Best over the counter medicine for sinus drainage and cough

Topic Overview

Medicines available without a prescription may help relieve pain and promote sinus drainage. Be safe with medicines. Read and follow all instructions on the label. You can:

• Try a pain reliever such as acetaminophen or ibuprofen to relieve facial pain and headache.
• Use a decongestant nasal spray, gel, or drops (such as Claritin Allergy or Drixoral) to help a stuffy nose. Don't use a nasal decongestant longer than the label says. Overuse can cause rebound congestion. It makes your mucous membranes swell up more than before you used the spray.
• Try an oral decongestant for a stuffy nose or head. It provides longer relief than the ones that are used in the nose, but it may cause more side effects.
• Try using a medicine that thins mucus and improves sinus drainage (mucolytic). Guaifenesin is a commonly used mucolytic. Mucolytics are often combined with other medicines such as cough suppressants.
• Acetaminophen can be found in many forms and comes in different doses. Be safe with medicines.
• Read and follow all instructions on the label.
• Do not take more than the maximum dose recommended on the label.
• Be careful when taking over-the-counter cold or flu medicines and acetaminophen (Tylenol) at the same time. Many of these medicines already contain acetaminophen. Too much acetaminophen can be harmful.

Be careful with cough and cold medicines. They may not be safe for young children or for people who have certain health problems, so check the label first. Do not give cough and cold medicines to a child younger than 6 unless your child's doctor has told you to. If you do use these medicines, always follow the directions about how much to use based on age and weight.

Be careful when taking over-the-counter cold or flu medicines and Tylenol at the same time. Many of these medicines have acetaminophen, which is Tylenol. Read the labels to make sure that you are not taking more than the recommended dose. Too much acetaminophen can be harmful.

Many doctors do not recommend using antihistamines unless your symptoms are related to having allergies. Antihistamines and decongestants may dry out the mucous membranes in your nose and sinuses and slow the movement of the cilia (the tiny hairs that line the nose, sinuses, and the air passages inside the lungs and that remove irritants). This can make mucus thicker, adding to drainage problems. But other experts believe antihistamines may help treat sinusitis by reducing the amount of mucus that builds up in the sinus cavities. Don't give antihistamines to your child unless you've checked with the doctor first.

Credits

Current as of: September 8, 2021

Author: Healthwise Staff
Medical Review:
Patrice Burgess MD - Family Medicine
Anne C. Poinier MD - Internal Medicine
Kathleen Romito MD - Family Medicine
Adam Husney MD - Family Medicine
Donald R. Mintz MD - Otolaryngology
Martin J. Gabica MD - Family Medicine

Recent Blog Articles

May 14, 2022

• By Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing

You thought it would never end: that tickle in the back of your throat that made you cough or have to clear your throat. It's been going on for months. And now you know why: post-nasal drip. It's a common diagnosis. It can happen for a number of reasons: allergies, viral infections (including the common cold), sinus infections, irritants in the air (such as fumes or dust). Less common causes include something stuck inside the nose (common in small children), pregnancy, and certain medications. Temporary – and normal – causes of post-nasal drip includes certain weather conditions (especially cold, dry air) and spicy foods.

Whatever the cause, the problem is a steady trickle of mucus from the back of the sinuses that irritates the throat and nagging cough or other symptoms.

Now what?

Now that you have an official diagnosis, what can you do for it? There are a number of treatment options, including home remedies and over-the-counter medications:

• A humidifier or steam inhalation (as during a hot shower)
• Keeping well-hydrated (to keep the mucus thinner)
• Sleep on propped up pillows, to keep the mucus from collecting at the back of your throat
• Nasal irrigation (available over-the-counter)
• An oral decongestant, such as pseudoephedrine (as in Sudafed) or phenylephrine (as in Sudafed PE or Neo-Synephrine)
• Guaifenesin (as in Mucinex), a medication that can thin the mucus
• An antihistamine, such as
  • diphenhydramine, as in Benadryl
  • chlorpheniramine, as in Chlor-Trimeton
  • loratadine, as in Claritin or Alavert
  • fexofenadine (Allegra)
  • cetirizine (Zyrtec)
  • levocetirizine (Xyzal)
  • desloratadine (Clarinex)
• A nasal decongestant such as oxymetazoline (contained in Afrin) which constricts blood vessels in the nasal passages; this leads to less secretions. Such medications should only be taken for a day or two; longer-term use can cause more harm than good)

Keep in mind that many of these medications are combined in over-the-counter products. For example, there are several formulations of "Sudafed" containing pseudoephedrine or phenylephrine along with additional drugs including acetaminophen, dextromethorphan, and guaifenesin. While these combinations can be effective, it's important to read the label and avoid taking too much of any active ingredient.

What about prescription treatments?

If these approaches aren't effective, prescription treatments may be the next best steps, including:

• A nasal steroid spray (such as beclomethasone/Beconase or triamcinolone/Nasacort)
• Ipratropium (Atrovent) nasal spray which inhibits secretions (such as mucus)

Other treatments depend on the cause of the post-nasal drip. Antibiotics are not usually helpful, so they aren't usually prescribed for post-nasal drip (unless the symptoms are due to bacterial infection of the sinuses). For allergies, dusting and vacuuming often, covering your mattresses and pillowcases, and special air filter can help reduce exposure to allergy triggers.

What about chicken soup?

If you've been told that chicken soup helps with post-nasal drip (or other symptoms of a cold or flu), it's true! But it doesn't actually have to be chicken soup - any hot liquid can help thin the mucus and help you maintain hydration.

When should I call a doctor?

In most cases, post-nasal drip is annoying but not dangerous. However, you should contact your doctor if you have:

• Unexplained fever
• Bloody mucus
• Wheezing or shortness of breath
• Foul smelling drainage
• Persistent symptoms despite treatment

The bad news/good news about post-nasal drip

Post-nasal drip is among the most common causes of persistent cough, hoarseness, sore throat and other annoying symptoms. It can be caused by a number of conditions and may linger for weeks or months. That's the bad news. The good news is that most of the causes can be quickly identified and most will improve with treatment.

Image: Cecilie_Arcurs/Getty Images

Disclaimer:

As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.

No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

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