Upper respiratory infections—the common cold, basically—make you feel awful even though they’re usually harmless. You’re congested, your throat hurts, you’re coughing, and you just want relief. The pharmacy aisle is full of options, but which ones actually help?
Let me cut through the marketing and tell you what really works.
Pain and Fever Relief
Acetaminophen and ibuprofen are your foundation medications. They reduce fever, ease headaches, and help with body aches and sore throat pain.
Acetaminophen is easier on your stomach. Take it every 4-6 hours as needed, but don’t exceed 3,000 mg in 24 hours. I always remind patients to check other medications they’re taking—many cold medicines already contain acetaminophen.
Ibuprofen reduces inflammation along with pain, which is helpful for a sore throat. Take 400 mg every 6-8 hours with food. Some people alternate between acetaminophen and ibuprofen for stubborn symptoms, but check with a doctor before doing that regularly.
Decongestants That Actually Work
Pseudoephedrine is the most effective oral decongestant available over-the-counter. You’ll need to ask the pharmacist for it and show ID, but it’s worth the hassle if you’re really stuffed up.
It shrinks swollen nasal tissues so you can breathe. Take it every 4-6 hours. Just know it can make you jittery or keep you awake, so skip evening doses if you’re sensitive.
Phenylephrine is what you’ll find on regular shelves, but recent research shows it barely works better than placebo for most people. Save your money.
Cough Medicine
Dextromethorphan suppresses dry, unproductive coughs that keep you awake at night. Look for “DM” on the label. It won’t cure the cough, but it can quiet it down enough to let you rest.
For wet, productive coughs, guaifenesin helps thin mucus so you can cough it up more easily. Take it with plenty of water for best results.
Nasal Sprays
Saline nasal spray is genuinely helpful and completely safe. Use it as often as you want to flush out mucus and keep nasal passages moist. It’s cheap and surprisingly effective.
Oxymetazoline sprays like Afrin give fast relief for severe congestion, but here’s the critical rule—three days maximum. Use them longer and you’ll develop rebound congestion that’s worse than what you started with.
Throat Relief
Lozenges with menthol or pectin soothe sore throats temporarily. They work by coating irritated tissues and stimulating saliva production.
Throat sprays with benzocaine numb pain for a few hours. They’re helpful when your throat hurts so badly you can’t sleep.
What to Skip
Those multi-symptom cold medicines usually contain ingredients you don’t need. You end up paying more and taking medications that might cause side effects without helping your actual symptoms. Better to treat what’s bothering you specifically.
Antibiotics don’t work for viral URIs. They won’t speed recovery and can cause unnecessary side effects.
The Real Truth
Most URIs improve in 7-10 days regardless of treatment. These medications make you more comfortable while your immune system does the actual work of fighting the virus. Rest, fluids, and time are still your best medicine.
