Which Cold Medicine Is Right for Me?

When a cold hits, the medicine aisle can feel like a maze.

Do you need a decongestant or an antihistamine? Cough suppressant or expectorant? And what’s the difference between ibuprofen and acetaminophen, anyway?

The truth is, not all cold medicine is created equal — and taking the wrong one can leave you feeling even worse. Whatever your symptoms are, here’s what you need to know.

1. Cough.

The key to choosing the right cough medicine is figuring out if your cough is dry or wet.

If you have a dry, hacking cough that keeps you up at night, you’ll want a cough suppressant.

“Suppressants help quiet a cough by blocking the brain’s cough reflex, which triggers the urge to cough,” says Syed Hussain, MD, medical director of Hartford HealthCare Urgent Care. “These can be found in products like Robitussin DM or Delsym.”

But if your cough is wet and phlegmy, go for an expectorant like guaifenesin.

“Expectorants, like Mucinex, help thin mucus, making it easier to clear from your airways,” Dr. Hussain notes.

Not sure if you should choose cough syrup or a pill?

“Both work the same way, so it really comes down to your preference,” says Dr. Hussain. “Just be sure to follow the label. Typically, you should take cough syrup every four to six hours, or 12 hours for extended-release tablets. And try to avoid taking any cough medication with Sudafed, especially before bedtime or if you have high blood pressure.”

> Related: What to Eat and Drink for a Cold

2. Sore throat.

Is a sore throat making swallowing impossible?

“For quick relief, cough drops with menthol or honey can work wonders,” says Dr. Hussain. “Menthol has a cooling effect that soothes irritation, while honey has natural antibacterial properties.”

And don’t underestimate the power of a good home remedy.

“A saltwater gargle or a warm cup of tea with lemon and honey can be just as effective as store-bought treatments,” says Dr. Hussain.

But for longer term relief, over-the-counter products like acetaminophen or ibuprofen can help.

“Just be sure to see a doctor if your sore throat lasts more than a few days, comes with a fever, or if you notice white patches in your throat,” Dr. Hussain suggests.

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3. Fever.

It’s the age old question: is Advil or Tylenol better for my fever?

Both can help bring a fever down, but there are some key differences.

“Acetaminophen (Tylenol) is typically gentler on the stomach,” says Dr. Hussain. “But ibuprofen (Advil or Motrin) is better for reducing inflammation.”

So, if your fever came with body aches or a sore throat, ibuprofen might be the better choice – unless you have a stomach ache.

Wondering where Aspirin fits into the equation?

“Aspirin can also bring down your fever and pain. But it’s dangerous for children, as it can increase the risk of Reye’s syndrome,” says Dr. Hussain.

> Related: Is It RSV or a Cold?

4. Congestion.

Trying to choose between a decongestant or antihistamine?

“If your nose is blocked, a decongestant like pseudoephedrine (Sudafed) is your best bet,” says Dr. Hussain. “Decongestants shrink swollen blood vessels in your nose, making it easier to breathe. But these can also raise blood pressure, so if you have hypertension, be sure to check with your doctor first.”

If your congestion comes along with sneezing or watery eyes, an antihistamine like diphenhydramine (Benadryl) or loratadine (Claritin) might be the way to go. Just be careful – antihistamines are notorious for causing drowsiness.

“Antihistamines block the body’s allergic response, which can sometimes be triggered by colds,” says Dr. Hussain.

And what about nasal sprays? They work fast but be careful — using sprays like Afrin for more than a few days can lead to rebound congestion and headache.

5. Headache.

The best medication all depends on the type of headache you have.

“If it’s sinus pressure, a decongestant can help relieve it. But if it’s more of a general ache, ibuprofen, acetaminophen, or naproxen (Aleve) are all solid choices,” says Dr. Hussain.

But be careful relying too heavily on pain relievers.

“With long-term use, these can eventually cause rebound headaches,” says Dr. Hussain. “Don’t rely on them for more than a couple days without talking to your doctor.”

Here’s the bottom line.

Picking a cold medicine might seem confusing, but it doesn’t have to be.

“The key is matching your symptoms to the right ingredients — whether it’s a suppressant for a dry cough, a decongestant for congestion, or ibuprofen for a fever,” says Dr. Hussain.

And when in doubt? Check in with your doctor to make sure you’re making the right choice.

“Although most colds clear up on their own, there are times when you’ll need medication prescribed,” Dr. Hussain notes.

It’s time to see a doctor if you have:

• A fever over 102°F that doesn’t improve
• Shortness of breath or chest pain
• Symptoms lasting longer than 7-10 days
• Severe facial pain or swelling, which could indicate a sinus infection

The next time a cold sneak up on you, don’t let the medicine aisle overwhelm you. Knowing what to take — and what to skip — can help you feel better, faster. So grab your tissues, pick the right remedy, and get back to feeling like yourself again!

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