The Best Over-the-Counter Cold Medicines

Adults experience an average of two to four colds per year, according to a study in the February 2012 "Cochrane Database of Systematic Reviews." The common cold is caused by many different viruses and presents with symptoms like nasal congestion, sneezing, sore throat and cough 1. Without the use of any medication, the average life cycle of most colds is usually seven to 10 days. There is no cure for the common cold, and medications work by different mechanisms to affect the symptoms or duration of a cold. Of the over-the-counter treatments available, antihistamines and decongestants are among the most frequently used, often in combination 2.

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If you are experiencing serious medical symptoms, seek emergency treatment immediately.

Decongestants and Antihistamines

In response to the cold virus, the tissues in the nose swell and increase production of fluid and mucus. Decongestants reduce swelling in the nasal passages, which relieves the feeling of pressure and improves airflow through the nose. Pseudoephedrine (Sudafed) and phenylephrine (Sudafed PE) are popular OTC decongestants. Another class of drugs, antihistamines, work by preventing the body's cells from swelling and leaking fluid in response to the cold virus. Examples include brompheniramine (Bromfed, Dimetapp), chlorpheniramine (Chlor-Trimeton) and diphenhydramine (Benadryl). According to a study published in July 2003 in the "Cochrane Database of Systemic Reviews," decongestants and antihistamines have been shown to work better in combination than when used alone for reduction of general cold symptoms 1. Examples of combination drugs include Actifed (chlorpheniramine and phenylephrine) and Sudafed Sinus and Allergy (chlorpheniramine and pseudoephedrine). These drugs may have side effects, including dizziness, drowsiness, insomnia and dry mouth.


Zinc is a natural element found in cells throughout the body that can aid in reducing infections through its effect on the immune system. Zinc supplements have been studied for their effects on the symptoms and duration of the common cold. A study in the June 2011 "Open Respiratory Medicine" found that people who took oral zinc doses of at least 75 mg per day had significantly shorter colds than those who took lower doses or none at all. The zinc was given in lozenge form, intended to be dissolved slowly in the mouth. Zinc also comes in pill form, with common OTC brands like Zicam and Cold-Eeze. A reported side effect of zinc is a bad taste. In the past, zinc was also available in a nasal spray, but it carried the risk of permanent loss of sense of smell.

Pain Relievers

Pain relievers, also known as analgesics, are some of the most popular OTC medications used in the U.S. Among the most popular are acetaminophen (Tylenol), ibuprofen (Advil, Motrin) and aspirin (Bayer Aspirin, Ecotrin). Analgesics are widely used for common colds because they are thought to relieve associated symptoms such as headaches, ear pain, muscle and joint pain, and the general feeling of discomfort and fatigue. Some believe analgesics have no real benefit for colds, but a study published in the July 2005 "Clinical Therapeutics Journal" showed that aspirin and acetaminophen were both clearly more effective than a placebo against symptoms of a cold like fever, headaches and sore throat 4. The study also showed there was no significant difference between the two drugs in their ability to treat cold symptoms.

Warnings and Precautions

It's important to remember that there may be adverse side effects from the use of OTC cold medications, including drowsiness, which can affect your ability to drive. Check ingredients of combination drugs to avoid possible overdose, especially acetaminophen because it may lead to liver problems. If you are taking prescription medications, talk to your healthcare provider before using a new cold medication to prevent possible interactions. Also talk to your healthcare provider before starting a new OTC cold medication if you have problems like high blood pressure, heart disease or glaucoma. Finally, if your cold symptoms are severe and persist for a long period, see your provider for proper management. If you experience a fever that is not improving after a few days, shortness of breath or are coughing up blood, urgent medical attention is necessary.