What are medicines for colds, flu (influenza) and COVID-19?

If you have a cold, the flu (influenza) or COVID-19, you can take different types of medicines to relieve your symptoms or help you recover more quickly.

What types of medicines might I be prescribed?

Common medicines that may help manage your cold, flu or COVID-19 symptoms include:

• pain relief medicines, such as paracetamol and ibuprofen, to relieve headaches, fever, muscle aches, sore throat and sinus pain
• decongestant sprays or pills to unblock your nose
• cough suppressants to reduce your cough
• nasal sprays such as ipratropium to relieve a runny nose and sneezing
• antihistamines combined with decongestants, which relieve a runny nose and sneezing

Your doctor may also prescribe antiviral medicines if you have been diagnosed with the flu or COVID-19 and are eligible — these medicines are not recommended for every situation.

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What types of medicines will not be prescribed?

Common colds, the flu and COVID-19 are caused by viruses, not bacteria. Antibiotics only treat bacterial infections.

Your doctor won’t prescribe an antibiotic for a viral illness, unless they think you have a bacterial infection as well.

Antivirals are also not prescribed if you have a cold.

Learn about cold, flu and COVID-19 medicine for children.

How do medicines for colds, flu and COVID-19 work?

There are different medicines you might take for your cold, flu or COVID-19 symptoms.

Pain and fever relievers

Your doctor may recommend you take paracetamol or ibuprofen. You can buy them over the counter at your local pharmacy or supermarket.

Paracetamol works by blocking signals in the brain that control pain and fever.

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID). Ibuprofen blocks inflammation at the site of injury or illness, and reduces pain and fever.

Decongestants

Decongestants work by reducing swelling of the blood vessels in your nose. This clears your blocked or stuffy nose, making it easier for you to breathe.

Cough suppressants

Cough suppressants reduce your urge to cough by blocking the cough reflex in your brain. Check with your pharmacist before you take a cough suppressant or give one to your child.

Antihistamines

Antihistamines work by blocking the effects of histamine — a chemical your body releases during a cold that causes symptoms like a runny nose, sneezing and watery eyes. While antihistamines alone aren’t effective for colds, they can help relieve symptoms when combined with another medicine, such as a decongestant.

Intranasal ipratropium

Ipratropium reduces the amount of mucus your nose produces.

Antivirals

Antivirals work by preventing viruses from replicating or spreading between your cells. There are antivirals for the flu and COVID-19. You need to meet certain conditions to take antivirals, such as being at higher risk of severe illness. Your doctor will advise if they are right for you.

Combination cold and flu medicines

There are many cold and flu products that include different mixes of medicines. Many are available over the counter at your local pharmacy or supermarket.

Remember to read the instructions and any warnings. Some may be specifically for night-time as they may contain ingredients that can make you drowsy. Discuss with your pharmacist or doctor before starting any new medicines, or taking combination products with other medicines, such as paracetamol or ibuprofen.

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What are the side effects or risks of colds, flu and COVID-19 medicine?

There are risks and side effects with all medicines, including over-the-counter medicines. Ask your pharmacist for advice on side effects before you start taking a new medicine. Always follow your doctor’s advice when taking prescription medicines.

Paracetamol

The most common side effect of paracetamol is an increase in some liver enzymes.

Rare side effects include:

• allergic reaction
• low blood pressure
• blood problems (neutropenia)

Paracetamol overdose can cause severe and permanent liver damage:

• Adults should not take more than 8 regular (500 mg) tablets or 6 controlled-release tablets a day.
• For children, follow the label’s dose and timing, or ask a pharmacist for advice. If pain or fever lasts more than 48 hours, or you are concerned, see a doctor.

There are many brands of paracetamol, including some combined with other medicines. To avoid overdose, check the strength and dose carefully.

Do not use more than one product with paracetamol at the same time. Read the label of the medicine before you take it. Follow your doctor’s or pharmacist’s advice.

You can safely take paracetamol if you’re pregnant or breastfeeding.

Ibuprofen

Ibuprofen can cause side effects of:

• nausea and diarrhoea
• stomach ulcers
• gastrointestinal bleeding
• elevated liver enzymes
• high blood pressure

There are some risks with ibuprofen, including if you:

• are dehydrated and take ibuprofen, it can damage your kidneys
• live with asthma, ibuprofen can cause your airways to narrow
• have a blood clotting disorder, ibuprofen can increase your risk of bleeding

Your doctor may recommend you don’t take ibuprofen (and other NSAIDs) if you:

• live with liver disease, heart disease, heart failure or have had a stroke or heart attack
• have a peptic (stomach) ulcer or have had a gastrointestinal (GI) bleed
• have kidney disease
• are pregnant

Decongestants

In rare cases, decongestants can cause hallucinations or seizures.

You should avoid decongestants if you:

• are in your first trimester of pregnancy
• have severe heart disease
• have high blood pressure not managed well by medicines

You can safely take decongestants whilst breastfeeding, but they may reduce your milk supply.

Do not take intranasal decongestants for more than 5 days in a row.

Ipratropium

Inhaled ipratropium can cause side effects that usually go away on their own, including:

• nosebleeds
• dry nose
• headaches

Cough suppressants

Cough suppressants can cause the following side effects:

• drowsiness
• constipation
• nausea and vomiting

If you take cough suppressants, do not drive or operate any heavy machinery. You should also avoid alcohol as it can make you even more drowsy.

Antihistamines

Some antihistamines, including diphenhydramine, can cause:

• drowsiness and confusion
• headaches
• constipation
• dry eyes
• dry mouth

If you feel drowsy when taking an antihistamine, do not drive or operate any heavy machinery.

Nasal antihistamines can cause irritation in or around your nose.

When should I see my doctor?

You should see your doctor if you have a cold, the flu or COVID-19 and your symptoms are not getting better or are getting worse. See your doctor if you have another serious health condition that may get worse with your symptoms.

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Are there any alternatives to these medicines?

Preventing illness is the best alternative to getting sick and needing medicines.

There are ways you can try to prevent getting a cold, the flu or COVID-19:

• Get your flu and COVID-19 vaccines to protect against catching and spreading these illnesses.
• Practice good hand hygiene.
• Social distancing can help prevent the spread of infection.

Alternative treatments may also help relieve your symptoms:

• Zinc supplements have been shown to help relieve cough and nasal discharge, if you take supplements every day and within 24 hours of becoming ill.
• There is some evidence that probiotics containing Lactobacillus casei can reduce the duration of your symptoms.

Echinacea and vitamin D supplements do not improve common cold symptoms. If you already have symptoms, vitamin C supplements won’t reduce their severity or make them go away faster.

Resources and support

• Healthy WA has information about symptoms and treatment of the common cold.
• Learn more about the flu vaccine and check if you are eligible for a free vaccine under the National Immunisation Program, on the Department of Health, Disability and Ageing website.

Information for Aboriginal and/or Torres Strait Islander peoples

• Learn more about COVID-19 with NSW Health fact sheets for Aboriginal and/or Torres Strait Islander peoples.

Languages other than English

• NSW Health has translated fact sheets on the flu into different community languages.

You can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.