Buzz
When you're miserable with a cold, all you want is something that will make you feel better, even if it can’t cure you. Sadly, many so-called remedies are just placebos, though some over-the-counter options do offer more than others.
Before diving into which medicines are most effective, it’s crucial to remember: Cold medicines won’t cure your cold or speed up its recovery. They’re designed to alleviate your symptoms and make you feel a bit more comfortable while your immune system tackles the virus.
Pseudoephedrine (original Sudafed) is the real deal
If you're dealing with a blocked nose, pseudoephedrine is the real solution. Back in the day, you could easily find it on store shelves. Sudafed was one popular brand. (Sudafed, pseudoephedrine, get it?) But because pseudoephedrine can be turned into methamphetamine, a law passed in 2006 limited its sale. Be prepared to show your ID to the pharmacist if you want to get your hands on the effective stuff.
Research has proven that pseudoephedrine is effective at relieving nasal congestion. When you feel like your nose is clogged with thick or sticky mucus, that’s not entirely accurate. The blood vessels in your nasal passages and sinuses swell, narrowing the airways. Pseudoephedrine works by shrinking those blood vessels, reducing the swelling and opening up your passages for easier breathing.
Pseudoephedrine also constricts blood vessels elsewhere in the body, which can lead to an increase in blood pressure for some individuals. It’s even used off-label to treat priapism (prolonged erections).
Most other cold medicines don’t offer much relief (if any at all).
Phenylephrine is the decongestant that replaced pseudoephedrine in over-the-counter products. (It’s the active ingredient in Sudafed PE. Don’t be fooled.) Unfortunately, it doesn’t seem to work very well, and some studies suggest it doesn’t work at all. In fact, two pharmacists published a paper in 2022 titled 'Why Is Oral Phenylephrine on the Market After Compelling Evidence of Its Ineffectiveness as a Decongestant?' And when it comes to medicines intended to ease your cough, the evidence is similarly underwhelming.
Dextromethorphan, often used as a cough suppressant, has little supporting evidence to prove it actually works. The same can be said for guaifenesin, an expectorant meant to loosen mucus for easier coughing. According to a Cochrane review, there isn't sufficient evidence to confirm whether these or other over-the-counter cough medicines are effective.
By the way, children under 4 years old should avoid using any of the cough or cold medications we've discussed, as per the FDA’s guidelines. Thankfully, simple home remedies like staying hydrated and using a bulb syringe to clear nasal mucus are both safe and tend to offer relief.
Tylenol and ibuprofen can be effective for relieving fever and pain.
There is, however, one more class of over-the-counter medicines that could actually provide some relief when you're dealing with a cold, though they may not be what you typically think of when considering cold remedies.
Acetaminophen (like regular Tylenol) and ibuprofen (such as Motrin or Advil) are recognized as effective pain relievers and fever reducers. They are safe for use in children, even young ones. However, the American Academy of Pediatrics cautions that if a baby under 3 months old has a fever, you should always contact their pediatrician and avoid administering any medication unless advised, as fevers at this age can be potentially life-threatening and require medical attention.
If you're accustomed to checking brand names, be sure to flip the package over and confirm that the ingredients match your expectations. Regular Tylenol is simply acetaminophen, but the company also offers a Tylenol Cold and Flu, which contains all three ingredients we previously mentioned that don't actually help with colds or coughs. Advil has a comparable product as well. These are the ones you should avoid.
An important reminder: Tylenol, or acetaminophen, is commonly included in many cold medicines as part of a mix of ingredients. It can also be potentially harmful if taken in excess. If you're combining different medications, ensure that you're not accidentally doubling up on this ingredient.
Stock up your medicine cabinet with the following essentials:
Original Sudafed for congestion (only available by prescription when purchased on Amazon, or you can pick it up in person at your local pharmacy)
Regular (or extra strength) Tylenol for managing fever and pain
Honey if you're seeking a natural cough syrup option
Honey is the best choice for cough syrup
You’ve got a working decongestant (pseudoephedrine) and something to tackle your fever and headache (acetaminophen or ibuprofen). But what about that irritating cough? There’s a solution, but you’ll need to leave the pharmacy aisles and head over to the grocery section.
While honey won’t cure your cold, it does seem to soothe sore throats and ease coughing, at least a little. Studies often show it works better than most over-the-counter cough syrups. (Is this because honey is magical, or because those syrups are pretty ineffective? Probably the latter, to be honest.) Skip the honey-based cough syrups—they exist—just grab real honey and stir it into some hot water or tea. It’s cheaper and easier.
A crucial note about honey: honey is not safe for babies under 1 year old. There’s a small risk of botulism, and infants are especially vulnerable. Since honey won’t provide significant relief, it’s not worth the risk.
Homeopathic cold remedies are ineffective.
Almost every ‘children’s’ cold medicine is useless. The ones containing decongestants and antihistamines aren’t safe for kids under 4. But if you’re already in the medicine aisle, ‘natural’ brands will try to fill the gap with mixtures of vitamins, honey, and herbs. These don’t really work either, yet they somehow cost around eight bucks a bottle.
It gets even worse. In both the kids' and adults' sections, you’ll find homeopathic remedies, which are essentially scams and should be illegal. Be cautious of anything labeled ‘homeopathic’ or with ingredients measured in ‘X’ or ‘C’ instead of proper units like milligrams.
These aren’t just natural supplements, despite what the labels may imply, and homeopathy is not another term for home remedies. Homeopathic ‘medications’ exploit a strange loophole in FDA and FTC policies that allows them to be sold as drugs while claiming to work through magical means. I wish I were making this up, but I’m not. Save your money.
