Table of ContentsView AllTable of ContentsAntibioticsAntihistamines/DecongestantsAntiviralsCough MedicinesDecongestantsNasal Sprays
Table of ContentsView All
View All
Table of Contents
Antibiotics
Antihistamines/Decongestants
Antivirals
Cough Medicines
Decongestants
Nasal Sprays
Most people don’t need prescription medicine to treat the common cold or influenza. The first line of treatment for these viral infections is self-care: fluids, rest, and over-the-counter (OTC) medications. Severe upper respiratory tract symptoms, though, may benefit from prescription drugs.
Antiviral medications can help to shorten the duration and reduce symptoms of the flu and COVID-19, for example. Antibiotics may be needed to treat a bacterial infection. Other prescription cold medicines include antihistamines, cough medicines, and nasal sprays.
This article discusses prescription cold medicine and other treatments for upper respiratory tract infections.
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When to See a Doctor for a Cold or Flu
The common cold, influenza, and COVID-19 are viral infections and cannot be treated with antibiotics.
However, sometimes what you think is a cold can be a bacterial infection. A respiratory virus can set the stage for a secondary bacterial infection. Bacterial infections require treatment with antibiotics.
Bacterial infections that may affect the upper respiratory tract include acute otitis media, bronchitis, epiglottitis, pneumonia, andstrep throat.
If you have one of those infections, your healthcare provider may prescribe the following antibiotics:
Why You Don’t Need Antibiotics for a Cold or the Flu
Antihistamines
Antihistamines are widely available over the counter and included in combination cold medicine.
Sometimes, your doctor may prescribe an antihistamine to relieve cold and flu symptoms. Prescription antihistamines include:
These are all first-generation antihistamines, which commonly cause drowsiness. They are similar to OTC drugs Benadryl (diphenhydramine) and Triaminic (chlorpheniramine) and may help you sleep when you’re stuffed up.
Newer antihistamines like Claritin (loratadine) and Zyrtec (cetirizine) do not cause drowsiness and are better for daytime use. These second-generation antihistamines are available without a prescription.
Do Antihistamines Relieve Cold and Flu Symptoms?Most cold and flu medicines contain antihistamines. However, there isn’t a lot of evidence to support their use. A 2015 study found antihistamines may ease cold symptoms on the first or second day. After that, though, antihistamines do not appear to offer any benefits for cold and flu symptoms.
Do Antihistamines Relieve Cold and Flu Symptoms?
Most cold and flu medicines contain antihistamines. However, there isn’t a lot of evidence to support their use. A 2015 study found antihistamines may ease cold symptoms on the first or second day. After that, though, antihistamines do not appear to offer any benefits for cold and flu symptoms.
Should You Take Allergy Medications for a Cold?
Antivirals are medications that specifically target viruses in an effort to prevent them from reproducing. Your healthcare provider may prescribe antiviral medications if you have influenza or COVID-19.
Antivirals can help shorten the duration of a viral illness, reduce symptoms, and prevent complications. They are most effective when taken within 48 hours of symptom onset.
Antivirals approved to treat influenza include:
Antivirals approved to treat COVID-19 include:
While anyone can be prescribed antivirals, they are especially important for people at high risk of complications. This includes people who are older, immunocompromised, obese, or have other comorbidities.
How Does Tamiflu Treat the Flu?
Coughing is a common (and often annoying) symptom of respiratory infections. It is your body’s natural way of clearing your airways and preventing pneumonia. As such, it is not necessary to treat a cough unless it disrupts your ability to sleep or work.
Cough medicines come in two forms:
If OTC cough medicines do not relieve your cough, your healthcare provider may prescribe something stronger, such as:
Prescription cough medications that contain either codeine or hydrocodone include:
Cough medicines that contain codeine or hydrocodone should only be used for short-term treatment of a severe cough. They are not approved for use in children and should not be used during breastfeeding.
Misuse of narcotic cough suppressants can lead to addiction, overdose, or death.
The Dangers of Prescription Cough Medicine
Decongestants are sold over the counter as Sudafed (pseudoephedrine) and Sudafed PE (phenylephrine) and are found in combination cold medicines.They are often taken along with antihistamines or cough suppressants to relieve cold symptoms.
There are currently no prescription decongestants on the market in the United States.
Pseudoephedrine-containing products are sold “behind the counter” because they can be used to make methamphetamine drugs. As a result, many cold medicines contain phenylephrine instead. However, a Food and Drug Administration panel has concluded that phenylephrine isn’t effective as a decongestant when taken orally.
Decongestants should not be given to children under 6. For children ages 6 to 12, check with their healthcare provider first.
What Are Decongestants?
Nasal sprays are an effective way to deliver medication to the source of your cold symptoms. Medications in nasal sprays include corticosteroids, antihistamines, and decongestants.
OTC nasal sprays can often help treat congestion and a runny nose from a viral respiratory infection. These include:
If OTC nasal sprays do not bring relief, your healthcare provider may prescribe a combination nasal spray, such as:
Using Nasal Steroids
Summary
The common cold and flu can often be treated at home with rest, plenty of fluids, and OTC medications. Sometimes, however, what you think is a cold, flu, or viral infection is more serious and requires prescription medications.
If you suspect you have the flu or COVID, ask your healthcare provider if prescription antiviral medications may be right for you. These often need to be started within the first two days of symptoms.
Other prescription medications used to treat colds and upper respiratory symptoms include antibiotics (for bacterial infections), antihistamines, cough medicine, and nasal sprays.
If you are concerned a cough is something more serious than a common cold virus or your cold symptoms are worsening, see your healthcare provider. You may need a prescription to help you feel better.
The Difference Between a Cold and the Flu
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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U.S. Food and Drug Administration.FDA clarifies results of recent advisory committee meeting on oral phenylephrine.
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