Best Medicine to Buy for Fever, Cough, Congestion or Runny Nose, According to a Doctor

If you walked into a pharmacy, you were greeted with an insane choice of combination cold remedies. With a variety of labels like cold & flu, nighttime, cough & sinus, extra strength and maximum strength, it’s difficult for anyone to know exactly what they need. I’ll try to break it down based on the symptom you want to treat and the ingredient you should be looking for.

The best medicines for fever

A common symptom that many people start with is a fever and the medication you are looking for is acetaminophen, known as Tylenol. If the product label says fever or pain reliever, it likely contains acetaminophen. It is important to know if acetaminophen is present in the product because taking too much can cause liver damage. If the combination product contains acetaminophen, you should not take more acetaminophen separately.

Additionally, instead of acetaminophen, some combination products use ibuprofen, known as Motrin, to reduce fever or treat body aches. This is different from acetaminophen. Personally, I prefer ibuprofen for fever and body aches, but some people may not tolerate it due to stomach irritation.

Best cough medicines

Another common symptom that people want to treat is a cough. Dextromethorphan is the active ingredient most often used for this purpose. Often the name of the drug has the initials DM.

To calm and relieve a cough, the active ingredient you’re looking for is guaifenesin. This would probably be labeled as an expectorant.

Best Medications for Runny or Congestion

If you have a runny nose or congestion, until recently the most common non-drowsy active ingredient was phenylephrine. However, you may have heard that an FDA committee questioned its effectiveness when taken orally. There is a good chance that it will be removed from many products because it is not considered effective.

CVS has already removed cold medications that use only phenylephrine from its shelves, but they are still present in many combination products. I should point out that this is not considered harmful, it’s probably just not helpful.

Unfortunately, the most used active ingredients for runny noses and congestion fall into the drowsiness category. That is, they will make most people sleepy and are often associated with products labeled for nighttime use. I’m talking about antihistamines, some of the most used are doxylamine, diphenhydramine (known to many as Benadryl), brompheniramine and chlorpheniramine.

The last active ingredient that I personally consider to be the most effective for treating runny noses and congestion is pseudoephedrine. Unfortunately, because it can be used in making illegal drugs, it’s kept behind the pharmacy counter and you’ll have to ask for it specifically.

This doesn’t require a prescription, the DEA just doesn’t want anyone to be able to purchase more than a certain amount at a time. There are also combination products containing pseudoephedrine and these are also kept behind the counter in pharmacies.

Combined medical attack

My personal preference is not to use a combination product. If I had a cough and runny nose, I might use a product containing only dextromethorphan and take pseudoephedrine. If I had a fever and body aches, I would add ibuprofen. By taking separate products, I treat my symptoms more directly and reduce the risk of overlapping medications or additional side effects.

If you choose a combination product, I encourage you to read the active ingredient label carefully and research what you need. If you have questions to ask the pharmacist to help you make choices, this is also particularly important if you have other health conditions and are taking other medications.

Buy generic

Finally, I encourage you to save money by purchasing the generic versions of all of these medications. Although generics may have a different taste or texture, the active ingredients are exactly the same and the price is often several dollars less for the generic. None of these medications will make your illness go away faster, they will only make it easier to tolerate symptoms while your body fights the infection.

Shop with Dr. McGeorge: What to Buy for Colds, Pain, and More at the Drugstore