For the flu, you can take a combination of prescription antivirals to shorten the illness and over-the-counter medications to manage symptoms like fever, body aches, cough, and congestion. Antivirals work best when started within 48 hours of your first symptoms, while OTC options can help you feel more comfortable at any point during the illness. What you reach for depends on your symptoms, how long you’ve been sick, and whether you’re in a higher-risk group.
Prescription Antivirals
Four FDA-approved antiviral medications can actually fight the flu virus rather than just mask symptoms. The most commonly prescribed is oseltamivir (Tamiflu), a pill you take twice a day for five days. It works by blocking an enzyme the virus needs to spread from cell to cell in your body. There’s also baloxavir (Xofluza), which takes a different approach by stopping the virus from copying its genetic material. The appeal of baloxavir is convenience: it’s a single dose, one time, and you’re done.
Two other options exist but are less commonly used. Zanamivir (Relenza) is inhaled through a disk device, and peramivir (Rapivab) is given through an IV, typically in a hospital or clinic setting.
The critical detail with all antivirals is timing. They’re most effective when started within 48 hours of symptom onset. The sooner you begin, the more you shorten the duration and severity of illness. If you’re in a high-risk group, including adults 65 and older, pregnant women, young children, or people with chronic conditions like asthma, diabetes, or heart disease, getting an antiviral quickly is especially important. These groups face a higher chance of serious flu complications like pneumonia, so doctors will often prescribe antivirals based on symptoms alone rather than waiting for test results.
OTC Pain Relievers and Fever Reducers
Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) are the go-to options for the fever, headache, and muscle pain that come with the flu. Both bring down fever and reduce the deep body aches that make it hard to get out of bed. Neither one kills the virus, but they can make the difference between lying miserable on the couch and actually getting some rest.
For children, acetaminophen is safe after 3 months of age, and ibuprofen after 6 months. One important safety note for kids and teenagers: never give aspirin during the flu. Aspirin use during viral infections like influenza is strongly linked to Reye syndrome, a rare but serious condition that causes swelling in the liver and brain. Stick with acetaminophen or ibuprofen instead. Ibuprofen should also be avoided in children who are dehydrated or vomiting continuously.
Cough and Congestion Medications
The type of cough you have determines which medication to use. If you have a wet, mucus-producing cough, an expectorant containing guaifenesin can help. It thins and loosens mucus so you can cough it up more effectively. It won’t stop your coughing, but it makes each cough more productive, clearing out your airways faster. Don’t use an expectorant for a dry cough.
For a dry, hacking cough that keeps you up at night, a suppressant containing dextromethorphan (often labeled “DM” on packaging) can quiet the cough reflex. Many combination cold and flu products bundle these with a pain reliever and decongestant, so check the ingredient labels carefully to avoid doubling up on acetaminophen or other active ingredients you’re already taking separately.
Honey is another option for cough relief, performing about as well as dextromethorphan at reducing cough frequency in studies of children. A Cochrane review found it may actually work better than some antihistamine-based cough medications. A spoonful before bed can help ease nighttime coughing. However, honey should never be given to infants under 12 months old due to the risk of botulism.
Staying Hydrated
Flu symptoms like fever, sweating, vomiting, and diarrhea all drain fluids and electrolytes from your body. Replacing them isn’t optional. Water is the foundation, but if you’ve been vomiting or have diarrhea, drinks with electrolytes (sports drinks, oral rehydration solutions, or broth) help replenish sodium and potassium your body is losing. A general daily fluid target is about 15.5 cups for men and 11.5 cups for women from all sources, including food, though you may need more when running a fever.
Signs you’re falling behind on fluids include dark urine, dry mouth, and dizziness. In children, watch for no urination for 8 hours, dry mouth, or no tears when crying.
Supplements and Natural Remedies
Zinc, vitamin C, and elderberry are the most popular supplement choices during flu season, though the evidence behind them varies. Most of the research has been conducted on colds rather than influenza specifically, so the results don’t translate perfectly.
Zinc lozenges, taken at doses around 80 mg per day and started within 24 hours of symptoms, shortened the duration of nasal congestion, sore throat, cough, and muscle aches in a meta-analysis of clinical trials. The key is starting early and using zinc acetate lozenges rather than other forms.
Vitamin C is less impressive. A large Cochrane review of over 11,000 people found that taking it regularly did not prevent colds in the general population. Some studies showed modest reductions in symptom length and severity, but those results weren’t consistent across trials. It’s unlikely to hurt, but don’t expect it to cut your flu short in a meaningful way.
Elderberry has more promising data. A 2019 meta-analysis of four studies found that black elderberry supplements significantly reduced both the duration and severity of upper respiratory symptoms compared to placebo. It’s available as syrups, lozenges, and capsules, and is generally well tolerated.
Warning Signs That Need Immediate Attention
Most people recover from the flu within one to two weeks with the treatments above. But certain symptoms signal something more dangerous is happening. In adults, seek emergency care for difficulty breathing, persistent chest or abdominal pain, confusion or inability to stay awake, seizures, not urinating, or severe weakness. A fever or cough that improves and then comes back worse is also a red flag, as it can indicate a secondary infection like pneumonia.
In children, the warning signs include fast or labored breathing, bluish lips or face, ribs pulling in with each breath, severe muscle pain (a child who refuses to walk), dehydration, or unresponsiveness. Any fever in an infant under 12 weeks warrants immediate medical evaluation, as does a fever above 104°F that doesn’t respond to medication.