Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2004;70(7):1341-1342

How can I tell if I have a cold or the flu?

Colds and the flu have many of the same symptoms. A cold is usually mild, while the flu tends to be more severe.

When you have a cold, you usually feel tired and have a sneeze, cough, and runny nose. You may not have a fever, or you may run a low fever (just one or two degrees higher than usual). You also may have sore muscles, a scratchy or sore throat, watery eyes, and a headache.

The flu starts suddenly and hits hard. You will probably feel weak and tired, and have a fever, dry cough, runny nose, chills, sore muscles, a bad headache, eye pain, and a sore throat. It usually takes longer to get over the flu than it does to get over a cold.

What causes colds and the flu?

More than 100 different viruses can cause colds. There are not as many viruses that cause the flu. That is why there are vaccines (shots) to help keep you from getting the flu.

What about medicine?

No medicine can cure a cold or the flu. Antibiotics do not work against viruses. Some medicines can help with some of your cold or flu symptoms. Check with your doctor before giving any medicine to children. You can buy many cold and flu medicines at the drugstore without a doctor’s prescription. See the box below for a guide to common ingredients in cold and flu medicines.

Some prescription medicines, called antivirals, can help with flu symptoms. These medicines may help you feel better if you start taking them soon after you begin to get sick. These medicines come as pills or in an inhaler. The inhaled kind may cause problems for some people with asthma or chronic obstructive pulmonary disease (or COPD). If you have asthma, be sure the doctor treating you for a cold or flu knows that you have asthma.

What is in over-the-counter cold and flu medicines?

The following ingredients are found in many cold and flu medicines. Read labels carefully. If you have questions, talk to your doctor or pharmacist.

  • Analgesics and anti-inflammatories relieve aches and pains and reduce fever. Some examples are acetaminophen (one brand name: Tylenol), aspirin, ibuprofen (some brand names: Motrin, Advil), ketoprofen (one brand name: Orudis), and naproxen (one brand name: Aleve). Children and teenagers should not take aspirin.

  • Antitussives keep you from coughing. One example is dextromethorphan (some brand names: Coricidin, Robitussin). Do not take an antitussive if you are coughing up mucus.

  • Expectorants help thin mucus so it can be coughed up more easily. One example is guaifenesin (one brand name: Mucinex).

  • Oral decongestants shrink the passages in the nose and reduce congestion. An example is pseudoephedrine (one brand name: Sudafed).

Should I call my doctor?

In most cases, you do not need to see your doctor when you have a cold or the flu. You can treat your symptoms by following the advice in the box below. If you just started having symptoms of the flu, call your doctor to see if you can take an antiviral medicine. Also, call your doctor if you have any of the following:

  • A cold that lasts for more than 10 days

  • Earache or drainage from your ear

  • Severe pain in your face or forehead

  • Temperature higher than 102°F

  • Shortness of breath

  • Hoarseness, sore throat, or a cough that will not go away

  • Wheezing

How to treat your cold and flu symptoms

  • Stay home and rest, especially while you have a fever.

  • Stop smoking and avoid secondhand smoke.

  • Drink plenty of fluids like water, fruit juices, and clear soups.

  • Do not drink alcohol.

  • Gargle with warm salt water a few times a day to help a sore throat feel better. Throat sprays or lozenges also may help with sore throat pain.

  • Use salt-water (saline) nose drops to help loosen mucus and moisten the tender skin in your nose.

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