Viral upper-respiratory infection, most often rhinovirus. Nothing OTC shortens it; everything is symptom management. Recovery is rest, fluids, and time, typically 7 to 10 days with the worst on days 2 to 4. Reference: MedlinePlus: Common Cold.
Rough diagnosis
Usually starts with a sore or scratchy throat, then congestion and runny nose, then a cough as it drains. Gradual onset, mild overall.
Typical symptoms:
- Sore throat, often worst on waking
- Nasal congestion, runny nose, sneezing
- Fatigue and low energy
- Mild cough, sometimes lingering a week or two past everything else
- Post-nasal drip
- Mild headache or body aches
- Low-grade fever at most; often none in adults
- Watery eyes, ear pressure
Don’t confuse with
The first column is the cold itself, as the baseline.
| Cold | Flu | COVID | Sinus infection | |
|---|---|---|---|---|
| Onset | gradual | sudden, hits hard | variable | after a cold lingers |
| Fever | rare, low | high, chills | common | possible |
| Aches | mild | severe | common | facial pain or pressure |
| Sore throat | mild, early | sometimes | sometimes | none |
| Duration | 7 to 10 days | 1 to 2 weeks, worse | variable | 10+ days, or worsens after improving |
Strep is the other one worth knowing: severe sore throat with no cough, white patches, sudden fever. That needs antibiotics.
Get seen if symptoms last past 10 days, fever hits 103 °F or lasts 3+ days, breathing gets difficult, facial pain is severe, or things improve and then get worse again.
What to take (generics)
| Symptom | Active ingredient | Notes |
|---|---|---|
| Sore throat, aches, fever | acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) | Motrin and Advil are both ibuprofen, so pick one. Tylenol can be combined with ibuprofen. |
| Congestion | saline spray; oxymetazoline spray (Afrin) | Oxymetazoline max 3 days (rebound congestion). Oral phenylephrine doesn’t work. Pseudoephedrine works but is behind the counter. |
| Cough | dextromethorphan (DM); honey | Honey is about as effective. |
| Chest mucus | guaifenesin (Mucinex) | |
| Nighttime, runny nose | diphenhydramine, doxylamine | Sedating; this is what’s in NyQuil. |
Single-ingredient generics beat combo products, since you only take what the symptom needs.
Low-evidence but harmless (this is what Whole Foods 365 OTC mostly stocks): zinc lozenges (weak support if started early), elderberry, echinacea, garlic (crushing a clove and letting it rest 10 to 15 minutes does produce allicin, but the cold evidence is thin and colds are viral, so antibacterial doesn’t help), and ginger with honey for the throat.
Interactions with my meds
- Adderall XR: skip decongestants (pseudoephedrine, phenylephrine). Stimulant stacking on heart rate and blood pressure. Saline spray instead.
- Trazodone: skip dextromethorphan (serotonergic overlap, small but avoidable). Don’t add diphenhydramine or doxylamine on top; trazodone is already the sleep aid.
- High-dose fish oil: mildly additive bleeding tendency with ibuprofen. Fine for a few days, just don’t overdo it.
Default protocol
Tylenol or ibuprofen as needed, saline spray, honey and ginger tea, trazodone at night as usual, rest and fluids.