenges, tablets, or syrup) can reduce the length of colds when taken within 24 hours of the onset of symptoms, but zinc can have side effects such as nausea and other gastrointestinal problems and may interact with other medications.
• Vitamin C Taken regularly, vitamin C does not reduce the likelihood you'll catch a cold and has only a slight impact on the length and severity of an illness. People who take vitamin C only when they’re sick don’t benefit at all.
• Echinacea Research does not support the use of echinacea (an herb) to either prevent or treat colds.
• Probiotics The scientific evidence is weak that probiotics (“good” bacteria found in supplements and certain foods) help prevent colds.

Besides resting and drinking plenty of fluids, the following natural remedies may provide symptom relief for a cold or the flu, according to the Mayo Clinic:

• Eat chicken soup. Warm fluids can be soothing and loosen congestion.
• Adjust a room’s temperature and humidity. The air should be warm but not overheated; if it’s dry, use a humidifier.
• Soothe your throat. Gargling with salted water can ease pain. Tea with honey can also help.
• Use nasal drops or spray. Both the homemade and OTC kinds can relieve nasal congestion, notes the Mayo Clinic.

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The CDC recommends prompt medical attention for people who get the flu and are at high risk of developing complications, such as adults who are 65 and older, pregnant women, and people with chronic conditions such as asthma, diabetes, heart disease, HIV, and cancer. People taking immunosuppressive medications are also at a higher risk for flu complications.

For people in these groups, treatment may include antiviral medications; these prescription drugs are used to battle influenza viruses.

The U.S. Food and Drug Administration (FDA) has approved the following antivirals to treat flu:

• Tamiflu (oseltamivir) is available as a liquid or a capsule, and it can be prescribed for infants who are least 14 days old, children, and adults.
• Relenza (zanamivir) is available as a powder that is inhaled, and it can be prescribed for people who are 7 and older.
• Rapivab (peramivir) is given intravenously, and it can be prescribed for people who are 2 and older.
• Xofluza (baloxavir marboxil) is available as a single-dose pill that can be prescribed for people who are 12 and older.

“Antiviral medications might shorten the duration of symptoms somewhat, but in order for them to be effective, they need to be started in the first two days of illness,” says Dr. Ohl.

The CDC stresses that these drugs are a second line of defense against the flu: A flu vaccine remains the best way to stay healthy.

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What Treatment Options Are Safe During Pregnancy?

According to the Cleveland Clinic, natural remedies like saline nasal drops and warm saltwater gargling are ideal cold and flu treatments during pregnancy.

Vicks VapoRub and cough drops (with the exception of sugar-free cough drops for gestational diabetes that contain blends of herbs or aspartame) are also considered safe during pregnancy.

Women who are pregnant or trying to get pregnant should check with their healthcare provider before taking any drug. While no medication can be considered 100 percent safe for pregnant women, the Cleveland Clinic lists the following as among those generally considered to be okay:

• Acetaminophen
• Diphenhydramine (Benadryl)
• Dextromethorphan (Robitussin)
• Guaifenesin (Mucinex)

Note: Do not take the sustained action (abbreviated on labels as "SA") or multisymptom forms of these drugs.

As for the decongestant pseudoephedrine, the Cleveland Clinic recommends that pregnant women avoid it in the first trimester, while a review published in the journal American Family Physician concluded that women should use it only sparingly later in pregnancy.

If you’re pregnant and you get flu symptoms, call your healthcare provider right away advises the CDC. Pregnant women can take influenza antiviral medication and should begin treatment as soon as possible.

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What Treatment Options Are Safe While Breastfeeding?

Natural remedies like saline nasal drops and warm saltwater gargles are great options for cold and flu treatment while breastfeeding.

In addition, the following drugs are among those generally considered safe, according to the Mayo Clinic, which recommends seeking input from a healthcare provider before taking any medication.

• Analgesics for pain and fever Acetaminophen, ibuprofen, and naproxen — short-term use only
• Antihistamines Loratadine and fexofenadine
• Decongestants Pseudoephedrine — use with caution, as it can decrease milk supply

For breastfeeding mothers with the flu who are at high risk of complications, antiviral medications are considered safe. Oseltamivir is the top choice, notes the CDC, adding that very little of the drug ends up in breast milk.

Additional reporting by Pamela Kaufman.