For cold and flu treatments, do you need a prescription, or is over-the-counter enough?

Having a cold or flu can cause a nagging cough, chills and fever — but what’s the best way to treat these viruses?

Many options can alleviate cold and flu symptoms, including over-the-counter (OTC) and prescription medications — and it’s important to know the difference.

“A prescription medication requires authorization from a health care provider, and an over-the-counter medication allows you to self-treat conditions such as colds, allergies, headaches and joint pain,” Dr. Elaena Quattrocchi, a pharmacist and associate professor in the Division of Pharmacy Practice at Long Island University in Brooklyn, New York, told Fox News Digital.

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“You can buy OTC medications in a pharmacy, but also in supermarkets and other stores,” she said.

Prescription medications should only be taken if given to a patient by a health care professional, Quattrocchi advised. 

Some medications are available in both a prescription and an OTC version, varying by size of the doses and length of time they’re taken.

“Prescription medications are better for treating the flu, since there are antiviral agents that can be prescribed,” the pharmacist told Fox News Digital. “The medications must be given in a timely fashion or they will not work.”

The majority of supplements for cold and flu “lack evidence for efficacy,” Quattrocchi noted.

If cold symptoms persist or if a person seems to get better and then gets worse, this could be a sign of an underlying infection that requires medical attention, she noted.

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“The only tried-and-tested treatments for influenza are the FDA-approved antivirals,” said Dr. Aaron E. Glatt, chair of the department of medicine and chief of infectious diseases at Mount Sinai South Nassau in Long Island, New York.

“Certainly, they are not anywhere near perfect, and should be used as appropriate under a physician’s guidance.”

When it comes to symptom relief, Glatt said, “Over-the-counter remedies will at best provide improvement a couple of hours earlier, but could also have potential toxicities and side effects that may be worse than those few hours of symptom relief.”

Many medications for viral infections target symptom control, said Dr. Frederick Davis, the associate chair of emergency medicine at Northwell Health Long Island Jewish Medical Center in New Hyde Park, New York.

“Some prescription medications might target a specific virus — like Paxlovid for COVID or Tamiflu in cases of flu,” he said. 

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“These prescription drugs might reduce the severity or duration of symptoms.”

Potential side effects

OTC medications do have some side effects — and just because a drug is available without a prescription doesn’t mean it is safe or appropriate for every individual, Davis and Glatt cautioned.

Pseudoephedrine, an ingredient found in many OTC medications, is an effective decongestant but can produce some side effects for people, such as difficulty sleeping, dizziness and nervousness, Davis pointed out.

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“It can also increase blood pressure, which can be a concern for those who already have elevated blood pressure,” he said.

The drug is now sold behind the pharmacy counter because of its use by some to make methamphetamines from it, Davis noted.

Certain nasal decongestant sprays, like Afrin, can relieve sinus and nasal congestion, but cannot be used for more than three days because they can cause rebound congestion.

Another OTC medication called phenylephrine was “taken off the shelf because it was deemed ineffective,” said Davis.

It is important that individuals tell their health care provider and pharmacist about any OTC medications they are taking or plan to take, as some may be contraindicated if a person has certain underlying medical conditions, Quattrocchi told Fox News Digital.

“Some OTC medications can interact with prescription medications,” she added. “Some vitamins and supplements can interact as well.”

The pharmacist also warned about giving OTC medications to children. 

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“OTC medications should never be given to children without consulting their pediatricians,” she told Fox News Digital. 

“The FDA doesn’t recommend OTC medications for cough and cold symptoms in children younger than 2 years of age because they can cause serious side effects.” 

Quattrocchi also warned parents to never give a child any medication that is intended for an adult.

“For children, never use aspirin-containing products to treat a fever,” she said. “Do not use honey in children under 12 months old, as it can contain bacteria that can cause botulism.”

The pharmacist also emphasized the importance of reading labels carefully, as certain types of medications have an adult version and a baby version.

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When deciding between an OTC and prescription medication, choosing the latter may help cut costs in some cases.

“OTC drugs may be more expensive than prescription medications that are covered under a patient’s health plan,” Quattrocchi said.

Besides taking medication, there are other methods to help alleviate cold and flu symptoms. 

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Another typical approach is to get plenty of rest, drink plenty of fluids and reduce the risk of spreading it to others through handwashing.

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Beyond treating flu symptoms, health experts agree that it is even more important to avoid getting influenza in the first place.

“The best real prevention against influenza is to get vaccinated, and to stay home if you are sick so as to not expose everyone else,” Glatt, who is also a spokesperson for the Infectious Diseases Society of America, told Fox News Digital.

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