With the arrival of cooler weather here is the season for hacking and sniffling. Once again, ugly-looking people roam the aisles of American pharmacies, clutching tissues and looking for relief — and often coming up empty-handed.
Last year, the FDA recommended that phenylephrine, a decongestant in many popular cold medications that has been shown to be ineffective when taken orally, be removed from pharmacy shelves. (It will take some time (For that to happen, which explains why you can still find the ingredient in NyQuil and other cold medicines.) But that doesn’t mean all the other syrups and gels and tablets available for purchase are effective. In fact, most over-the-counter cold medications do little to ease the symptoms that cause us most misery during respiratory virus season.
Still, there are some exceptions worth knowing, as well as several non-pharmaceutical interventions that may ease your suffering while you wait. And it’s wise to be aware of ways to avoid catching ick in the beginning or spreading it to others.
Let’s get this out of the way: You can prevent and treat some viral causes of cold symptoms
Cold symptoms are often caused by viruses for which we do not have vaccines, simple or inexpensive tests, and antiviral drugs. However, there are some important exceptions: Covid and flu can be prevented with vaccines, and there is an RSV vaccine for children and adults 65 years of age and older. All of these viruses can be detected with tests, and there are drugs such as Tamiflu (oseltamivir) and Paxlovide (nimetrelvir-ritonavir) to help reduce the severity of flu and Covid infections in certain groups of people, respectively. Talk to a doctor to find out if these are right for you.
It is also worth taking some preventive measures. Hand washing in shared spaces, ventilation and filtering air, strategic masking, and distancing from sick people can all help prevent illness. Even if these practices only reduce the viral dose you receive, it can still make for a less uncomfortable cold season; As with many viral illnesses, the dose produces the poison.
Reach for this, not that
People with colds do not need to take medicine. If your fever doesn’t last more than three days or you don’t have other symptoms like shortness of breath, cold symptoms are usually not signs of an underlying illness that needs treatment. However, many people want to feel better when they have a cold, and they especially want better rest than a runny nose or a sticky cough.
If that’s you, it’s wise to be selective when choosing a cold medicine, as not everything marketed to you is likely to be equally helpful. Here’s what’s proven to work:
Pain and fever reducer
Medicines that reduce pain and inflammation — the Tylenol or ibuprofen you usually use when you have a headache — can relieve the fever, aches and pains that accompany a cold, some fatigue and even some sneezing. Children, including infants, can safely take these medications in weight-appropriate doses; Check the packaging to make sure you are giving the correct amount.
Decongestants and antihistamines
For adults with stuffy noses, the only thing to bother with is a decongestant PseudoephedrineActive ingredients in regular Sudafed. Confusingly, this is not the active ingredient in Sudafed PE, which contains the soon-to-be discontinued phenylephrine. Because of its illegal use in the manufacture of methamphetamine, pseudoephedrine is kept behind the counter and only sold to consumers in limited quantities. You need to ask the pharmacist for this.
There is evidence that pseudoephedrine may work better in treating snot-related symptoms Combined with an antihistamine. But the antihistamines in your allergy medicine (Zyrtec, Allegra, and Claritin) won’t be as effective for colds; Most combination cold medicine variations are usually outdated, which is what it seems good job For nasal symptoms caused by viruses.
Decongestants and antihistamines Not safe for children under 6 years of age and older children should be used with caution.
It is not uncommon for people using these medications to experience side effects such as drowsiness, dry mouth, and trouble sleeping. Additionally, they are not safe for use by people with high blood pressure, glaucoma, kidney disease and other conditions. People with pre-existing conditions and those taking certain medications, including some antidepressants, should check with a healthcare practitioner or pharmacist before taking these medications.
Nasal sprays and inhalers
Nasal sprays or inhalers that contain some anti-nasal ingredient have been shown to make coughs and colds a little less miserable. Active ingredients are looked for Cromolyn sodium (in over-the-counter brands like Nasalchrome) and ipratropium bromide (Atrovent is only available as a prescription). They have not been studied in children under 6, so again, only use them according to package directions for older children.
Many people also find relief from saline nasal sprays and Nasal irrigationBut make sure you follow the instructions on the package to avoid the risk of other infections.
Cough medicine
When it comes to cough medicine in particular, a 2014 review Studies have found little evidence to suggest they are effective. This category includes medicines advertised as cough suppressants (eg Dextromethorphanwhich are thought to reduce the frequency of coughing) or expectorant medicines (eg guaifenesinwhich theoretically makes the cough more effective at extracting the gun). Plus, this can be medication Dangerous for small childrenand is not recommended for children under 6 years of age.
It is worth noting that in small but well-designed studies, including one conducted by a pharmaceutical company, dextromethorphan slightly The cough has subsided Both adults and Older children. Overdose It can be dangerous, though, and the benefit is so small that most experts don’t think it’s worth the trade-off so generally don’t recommend it to patients. However, if you find this medicine helpful, it is safe to use in moderation. Choose formulations that contain only dextromethorphan (rather than combination drugs) and take them according to package directions.
Honey, zinc and vitamin C
There is evidence that a few teaspoons honey By reducing nighttime coughs, it’s a safer and more cost-effective choice than cough medicine for most people (note that honey is not safe for children under one year old). In addition, Oral zinc Some people can shorten the time they experience cold symptoms after infection, although the bad taste and nausea may not benefit some people. (Avoid nasal zinc; overdose can cause permanent loss of smell.) There is some evidence that very active people take high doses of vitamin C—one gram per day for one week. Smaller and less severe coldsBut it’s not entirely clear whether the effect translates to people with normal activity levels.
There is help beyond cold medicine
Some of the most effective cold treatments you can do are free, more or less. Sleeping on plenty of pillows can help reduce nighttime coughing and congestion by allowing gravity to drain all the excess gunk from your nose, sinuses, and throat down. You can even raise the head of your bed by placing bricks or cinder blocks under the upper legs.
getting Get plenty of rest Regularly — eight hours a night or more — can make cold symptoms less severe if you’re infected and help you fight off a cold. Boosting your immune system. Drink plenty of fluids to avoid dehydration, keep your mucous membranes nice and moist, and loosen all the sticky stuff.
Routine viral coughs and colds are usually worst for the first three to five days, and you may have a fever for the first two to three days. However, it’s common for mild symptoms to linger, even if they don’t indicate anything bad: a cold and congestion can hang around for seven to 10 days, and a post-viral cough (usually due to persistent irritation) can last up to three weeks.
If things aren’t going well, it may be time to get professional help. Contact a health care provider — whether it’s your primary care physician or someone at your neighborhood urgent care clinic — if you have a fever for more than three days or if you have severe symptoms such as shortness of breath, sore throat, can’t stay hydrated, persistent dizziness, or Difficulty getting out of bed.
Cold symptoms can be caused by conditions other than viral infections: seasonal allergies can also strike in the winter, and bacterial infections of the ears, sinuses, upper airways, and lungs can start with symptoms that look a lot like a bad cold. So if you have anything else going on that seems unusual or concerning to you, contact a provider to determine if it’s something that requires more than usual home care.
