Cough, runny nose, or the flu? Which remedies really work?

A stuffy nose, cough, and fever often occur together, but they don’t always require the same treatment. We explain what works for a cold or the flu, why many cough syrups offer little benefit, and when prescription medication or a visit to the doctor is necessary.

A cold, the flu, or something else?

A cold often starts with sneezing, a sore throat, and a runny nose. The flu usually starts suddenly, with a fever, chills, headache, muscle aches, and feeling really sick. COVID-19 and other respiratory viruses can also cause these symptoms. It’s not always possible to identify the virus based on symptoms alone.

Yellow or green nasal discharge and colored mucus do not necessarily indicate a bacterial infection. The color is often caused by immune cells. A cough following a viral infection can last 2 to 4 weeks without the need for antibiotics.

Over-the-counter: targeted relief

Saline solution can clear a stuffy nose and may be used for a longer period. Xylometazoline reduces swelling of the nasal mucosa, but use it for no more than 7 days. Longer use can actually cause a persistent stuffy nose. Different strengths apply to children; let us help you choose the right product.

Acetaminophen is the first choice for pain and fever. Check combination products to ensure you don’t inadvertently take a double dose of acetaminophen. Ibuprofen and naproxen are anti-inflammatory pain relievers (NSAIDs), but they can cause problems if you have stomach or kidney disease, heart failure, are taking blood thinners, or are pregnant.

Coughing helps clear mucus from your airways. A cough drop or honey can soothe the throat; do not give honey to children under 1 year of age. For a dry cough, noscapine can suppress the urge to cough. Apotheek.nl lists it as a possible option for children and adults, but also notes that doctors no longer recommend it because its effectiveness is uncertain and it may cause side effects. Do not use it for a productive cough. Noscapine is approved for children ages 3 and older; for children ages 1 to 3, a doctor may sometimes prescribe it off-label. Follow the package insert or the pharmacy label. Dextromethorphan can have significant interactions with certain medications, including some antidepressants. Noscapine can also interact with certain medications. If you are taking any medications, consult your pharmacist beforehand. For mucolytics such as acetylcysteine and bromhexine, there is no evidence that they help with a common productive cough; treatment is usually not necessary.

With a prescription: treat only a clear cause

Antibiotics are not effective against the common cold or the flu. In the case of bacterial pneumonia, for example, your doctor may prescribe amoxicillin. Salbutamol, a bronchodilator, and inhaled corticosteroids, which reduce inflammation, are intended for asthma or COPD and not for a common cough.

Oseltamivir inhibits the influenza virus but is not routinely recommended in general practice. The family doctor may consider it for a small group of people at very high risk of a severe course of the illness. If treatment is started, it should preferably be within 48 hours of the onset of symptoms. It may potentially shorten the duration of symptoms by about a day; nausea and vomiting are possible side effects.

When should you call?

Call immediately if you experience rapid or labored breathing at rest, wheezing, drowsiness or confusion, a rapid worsening of symptoms, or coughing up blood. Call your primary care physician the same day if you develop a fever again after being fever-free for a few days. Call on weekdays if you have chest pain, a fever lasting longer than 3 days, a cough lasting longer than 4 weeks when you are otherwise healthy, or if you are concerned.

We review your choice

We assess which active ingredient, strength, and dosage form are appropriate for your symptoms and medications. We also explain how to use nasal sprays or inhalers and record relevant over-the-counter medications in your medication record. We are your trusted neighborhood pharmacy, work closely with your primary care physician, and answer your questions online as well.

Read on Apotheek.nl how cold and cough remedies work.