OTC pre-cold medications: 4 types

OTC medications can help you feel better in the early days of the common cold. These products help prevent symptoms like a stuffy nose, runny nose, cough, pain, and fever. These medications can help relieve cold symptoms before they worsen.

OTC pre-cold medications are generally safe. But it can be helpful to speak with a doctor about your medical history and other medications you may be taking to avoid any side effects.

OTC options that can help manage pre-cold symptoms include:

Decongestants

Decongestants work by narrowing the blood vessels inside your nose. When you have a cold, your immune system causes the area inside your nasal passages to swell. By narrowing the blood vessels, it’s easier for you to breathe.

Examples of decongestants include:

• pseudoephedrine (Sudafed Congestion)
• naphazoline (Privine)
• oxymetazoline (Afrin)

Many of these decongestants are also sold as part of combination products that also contain other pre-cold medications, such as antihistamines. 

Some side effects of decongestants include:

• dizziness
• trouble sleeping
• nervousness
• heart palpitations

You should avoid decongestants if you have high blood pressure, diabetes, glaucoma, a heart condition, or problems with your thyroid or prostate.

In September 2023, the Food and Drug Administration (FDA) found that a common oral decongestant called phenylephrine (Vazculep) was not effective. But it did not find evidence the product was unsafe. The FDA did not comment on phenylephrine in its spray form.

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Antihistamines

Antihistamines work by blocking the action of histamine. Histamine is a chemical the body makes after exposure to a trigger such as an allergen. This reaction can lead to symptoms like runny nose, sneezing, itching, and watery eyes.

Some common OTC antihistamines include:

• diphenhydramine (Benadryl)
• chlorpheniramine (Chlor-Trimeton)
• cetirizine (Zyrtec)
• loratadine (Claritin)
• fexofenadine (Allegra)

Antihistamines have potential side effects such as:

• drowsiness
• dry mouth
• dizziness
• ringing in the ears (tinnitus)

You may also experience blurred vision or constipation. In this case, it’s important to speak with a healthcare professional.

These side effects are more common with first-generation antihistamines, such as diphenhydramine.

Certain health conditions can cause the body to react adversely if you take antihistamines. Consider speaking with a doctor before taking an antihistamine if you have any of the following conditions:

• kidney disease
• liver disease
• glaucoma
• high blood pressure
• heart disease
• thyroid disease
• breathing problems
• enlarged prostate

A 2022 review of clinical studies found a lack of data on whether combination products, specifically antihistamine‐analgesic‐decongestant combinations, are effective at treating colds. 

Cough suppressants

OTC cough medications are available in two forms: cough suppressants (antitussives) and expectorants. Cough suppressants stop the body’s cough reflex. Expectorants make mucus thinner, so it’s easier for your cough to clear your airways.

Dextromethorphan (Delsym) is a common cough suppressant, and guaifenesin (Mucinex) is a common expectorant. These ingredients are also available in many combination products, such as Robitussin Cough and Chest Congestion DM, which contain both dextromethorphan and guaifenesin.

Side effects of cough medication can include:

• irritability
• sleepiness
• dizziness

If you have a cough that lasts more than a few weeks or experience a fever or shortness of breath, you should speak with a doctor before taking an OTC cough medication.

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Pain relievers

A common symptom of a cold is body pain. OTC pain relievers can help with this. Common examples include acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as acetylsalicylic acid (Aspirin) and ibuprofen (Advil).

Acetaminophen works on a pathway in the central nervous system to reduce pain and fever. Common side effects can include:

• nausea
• fatigue
• abdominal pain
• agitation
• loss of appetite

NSAIDs can help prevent pain, fever, and inflammation. Common side effects can include:

• nausea
• vomiting
• stomach pain
• heartburn

When should you speak with a doctor?

Colds usually get better on their own after several days. You might consider consulting with a doctor if:

• your symptoms don’t improve after 10 days
• you have a fever that lasts longer than 4 days
• you experience trouble breathing, fast breathing, or dehydration
• your symptoms get better but then come back
• you have a chronic medical condition that gets worse

Summary

If you feel a cold coming on, you might be able to lower your symptoms with OTC pre-cold medications.

Common examples of medications that can help manage symptoms before they worsen include:

• decongestants
• antihistamines
• cough suppressants
• pain relief

Many pre-cold medications should be used with caution if you’re taking other medications. You might want to speak with a doctor to avoid drug interactions.

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