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Take Care With Cold Medications

Content provided by the Faculty of the Harvard Medical School
Excerpted from a Harvard Special Health Report

There is no cure for the common cold, and no medication can prevent a cold or make it go away faster. However, some prescription and over-the-counter (OTC) medications may help you feel a little better. As with all drugs, you have to balance the benefits of taking cold medicines with the risks and possible side effects. See the table below for information about these medicines. Some of them may also help relieve flu symptoms.

In general, there is not much difference between OTC cold remedies and those your doctor prescribes for you. The only exception is guaifenesin with codeine (Robitussin AC), available only by prescription, which can help people cough less and sleep better. For most people, it is worthwhile to treat bothersome symptoms if the medication helps them feel better. That said, some experts feel that these medications are of limited or even no value for treating cold symptoms. In any case, it's best to choose a medication targeted to your specific symptoms. For example, if your main symptom is coughing, pick cough suppressant as opposed to a general cold medication. The shelves and shelves of products in the pharmacy basically consist of the same handful of drugs in different combinations.

Medications to treat the symptoms of a cold*

Medication type (Common names)

How they work

Common side effects

OTC or prescription


Decongestants (Sudafed, Advil Cold and Sinus, others; nasal decongestants such as Afrin)

Reduce nasal congestion by decreasing swelling in the nasal passages. Often combined with an antihistamine.

Nervousness, restlessness, difficulty sleeping; heartburn, indigestion; palpitations; urinary retention in men with benign prostatic hyperplasia.


Occasional use of decongestants by pregnant women is not likely to cause problems in the fetus or newborn baby.

People with high blood pressure should talk to their doctor before taking this medication.

Cough suppressants (also called antitussives; local: Triaminic Cold & Cough, Robitussin Maximum Strength, others; central: codeine, dihydrocodeine, others)

Stifle the body's urge to cough either locally by decreasing sensation felt in the throat or centrally by affecting the part of the brain where the urge to cough originates.

Centrally acting cough suppressants (available only by prescription) may contain narcotics that can be addictive or cause drowsiness or dizziness. Locally acting (usually OTC) cough medicines rarely have side effects.


Might be harmful to the fetus and therefore should be avoided by pregnant women unless a doctor determines that the potential benefit outweighs the potential harm.

Expectorants (guaifenesin, Robitussin, others)

Loosens the mucus, or phlegm, in the lungs.

Drowsiness, headache, rash, nausea, vomiting.


Risk to pregnant women is unknown.


antipyretics (acetaminophen [Tylenol], ibuprofen [Advil, Motrin], aspirin, naproxen sodium [Aleve], others)

Relieve pain and reduce fever.

High doses of acetaminophen, especially when combined with alcohol, can cause potentially fatal liver damage. Many OTC products contain acetaminophen and should be taken into account when totaling intake.

Potentially serious side effects for the other medications include kidney damage and gastrointestinal problems, such as stomach pain, heartburn, nausea, or bleeding from the stomach. Rarely seen when the medications are used for a short time.

Usually OTC, though a doctor can prescribe higher-strength versions of the OTC products.

If you consume three or more alcoholic drinks a day, every day, don't take acetaminophen.

Avoid taking aspirin, ibuprofen, or naproxen if you have reflux, gastritis, or an ulcer.

Children under age 18 should never take aspirin if they are thought to have the flu or chickenpox.

*See note regarding cold medicines and children and teens. Pregnant or nursing women, people with medical conditions, and people taking other medications should always check with their doctors before taking any OTC medication.

Last Annual Review Date: 2007-10-01 Copyright: Harvard Health Publications

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