From the Guidelines
For a viral upper respiratory infection (URI) causing sore throat and cough, the best medications are primarily symptom-based treatments, including over-the-counter pain relievers like acetaminophen or ibuprofen, throat lozenges, and cough suppressants like dextromethorphan. The management of viral URI is primarily directed toward relief of symptoms, as antibiotics are ineffective for viral illness and do not provide direct symptom relief 1.
Symptom-Based Treatments
- Over-the-counter pain relievers like acetaminophen (Tylenol) 325-650mg every 4-6 hours or ibuprofen (Advil, Motrin) 200-400mg every 6-8 hours can reduce throat pain and inflammation.
- For sore throat relief, throat lozenges containing benzocaine or menthol, warm salt water gargles (1/4 to 1/2 teaspoon of salt in 8 ounces of warm water), and honey (1-2 teaspoons, not for children under 1 year) are effective options.
- For cough, dextromethorphan (Robitussin DM, Delsym) can suppress coughing, while guaifenesin (Mucinex) helps thin mucus.
- Staying hydrated, using a humidifier, and getting adequate rest support recovery.
These treatments work by temporarily reducing pain signals, decreasing inflammation, moisturizing irritated tissues, or suppressing the cough reflex. Since viral infections don't respond to antibiotics, symptom management is the primary approach while your body fights the infection, which typically resolves within 7-10 days 1.
Additional Considerations
- Nasal saline may be palliative and cleansing with low risk of adverse reactions 1.
- Oral decongestants may provide symptomatic relief and should be considered barring any medical contraindications, such as hypertension or anxiety 1.
- Topical intranasal steroids may have a role in managing VRS, even though they do not have a Food and Drug Administration (FDA) indication for this purpose 1.
From the FDA Drug Label
Package/Label Principal Display Panel Compare to Delsym® active ingredient Dextromethorphan Polistirex Extended-Release Oral Suspension Cough Suppressant Purpose Cough suppressant
The best medication prescribed for cough in the setting of a viral upper respiratory infection (URI) is dextromethorphan (PO), a cough suppressant 2 2. However, there is no information about the best medication for sore throat. Key points:
- Dextromethorphan is used for cough relief
- No information is available for sore throat treatment in the given context
From the Research
Medications for Sore Throat and Cough in Viral URI
- The best medications for a sore throat and cough in the setting of a viral upper respiratory infection (URI) include:
- Acetaminophen or ibuprofen for pain and fever relief 3
- Aspirin (acetylsalicylic acid) for pain and fever relief, as well as reduction in sore throat pain intensity 4, 5
- Lozenges containing amylmetacresol and 2,4-dichlorobenzyl alcohol (AMC/DCBA) or hexylresorcinol for symptomatic relief of sore throat 6, 7
- These medications can help alleviate symptoms such as headache, achiness, and feverish discomfort, but may not be effective against sinus sensitivity to percussion or sore throat in all cases 4
- It's essential to note that antibiotics are not effective against viral URIs and should not be used unless a bacterial infection is present 3
Mechanism of Action
- Aspirin (acetylsalicylic acid) has been shown to provide relief from sore throat pain, headache, and muscle aches and pains associated with URTI by reducing pain and inflammation 5
- AMC/DCBA lozenges have been found to have virucidal effects against parainfluenza virus type 3 and cytomegalovirus, and can provide rapid analgesic effects that last for 2 hours 6, 7