Choosing Cold and Flu Relief: A Pharmacist's Guide

Most colds and many cases of flu get better on their own within a week or two. The right non-prescription products won't cure them faster, but they can make you more comfortable while your body does the work. The trick is to treat the symptoms you actually have, and to avoid doubling up on the same ingredient.

Start with the symptom, not the brand

Cold and flu aisles are crowded with combination products. Many contain two to four active ingredients, and you may not need all of them. Pick a product that matches your main symptom:

• Fever, aches, sore throat: acetaminophen (Tylenol and generics) or ibuprofen (Advil, Motrin and generics)
• Stuffy nose: a saline rinse or spray first; a decongestant spray for no more than 3 days, or an oral decongestant if your pharmacist agrees
• Runny nose and sneezing from allergies: a non-drowsy antihistamine such as cetirizine or loratadine
• Dry, tickly cough: honey (for anyone over 1 year old), lozenges or a cough suppressant
• Chesty, wet cough: fluids, steam and time; an expectorant may help some people

Read the active ingredients

The most common mistake our pharmacists see is taking two products that contain the same medicine. Acetaminophen, for example, is in many "cold and flu" and "nighttime" products. Taking a combination product plus plain acetaminophen can go over the safe daily limit and harm your liver.

• Check the "medicinal ingredients" box on every product you take
• Keep a note of the times and doses you've taken
• Don't combine two products that both contain a pain reliever, an antihistamine or a decongestant

Who should check with a pharmacist first

Some cold remedies aren't right for everyone. Ask before using them if you:

• have high blood pressure, heart disease, glaucoma, thyroid problems or an enlarged prostate (decongestants can make these worse)
• have kidney disease, stomach ulcers or take a blood thinner (ibuprofen and naproxen may not be safe)
• are pregnant or breastfeeding
• are buying for a child: many cough and cold products aren't recommended for children under 6, and doses for children are based on weight
• take prescription medications, especially for mood, sleep, seizures or blood pressure

Our pharmacists are available 24/7 to help you choose, at no cost.

Simple things that help

• Rest, and stay home while you have a fever so you don't pass it on
• Drink plenty of fluids: water, broth, warm drinks
• Use a humidifier or breathe steam from a shower
• Gargle with warm salt water for a sore throat
• Wash your hands often and cough into your elbow

When to see a doctor

Get medical care if you or your child:

• have trouble breathing, chest pain or a bluish colour to the lips
• have a fever above 39°C, or a fever lasting more than 3 days
• feel better and then suddenly get worse
• are confused, very drowsy or hard to wake
• can't keep fluids down or show signs of dehydration
• are an infant under 3 months with any fever

If you're not sure, call Health811 (Ontario) or your province's 811 line to speak to a nurse, any time of day. In an emergency, call 911.

Prevention is still the best medicine

An annual flu shot is the best protection against influenza, and COVID-19 vaccines are recommended for many Canadians each fall. Vaccines are free for most Ontarians at pharmacies and clinics. Ask our pharmacists about what's recommended for you.