It starts as sniffles, and before you know it, you’re in the midst of a multitude of symptoms, ranging from fever and chills to a relentless cough and drippy nose. The question then becomes; which medicine is going to offer relief? We asked Abby Todt, PharmD, BCPS, Pharmacy, Parkview Health, to help us decipher the options on those crowded drugstore shelves.

What's the difference between the common cold and the flu?

Both illnesses are often confused with one another since they can present in similar manners. The common cold generally has a gradual onset, with symptoms such as a sore throat, low-grade fever, runny nose and/or nasal congestion, sneezing, cough and watery eyes. The common cold can last anywhere from a few days to weeks. The flu, in comparison, has a sudden onset with symptoms such as high fever, headache, muscle pains or weakness, fatigue and persistent cough. The flu normally lasts less than a week.

What can I use to treat the common cold?

There is no specific treatment for the viruses that cause the common cold. Most treatments are aimed at relieving symptoms caused by the virus but do not shorten or cure a cold. Also, antibiotics are not used to treat the common cold. They only treat illnesses caused by bacteria, not viruses.

Which medications are best to treat the symptoms of the common cold in adults?

Patients who have other underlying medical conditions or diseases need to consult with their physician before beginning any over-the-counter treatment, as they may interact with other medications.

• Runny nose - In patients older than 12 years of age, Nyquil™ (doxylamine succinate), Tavist (clemastine fumarate), chlorpheniramine maleate or Benadryl® (diphenhydramine) may help relieve symptoms. Although they may also cause sleepiness. Chlorpheniramine maleate is the least sedating of the products listed above.
• Nasal congestion - The best oral medication would be Sudafed® (pseudoephedrine), which is a medication behind the counter in the pharmacy. There is a medication that is similar and available over the counter, Sudafed PE® (phenylephrine), but it’s not nearly as effective as plain Sudafed®. These medications have precautions in some disease states, so it is best to consult your physician before treating your nasal congestion. The best nasal spray medication is Afrin® (oxymetazoline) and while this medication is very effective. It should only be used for 3 days due to the potential side effect of rebound congestion.
• Cough - The best way to address a cough is to assess what kind of cough it is. If the cough is dry and non-productive, you can utilize Delsym® (dextromethorphan). If the cough is wet and produces mucus, you can drink water to make the mucus thinner and utilize Mucinex® (guaifenesin).
• Fever/Sore throat - ​The best medication for fever and/or sore throat is plain Tylenol® (acetaminophen) or NSAIDs such as Motrin® (ibuprofen).

What medications are best to treat the symptoms of the common cold in children?

Many medications that are used in the common cold for adults should not be used in children because there have been few trials supporting their use in infants and children. Therefore, the best treatment is Children’s Tylenol® (acetaminophen) or Children’s Motrin® (ibuprofen) for fever or uncomfortable symptoms due to the common cold. Other than the medications listed, the best way to help your infant or child get rid of the common cold is by drinking an adequate amount of fluids. If further help or direction is needed, contact your physician or child's pediatrician.

What medication is best to treat the flu?

Unfortunately, the flu is much harder to treat over the counter, as there aren’t medications to treat this viral infection. The best measures to take are to get plenty of rest, drink enough fluids and utilize Tylenol® (acetaminophen) for fever.

There are medications that can be prescribed by your physician to help shorten the duration of the flu although studies have shown the medications shorten the flu by only a day.

The best way to prevent the flu is by getting a flu shot, which is covered by most insurance plans and can be given at almost all pharmacies or your physician’s office. While the shot does not cover all strains of the flu, it will protect you from the most common ones.