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When youâre feeling awful because of a cold, you just want something to fix youâif not to cure you, at least to help you temporarily feel better. Unfortunately a lot of remedies are placebos, but some things in the drugstore work better than others.
Before we talk about which medicines are best, here's an important note to consider: Cold medicines do not cure your cold, nor do they shorten its duration. If you're reading this because you want to know how to get rid of a cold fast, or what a doctor would prescribe you to get rid of a coldâsorry. Colds are caused by viruses, and there's no medication that will kill them off the way that antibiotics can kill off bacteria. The point of cold medicines is to help you be a little less miserable while you wait for your immune system to fight it off.
The companies that make cold medicines rely on our stuffy-headed memories. If you bought Sudafed (or Mucinex, or Dayquil) the last time you had a cold, they hope you'll buy the same thing this time, while makers of store brands are hoping you buy something the same color and figure it's good enough. But the brand name tells you next to nothing about what's actually inside the package.
Each of the major cold medicine brands sells a variety of products with completely different ingredients. Sometimes, there are so many that the same brand will sell the same thing under two different names. My favorite example of this is the labyrinth of Mucinex products: Their Maximum Strength Fast-Max Severe Congestion and Cough has the same dosage and ingredients as their Maximum Strength Sinus-Max Pressure, Pain, & Cough. Meanwhile, Maximum Strength Sinus-Max Severe Congestion & Painâwhich sounds like it should be very similar to the other Sinus-Max productâtakes out a cough-related ingredient and swaps in some acetaminophen (that's Tylenol). You are never going to have much luck navigating the cough and cold aisle on brand names and symptoms alone.
So where to go instead? Well, for quick relief of congestion, you'll need the good stuff they keep behind the counter.
If you have a stuffy nose, pseudoephedrine is the real deal. In the old days, you could find it on the store shelves. Sudafed was one brand name. (Sudafed, pseudoephedrine, get it?) But pseudoephedrine can be converted into methamphetamine, so a 2006 law restricted its sale. It's still an over the counter medication, but you'll need to take the time to show your ID to the pharmacist if you want to buy some.
Studies have shown pseudoephedrine to be effective at clearing nasal congestion. When you feel like your nose is âstuffedâ with dried or gooey mucus, thatâs not literally true. Blood vessels in the lining of your nose and sinuses swell up, and thatâs what narrows the air passages. Pseudoephedrine makes those blood vessels constrict, reducing the swelling and opening your airways so you can breathe easier.
(Pseudoephedrine also constricts blood vessels in other parts of the body, which is why it can increase blood pressure in some people, and why it is sometimes used off-label for priapism, also known as prolonged erections.)
Phenylephrine is the decongestant that replaced pseudoephedrine in over-the-counter products. Phenylephrine, the "PE" ingredient, has been known for years to be useless at treating cold symptoms when taken by mouth. This led two pharmacists to write a paper in 2022 entitled âWhy Is Oral Phenylephrine on the Market After Compelling Evidence of Its Ineffectiveness as a Decongestant?â) Finally, as of November 2024, the FDA agreed that phenylephrine products will (eventually) be removed from store shelves.
Phenylephrine is whatâs in Sudafed PE. This is another case of brand names leading you astrayâregular Sudafed is the good stuff, but Sudafed PE has the ineffective ingredient. Donât be fooledâanything with a PE in the name won't work.
But that's not the only cold medicine that probably does little to nothing for your cold. The "active" ingredients in cough medicines are probably useless too. Dextromethorphan is considered a cough suppressant, though there's not much evidence to suggest it actually does its job. Nor does guaifenesin, an âexpectorantâ thatâs intended to thin out mucus to make it easier to cough up. A Cochrane review concluded that thereâs not enough evidence to say whether these or any other over-the-counter cough medicines actually work.
By the way, children under 4 years of age should not use any of the cough or cold medicines weâve mentioned so far, according to the FDA. Fortunately, home remedies like drinking fluids and getting their snot sucked out with a bulb syringe are safe, and tend to bring actual relief.
There is one more category of over-the-counter medicines that may actually help you feel better when you have a cold, although theyâre probably not what youâre thinking of when you think of cold medicines.
Acetaminophen (regular Tylenol) and ibuprofen (Motrin or Advil) are known as pain relievers and fever reducers. They do work for these jobs, and they are considered safe to use even in young children. That said, the American Academy of Pediatrics warns that you should always contact your pediatrician for a fever in a baby less than 3 months old, and not give medication unless directed, since fevers at that age can be life threatening and need to be evaluated in a healthcare setting.
If youâre used to looking at brand names, please make sure you turn the package around and make sure it contains what youâre expecting on the ingredients list. Regular Tylenol is just acetaminophen, but the company also makes a Tylenol Cold and Flu that contains all three of the ingredients mentioned above that do not work for colds or coughs. Advil makes a similar product. These arenât the ones you want.
Another important note: Tylenol, or acetaminophen, is in a lot of cold medicines as part of a mixture of ingredients. Itâs also potentially toxic if you take more than the recommended amount. If youâre combining medications, make sure youâre not double-dosing on this ingredient.
So you have a decongestant that works (pseudoephedrine), and something to bring your fever and headache under control (acetaminophen or ibuprofen). Is there anything we can do about that nasty cough? There is, but youâll want to leave the pharmacy aisles and head over to the grocery shelves.
Honey isnât going to cure your cold, but it seems to soothe sore throats and relieve coughing, at least a little bit. Studies often show it works better than over-the-counter cough syrups. (Is this because honey is great or because cough syrups kind of suck? Possibly the latter, to be honest.) But donât bother with honey-based cough syrupsâyes, these are a thingâjust grab some actual honey and mix it into some hot water or tea. Thatâs cheaper and easier.
An important caveat on honey, by the way: honey is not considered safe to give to babies under 1 year old. Thereâs a small risk of botulism, and babies are particularly susceptible. Honey isnât going to help that much, so itâs not worth the risk.
Pretty much every âchildrenâsâ cold medicine is garbage. After all, the ones with decongestants and antihistamines arenât considered safe for kids under 4. But since youâre in the medicine aisle anyway, ânaturalâ brands are there to fill that gap with concoctions of vitamins, honey, and herbal supplements. These donât really do anything, either, but somehow they cost like eight bucks a bottle.
But it gets worse. In both the kidsâ and adultsâ sections, youâll find homeopathic remedies, which are pretty much scams and should be illegal. Watch out for anything that says âhomeopathicâ or that has ingredients measured in âXâ or âCâ instead of a real unit like milligrams. These arenât simply natural supplements, as the labels sometimes suggest, and homeopathy is not another word for home remedy. Homeopathic âdrugsâ are beneficiaries of a bizarre loophole in FDA and FTC policy that allows them to be marketed as drugs while claiming to work by magic. I wish I were making this up, but Iâm not. Save your money.
Full story here:
When youâre feeling awful because of a cold, you just want something to fix youâif not to cure you, at least to help you temporarily feel better. Unfortunately a lot of remedies are placebos, but some things in the drugstore work better than others.
Before we talk about which medicines are best, here's an important note to consider: Cold medicines do not cure your cold, nor do they shorten its duration. If you're reading this because you want to know how to get rid of a cold fast, or what a doctor would prescribe you to get rid of a coldâsorry. Colds are caused by viruses, and there's no medication that will kill them off the way that antibiotics can kill off bacteria. The point of cold medicines is to help you be a little less miserable while you wait for your immune system to fight it off.
Ignore brand names on cold medicines
The companies that make cold medicines rely on our stuffy-headed memories. If you bought Sudafed (or Mucinex, or Dayquil) the last time you had a cold, they hope you'll buy the same thing this time, while makers of store brands are hoping you buy something the same color and figure it's good enough. But the brand name tells you next to nothing about what's actually inside the package.
Each of the major cold medicine brands sells a variety of products with completely different ingredients. Sometimes, there are so many that the same brand will sell the same thing under two different names. My favorite example of this is the labyrinth of Mucinex products: Their Maximum Strength Fast-Max Severe Congestion and Cough has the same dosage and ingredients as their Maximum Strength Sinus-Max Pressure, Pain, & Cough. Meanwhile, Maximum Strength Sinus-Max Severe Congestion & Painâwhich sounds like it should be very similar to the other Sinus-Max productâtakes out a cough-related ingredient and swaps in some acetaminophen (that's Tylenol). You are never going to have much luck navigating the cough and cold aisle on brand names and symptoms alone.
So where to go instead? Well, for quick relief of congestion, you'll need the good stuff they keep behind the counter.
Pseudoephedrine (original Sudafed) is the good stuff
If you have a stuffy nose, pseudoephedrine is the real deal. In the old days, you could find it on the store shelves. Sudafed was one brand name. (Sudafed, pseudoephedrine, get it?) But pseudoephedrine can be converted into methamphetamine, so a 2006 law restricted its sale. It's still an over the counter medication, but you'll need to take the time to show your ID to the pharmacist if you want to buy some.
Studies have shown pseudoephedrine to be effective at clearing nasal congestion. When you feel like your nose is âstuffedâ with dried or gooey mucus, thatâs not literally true. Blood vessels in the lining of your nose and sinuses swell up, and thatâs what narrows the air passages. Pseudoephedrine makes those blood vessels constrict, reducing the swelling and opening your airways so you can breathe easier.
(Pseudoephedrine also constricts blood vessels in other parts of the body, which is why it can increase blood pressure in some people, and why it is sometimes used off-label for priapism, also known as prolonged erections.)
Anything with "PE" in the name isn't worth buying
Phenylephrine is the decongestant that replaced pseudoephedrine in over-the-counter products. Phenylephrine, the "PE" ingredient, has been known for years to be useless at treating cold symptoms when taken by mouth. This led two pharmacists to write a paper in 2022 entitled âWhy Is Oral Phenylephrine on the Market After Compelling Evidence of Its Ineffectiveness as a Decongestant?â) Finally, as of November 2024, the FDA agreed that phenylephrine products will (eventually) be removed from store shelves.
Phenylephrine is whatâs in Sudafed PE. This is another case of brand names leading you astrayâregular Sudafed is the good stuff, but Sudafed PE has the ineffective ingredient. Donât be fooledâanything with a PE in the name won't work.
Most cough medicines don't work, either
But that's not the only cold medicine that probably does little to nothing for your cold. The "active" ingredients in cough medicines are probably useless too. Dextromethorphan is considered a cough suppressant, though there's not much evidence to suggest it actually does its job. Nor does guaifenesin, an âexpectorantâ thatâs intended to thin out mucus to make it easier to cough up. A Cochrane review concluded that thereâs not enough evidence to say whether these or any other over-the-counter cough medicines actually work.
By the way, children under 4 years of age should not use any of the cough or cold medicines weâve mentioned so far, according to the FDA. Fortunately, home remedies like drinking fluids and getting their snot sucked out with a bulb syringe are safe, and tend to bring actual relief.
Tylenol and ibuprofen can help with fevers and pain
There is one more category of over-the-counter medicines that may actually help you feel better when you have a cold, although theyâre probably not what youâre thinking of when you think of cold medicines.
Acetaminophen (regular Tylenol) and ibuprofen (Motrin or Advil) are known as pain relievers and fever reducers. They do work for these jobs, and they are considered safe to use even in young children. That said, the American Academy of Pediatrics warns that you should always contact your pediatrician for a fever in a baby less than 3 months old, and not give medication unless directed, since fevers at that age can be life threatening and need to be evaluated in a healthcare setting.
If youâre used to looking at brand names, please make sure you turn the package around and make sure it contains what youâre expecting on the ingredients list. Regular Tylenol is just acetaminophen, but the company also makes a Tylenol Cold and Flu that contains all three of the ingredients mentioned above that do not work for colds or coughs. Advil makes a similar product. These arenât the ones you want.
Another important note: Tylenol, or acetaminophen, is in a lot of cold medicines as part of a mixture of ingredients. Itâs also potentially toxic if you take more than the recommended amount. If youâre combining medications, make sure youâre not double-dosing on this ingredient.
The best cough syrup is honey
So you have a decongestant that works (pseudoephedrine), and something to bring your fever and headache under control (acetaminophen or ibuprofen). Is there anything we can do about that nasty cough? There is, but youâll want to leave the pharmacy aisles and head over to the grocery shelves.
Honey isnât going to cure your cold, but it seems to soothe sore throats and relieve coughing, at least a little bit. Studies often show it works better than over-the-counter cough syrups. (Is this because honey is great or because cough syrups kind of suck? Possibly the latter, to be honest.) But donât bother with honey-based cough syrupsâyes, these are a thingâjust grab some actual honey and mix it into some hot water or tea. Thatâs cheaper and easier.
An important caveat on honey, by the way: honey is not considered safe to give to babies under 1 year old. Thereâs a small risk of botulism, and babies are particularly susceptible. Honey isnât going to help that much, so itâs not worth the risk.
Children's cold medicines are almost all scams
Pretty much every âchildrenâsâ cold medicine is garbage. After all, the ones with decongestants and antihistamines arenât considered safe for kids under 4. But since youâre in the medicine aisle anyway, ânaturalâ brands are there to fill that gap with concoctions of vitamins, honey, and herbal supplements. These donât really do anything, either, but somehow they cost like eight bucks a bottle.
But it gets worse. In both the kidsâ and adultsâ sections, youâll find homeopathic remedies, which are pretty much scams and should be illegal. Watch out for anything that says âhomeopathicâ or that has ingredients measured in âXâ or âCâ instead of a real unit like milligrams. These arenât simply natural supplements, as the labels sometimes suggest, and homeopathy is not another word for home remedy. Homeopathic âdrugsâ are beneficiaries of a bizarre loophole in FDA and FTC policy that allows them to be marketed as drugs while claiming to work by magic. I wish I were making this up, but Iâm not. Save your money.
Full story here:
![[DK]](/data/avatars/s/57/57999.jpg?1720990206){kind=avatar}
