Many cough and cold products contain three, four, or even five active ingredients. That can be convenient when every listed symptom is present, but it can also expose you to medication you don't need and make accidental duplication more likely. A safer approach is to identify your main symptoms and select the fewest active ingredients needed to address them.
For a Dry Cough: Dextromethorphan
Dextromethorphan is a cough suppressant.
It may help reduce the urge to cough when the cough is dry or interfering with rest.
It can cause dizziness or drowsiness and may interact with certain antidepressants and other medications. Ask a pharmacist before using it when you take medication for depression, anxiety, pain, or other neurological conditions.
Do not take more than the label recommends.
For Chest Congestion: Guaifenesin
Guaifenesin is an expectorant intended to loosen mucus and make coughing more productive.
Adequate fluid intake may help unless a healthcare professional has placed you on a fluid restriction.
A persistent cough with shortness of breath, chest pain, wheezing, blood, or high fever needs medical evaluation.
For Fever and Body Aches
Cold and flu products may contain:
- Acetaminophen
- Ibuprofen
- Naproxen
- Aspirin
Check every product you are using. Taking a separate pain reliever with a combination cold medicine can cause accidental duplication.
Acetaminophen is found in hundreds of prescription and OTC products, and FDA advises against using more than one acetaminophen-containing product at a time.1
For a Runny Nose
Some cold products contain sedating antihistamines such as:
- Diphenhydramine
- Doxylamine
- Chlorpheniramine
These ingredients may reduce a runny nose but can also cause drowsiness, dry mouth, constipation, blurred vision, confusion, and difficulty urinating.
Do not drive until you know how the product affects you. FDA advises patients to understand warnings for medicines that may impair driving.
For Nasal Congestion
Decongestants may include pseudoephedrine or phenylephrine.
They may not be appropriate for everyone, particularly people with:
- Uncontrolled high blood pressure
- Certain heart conditions
- Glaucoma
- Thyroid disease
- Prostate-related urination problems
- Medication interactions
Topical nasal decongestant sprays can cause rebound congestion when used longer than directed.
Daytime vs. Nighttime Products
“Nighttime” products frequently contain sedating ingredients.
Do not assume nighttime automatically means more effective. It may simply indicate that the product includes an antihistamine or other ingredient that causes drowsiness.
Avoid combining nighttime cold products with:
- Alcohol
- Sleep aids
- Sedating antihistamines
- Certain anxiety medications
- Other products that impair alertness
Should Children Use Cough and Cold Medicine?
FDA does not recommend OTC cough and cold medicines for children younger than two because serious and potentially life-threatening side effects can occur. Manufacturers commonly label these products not to be used in children younger than four.2
Never use an adult product to create a child's dose.
Ask a pediatrician or pharmacist before treating a young child.
Read the Active Ingredients Every Time
Products with similar brand names can contain different ingredients.
FDA notes that manufacturers may change ingredients or warnings and that similarly named OTC products can have different active ingredients. Read the Drug Facts label every time you buy or use a product.3
Seek Medical Care When
Contact a healthcare professional when there is:
- Difficulty breathing
- Chest pain
- Blue or gray lips
- Dehydration
- Confusion
- Severe weakness
- A high or persistent fever
- Symptoms that improve and then worsen
- Coughing up blood
- Symptoms lasting longer than expected
- A serious underlying medical condition
The Bottom Line
Choose cough and cold medication by active ingredient, not by the dramatic weather system printed on the box. Treat the symptoms you actually have and avoid unnecessary ingredients — especially acetaminophen or NSAIDs you may already be taking separately.
Frequently Asked Questions
What's the difference between dextromethorphan and guaifenesin?
Dextromethorphan is a cough suppressant that reduces the urge to cough, best suited to a dry cough. Guaifenesin is an expectorant that loosens mucus to make coughing more productive, which is more useful for chest congestion.
Can I give my toddler cough and cold medicine?
No. FDA does not recommend OTC cough and cold medicines for children younger than two, and most manufacturers label products not to be used under age four. Ask a pediatrician or pharmacist before treating a young child.
Are nighttime cold medicines more effective?
Not necessarily. "Nighttime" usually just means the product contains a sedating antihistamine or other drowsiness-causing ingredient, not that it treats symptoms more effectively.
How do I avoid accidentally doubling up on acetaminophen?
Check every product you're using for acetaminophen, since it's found in hundreds of prescription and OTC products. FDA advises against using more than one acetaminophen-containing product at the same time.
Identify your main symptoms first, then pick the fewest active ingredients needed to treat them. A five-symptom combination product is convenient only if you actually have all five symptoms.
References
- U.S. Food & Drug Administration. Acetaminophen: Safe Use of Over-the-Counter Pain Relievers and Fever Reducers. fda.gov/drugs/safe-use-over-counter-pain-relievers-and-fever-reducers/acetaminophen
- U.S. Food & Drug Administration. Use Caution When Giving Cough and Cold Products to Kids. fda.gov/drugs/special-features/use-caution-when-giving-cough-and-cold-products-kids
- U.S. Food & Drug Administration. The Over-the-Counter Drug Facts Label. fda.gov/drugs/understanding-over-counter-medicines/over-counter-drug-facts-label