Cold & Flu Treatment Prescription Medications for Colds or Flu By Naveed Saleh, MD, MS Naveed Saleh, MD, MS LinkedIn Twitter Naveed Saleh, MD, MS, is a medical writer and editor covering new treatments and trending health news. Learn about our editorial process Updated on March 26, 2021 Medically reviewed by Mary Choy, PharmD Medically reviewed by Mary Choy, PharmD LinkedIn Twitter Mary Choy, PharmD, is board-certified in geriatric pharmacotherapy. She currently serves as the director of pharmacy practice of the New York State Council of Health-System Pharmacists. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Antibiotics Antihistamines, Decongestants Antiviral Medications Cough Medicines Nasal Steroids The first line of treatment for the common cold and influenza is self-care (and patience) as you allow these viral illnesses to simply run their course. But there are cases in which you may need a medical evaluation and prescription medication to tame severe symptoms, prevent a worsening of your condition, or avoid related complications. Hero Images / Getty Images Cough suppressants, antihistamines, decongestants, and nasal steroids are prescription cold and/or flu medications that can help provide you some symptom relief, while the main job of antivirals and antibiotics is to stop what's causing your illness in its tracks. When to See a Doctor About Cold and Flu Symptoms Antibiotics Many people with nagging symptoms of cough and colds will ask their healthcare provider for antibiotics. Most colds are viral and will not respond to antibiotics. Your healthcare provider should only prescribe them if your condition is due to a bacterial infection (such as strep throat) or you have developed a secondary bacterial infection (such as pneumonia). For example, Pen-Vee K (penicillin), Amoxil (amoxicillin), or Keflex (cephalosporin) are all effective treatments for strep throat infections. Why You Don't Need Antibiotics for a Cold or the Flu Antihistamines and Decongestants Antihistamines work by blocking the release of histamine, which is a natural substance our bodies release when we're exposed to allergens. Decongestants work by causing blood vessels to constrict which helps relieve congestion. Both antihistamines and decongestants are used to dry up secretions, relieving a runny nose or nasal stuffiness. They do not cure a viral respiratory illness, but they can reduce some discomfort. Many are available over the counter, but your healthcare provider may prescribe a stronger version or combination medication. An example is Promethazine VC, which contains promethazine (an antihistamine) and phenylephrine hydrochloride (a decongestant that constricts blood vessels to reduce pressure). Your healthcare provider should ensure these medications do not interact with other drugs you are taking, cannot worsen any existing conditions you have, and are appropriate for your age group. The U.S. Food and Drug Administration (FDA) advises against giving any kind of cough or cold product that contains antihistamines or decongestants to children under 2 years of age. There is a risk of serious or life-threatening side effects. Antiviral Medications Antivirals are medications that specifically target viruses in an effort to prevent them from reproducing. In the case of flu, antiviral medications are most effective when taken within 48 hours of the onset of symptoms. They can help relieve symptoms and shorten the course of the illness, as well as reduce the risk of complications. Antiviral medications approved by the FDA for influenza include: Tamiflu (oseltamivir phosphate) Relenza (zanamivir) Rapivab (peramivir) Xofluza (baloxavir marboxil) While antiviral medications may be prescribed to anyone for which they are indicated, they are especially important for people in high-risk populations to help prevent consequences of the flu such as bronchitis and pneumonia. If you or someone you care for is younger than 2 years of age, 65 or older, immunocompromised, pregnant, extremely obese, living in a care facility, or in any other group considered at high risk for flu complications, contact a healthcare provider as soon as you notice any symptoms of the flu or are aware of exposure to the virus. Those who are not in a high-risk group may need an antiviral medication if they are hospitalized and have confirmed or suspected influenza, or their illness is severe, complicated, or progressive. Antiviral Medications for the Flu Cough Medicines Coughing is your body's natural way of clearing your airways and preventing pneumonia. You can expect to cough at some phase of the cold or flu. In general, your healthcare provider will not want to treat such a cough unless it continues to disrupt your sleep or activities after it should have cleared up. Some cough suppressants are available in over-the-counter strengths as well as prescription-strength medications (e.g., dextromethorphan). The prescription medications used to control a severe cough often contain codeine or hydrocodone, both of which are narcotic medications. They prevent the brain from triggering the cough reflex. Often, these narcotics are in combination medications that also include an antihistamine. An example is Tussionex PennKinetic, an extended-release oral suspension containing a combination of chlorpheniramine and hydrocodone. Another example is Nalex AC, which contains codeine and the antihistamine brompheniramine. Misuse of narcotic cough suppressants can lead to addiction, overdose, or death. In 2017, the FDA updated warnings of prescription codeine cough products for children, adolescents, and those who are breastfeeding. In 2018, they changed labeling requirements for safety information on prescription cough and cold medications that contain codeine or hydrocodone to say that they should not be used by those under 18 years of age. For children and teens, the risks outweigh the benefits of these products. Sometimes, healthcare providers will prescribe Tessalon Perles (benzonatate) for stubborn coughs. According to the FDA, benzonatate is not safe for children under age 10 because even a small amount can cause an overdose. Another type of cough medicine is called an expectorant. Expectorants such as guaifenesin help thin and loosen mucus so you can cough it up more easily. The Dangers of Prescription Cough Medicine Nasal Steroids Nasal steroids relieve the symptoms of a runny nose or sinus pressure, although they won't cure a cold or the flu. Flonase (fluticasone), formerly available by prescription only, is now sold over the counter. Your healthcare provider can prescribe Nasonex (mometasone). These drugs are effective, but can take hours to be effective. Using Nasal Steroids A Word From Verywell If you are concerned a cough is something more serious than a common cold virus, make an appointment. If anything, it will put your mind at ease, and if there is something wrong, your healthcare provider can prescribe treatment before things get worse. The Difference Between a Cold and the Flu 6 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Cleveland Clinic. The Common Cold and Viral Respiratory Infection: Management and Treatment. Centers for Disease Control and Prevention. What You Should Know About Flu Antiviral Drugs. Centers for Disease Control and Prevention. Influenza Antiviral Medications: Summary for Clinicians. U.S. Food and Drug Administration. FDA Drug Safety Communication: FDA restricts use of prescription codeine pain and cough medicines and tramadol pain medicines in children; recommends against use in breastfeeding women. U.S. Food and Drug Administration. FDA requires labeling changes for prscription opioid cough and cold medicines to limit their use to adults 18 years and older. U.S. Food and Drug Administration. FDA Drug Safety Communication: Death resulting from overdose after accidental ingestion of Tessalon (benzonatate) by children under 10 years of age. By Naveed Saleh, MD, MS Naveed Saleh, MD, MS, is a medical writer and editor covering new treatments and trending health news. 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