Written By: Mark Rogers, Pharm. D
As a pharmacist for 12 years, two of the most common questions I am asked are, “What is the best medicine to take for the cold and flu?” And, “How much does it cost?” Here are my top recommendations that won’t break the bank:
1) Headache, Fever, Muscle Aches, Sore Throat — Ibuprofen (Advil) & Acetaminophen (Tylenol)
I often use a combination of the two drugs, separating each by 3-4 hours so that I maintain a more consistent pain relief. Ibuprofen is the best treatment for a sore throat. Acetaminophen is great for a fever. Most people already have one or both of these at home, so the cost is zero.
2) Nasal Congestion — Pseudoephedrine (Sudafed) or Oxymetazoline (Afrin)
I recommend pseudoephedrine (PSE) over phenylephrine (Sudafed PE), which is useless. PSE can be a mild stimulant, so start with the 30mg tablets, as opposed to the 12 & 24-hour dosages, to avoid disrupting sleep. PSE should not be used in certain conditions like high blood pressure. In that case, I recommend a topical nasal decongestant like oxymetazoline. The generic formulations of both drugs are inexpensive.
3) Coughing — Mucinex/No Suppressant or Delsym
If a cough is productive, meaning you are coughing up phlegm, I do not recommend using a cough suppressant. It stops the natural process of clearing out chest congestion. However, using Mucinex can help loosen the phlegm, so the coughing is more productive. If you have a dry cough, Delsym is the best over-the-counter suppressant. Both Mucinex and Delsym can be expensive, but look for less expensive generic options.
4) Other Symptoms, as needed: Loperamide (Imodium), diphenhydramine (Benadryl)
Diarrhea – Loperamine (Imodium) is best
Sneezing – Diphenhydramine is best, and can help dry out your sinuses. Allergy drugs like Zyrtec take a day or more to start working, so are not the best option.
5) Combination Drugs —
I typically shy away from combination drugs. Most do not have the right combination of medicines or do not have the best option for each symptoms. Case in point, most combination cold medicines use phenylephine as a decongestant.
In summary: my recommended medications are a pain reliever, pseudoephedrine, and Mucinex or Delsym to help relieve of the most common cold symptoms.