There are a lot of cold and flu meds on the market. Some work pretty well; others, not so much. And most have side effects, even when taken short-term. That’s why it’s usually a good bet to start with home remedies, which often provide relief and tend to be safer than drugs. And it's almost never a good idea to ask your doctor for antibiotics: those drugs don't work against the cold or flu.

Note that most drugs listed below are also available as lower-cost generic or store brands. The listed drugs are examples and are often multisymptom products that contain several active ingredients.)

Aches and Fever

OTC Drugs
Acetaminophen (Tylenol), ibuprofen (Advil), and naproxen (Aleve)

How effective are they? All ease body aches and reduce fever.

What are the risks? Acetaminophen is safe when used as directed, but taking even a little more than the daily max can harm the liver. The other drugs—nonsteroidal anti-inflammatories, or NSAIDs—can cause intestinal bleeding and increase the risk of heart attack and kidney damage.

SPECIAL REPORT: HOW TO TREAT A COLD OR THE FLU

What they can interact with: Acetaminophen plus alcohol can threaten the liver. NSAIDs increase the risk of bleeding when taken with a blood thinner such as warfarin (Coumadin) or clopidogrel (Plavix).

Home Remedies
A cool compress or sponge bath: Either measure can help some if a temperature spikes and you don’t have acetaminophen or other fever medication in your medicine cabinet. And note that it is okay to let a fever run its course if it stays under 101° F. That’s because the high temperature is part of the body’s efforts to kill off the offending germs.

Congestion

OTC Drugs
• Oxymetazoline nasal spray (Afrin, Dristan Mucinex Sinus-Max Nasal Spray, Vicks Sinex Severe Nasal Spray)
• Phenylephrine (Equate Congestion Suphedrine PE Nasal Decongestant, Sudafed PE Congestion)
• Pseudoephedrine (Sudafed 12 Hour)
• Camphor, eucalyptus, or menthol rubs (Mentholatum, Vicks VapoRub)

How effective are they? The sprays work within minutes, faster than pills. Topicals can improve the flow of air through your nasal passages.

What are the risks? Topicals can irritate the skin. Sprays can worsen stuffiness if taken for longer than three days. Oral meds can raise blood pressure; cause insomnia, heartbeat abnormalities, tremors, anxiety, and hallucinations; and worsen glaucoma, thyroid disease, and symptoms of an enlarged prostate.

What they can interact with: Oral drugs combined with older antidepressants such as isocarboxazid (Marplan) and tranylcypromine (Parnate) make side effects much more likely, and they should not be taken together.

Home Remedies
• Chicken soup
: Modern science provides some backup for chicken soup’s reputation for easing congestion, coughs, and sore throats. Research suggests that it may inhibit the buildup of neutrophils, white blood cells that trigger the body’s inflammatory response and contribute to the aches and pains that accompany a cold and the flu. And the hot liquid and steam from any soup that’s mostly broth may help more directly, by opening up swollen airways and thinning mucus. (Read more about the benefits of homemade chicken soup.)

• Neti pots and nasal irrigation—a saltwater rinse for your nasal passages­—eases congestion from allergies and could help when it stems from a cold or the flu, too. There are two main forms: One squeezes saline into the nostrils from a squeeze bottle or bulb syringe. The other—a teapot-shaped device called a neti pot—uses gravity: Tilt your head sideways, then pour saline into the upper nostril; the liquid flows into one nasal cavity and out the other. To be safe, make sure you use distilled water or water that has been boiled, then cooled, and clean the device with distilled or boiled water after each use as well.

• Steam inhalation: Warm water vapor may help loosen mucus. Though it’s unclear whether that translates into reduced congestion, many people swear by it. Showering may be safer than putting your head over a piping hot pot of water, which could scald.

• Cool-mist humidifiers: The FDA says these devices can help shrink swelling in nasal passages and allow easier breathing. And the humidity can make it more difficult for flu viruses to survive. Just make sure to keep the device clean. (Read more about humidifiers.)

Cough

OTC Drugs
• Dextromethorphan (Robitussin Long-Acting CoughGels, Vicks DayQuil Cough)
• Guaifenesin (Mucinex 12 Hour, Tab Tussin)
• Topical rubs, patches, and lozenges that contain camphor or menthol (Halls Menthol Cough Drops, Mentholatum, Vicks VapoRub)

How effective are they? Guaifenesin, an expectorant, thins mucus, making coughs more productive. Dextromethorphan, a suppressant, blocks the cough reflex. Vapors from topicals can feel soothing. But it’s unclear whether any cough drug reduces episodes of coughing.

What are the risks? Topicals can trigger rashes and a burning sensation. Oral drugs can lead to nausea and make you sleepy. High doses of dextromethorphan can cause rapid heartbeat, loss of coordination, and hallucinations.

What they can interact with: Cough suppressants can cause increased sedation when taken with narcotics, sleeping pills, some antihistamines, or alcohol.

Home Remedies
Honey: It tastes good and feels soothing, and a 2014 review suggests that it’s better than a placebo at easing coughs. Add a teaspoon or two to a cup of tea or consume it straight off the spoon. And don’t worry, a little extra sugar when you’re sick won’t harm you. But one caution: Honey can contain the bacterium Clostridium botulinum, which in rare cases can damage muscles and nerves in babies. So don’t give it to infants younger than a year old.

Photo: Dan Saelinger

Runny Nose and Sneezing

OTC Drugs
Antihistamines, such as cetirizine (Zyrtec), chlorpheniramine (Aller-Chlor), diphenhydramine (Benadryl Allergy), fexofenadine (Allegra), and loratadine (Alavert, Claritin)

How effective are they? Very, when symptoms stem from allergies, but a 2015 review of 18 trials concluded that the drugs have little benefit when symptoms are from a cold.

What are the risks? Drowsiness, nausea, blurred vision, and difficulty urinating, and, with diphenhydramine, impaired coordination.

What they can interact with: Taking chlorpheniramine or diphenhydramine with narcotics, sleeping pills, or alcohol makes sedation more likely. Taking cetirizine, fexofenadine, or loratadine with certain antifungals or antibiotics increases the risk of side effects. Antacids with aluminum or magnesium, and grapefruit and certain other juices can make fexofenadine less effective.

Home Remedies
Honestly, there’s not much you can do besides stocking up on tissues. But note that a runny nose and sneezing help rid your body of germs. If you find yourself without a tissue in hand, sneeze into your elbow so that the germs don’t end up across the room infecting an innocent bystander.

Sore Throat

OTC Drugs
• Pain relievers such as acetaminophen (Tylenol), ibuprofen (Advil), and naproxen (Aleve)
• Benzocaine (Cepacol Extra Strength Sore Throat Sugar Free, Chloraseptic Warming Sore Throat Lozenges)
• Dyclonine (Sucrets Sore Throat Lozenges)
• Menthol (Halls Triple Action Soothing Drops, Vicks VapoDrops)
• Phenol (Chloraseptic Sore Throat Spray)

How effective are they? Pain relievers help. Benzocaine, dyclonine, and phenol work as local anesthetics, and menthol provides a cooling sensation in your throat. Medicated lozenges may work longer than the sprays.

What are the risks? High doses of benzocaine and dyclonine might in rare cases cause lightheadedness, shortness of breath, fatigue, or rapid heart rate. For the risks of pain relievers, see OTC drugs for aches and fever.

What they can interact with: None known for phenol or benzocaine lozenges. Menthol drops make bleeding more likely with warfarin. For pain relievers, see drugs for aches and fever.

Home Remedies
• Gargling with salt water:
It’s inexpensive, safe, and time-tested. Dissolve ½ to 1 teaspoon of salt into an 8-ounce glass of warm water, gargle in the back of the throat, then spit. Repeat a few times a day.

Just Say ‘No’ to Antibiotics

Many people believe that antibiotics speed recovery from a cold and the flu—and doctors write almost 50 million prescriptions for these and related respiratory infections each year.

Bad idea. Why? Because antibiotics work only against bacterial infections—and colds and flu are viral.

Taking antibiotics when they aren’t needed not only unnecessarily exposes you to their side effects—diarrhea, nausea, and potentially serious allergic reactions—but also can breed antibiotic-resistant bacteria among the broader population, undermining the effectiveness of the medications when they really are needed.

Doctors know that antibiotics don’t help with a cold or the flu. And though efforts are afoot to reduce unnecessary use, many doctors still prescribe the drugs because patients often ask—and because it’s faster and easier to write a prescription than it is to explain why it isn’t needed.

CR’s take If you have a cold or the flu, don’t ask for antibiotics, and don’t take them even if offered unless your doctor has specific reasons in your case.

Read more about the dangers of overusing antibiotics.

Just Say ‘No’ to Antibiotics

Many people believe that antibiotics speed recovery from a cold and the flu—and doctors write almost 50 million prescriptions for these and related respiratory infections each year.

Bad idea. Why? Because antibiotics work only against bacterial infections—and colds and flu are viral.

Taking antibiotics when they aren’t needed not only unnecessarily exposes you to their side effects—diarrhea, nausea, and potentially serious allergic reactions—but also can breed antibiotic-resistant bacteria among the broader population, undermining the effectiveness of the medications when they really are needed.

Doctors know that antibiotics don’t help with a cold or the flu. And though efforts are afoot to reduce unnecessary use, many doctors still prescribe the drugs because patients often ask—and because it’s faster and easier to write a prescription than it is to explain why it isn’t needed.

CR’s take If you have a cold or the flu, don’t ask for antibiotics, and don’t take them even if offered unless your doctor has specific reasons in your case.

Read more about the dangers of overusing antibiotics.

Editor's Note: This article also appeared in the January 2018 issue of Consumer Reports magazine.