For the flu, you can take a combination of prescription antivirals, over-the-counter fever and pain relievers, and symptom-specific medications to shorten the illness and feel better while your body fights it off. The most important decision is whether to get a prescription antiviral, which works best when started within 48 hours of your first symptoms.
Prescription Antivirals
Antiviral medications are the only treatments that actually fight the flu virus rather than just masking symptoms. Four are currently approved in the United States. Oseltamivir (Tamiflu) is the most commonly prescribed, available as a pill or liquid, and approved for anyone 14 days and older. Baloxavir is a single-dose pill for people 5 and older, which makes it convenient since you take it once and you’re done. Zanamivir is an inhaled powder for ages 7 and up. Peramivir is given as an IV infusion by a healthcare provider, typically reserved for people who can’t take oral medications.
Timing matters more than which antiviral you choose. All of them are designed for early treatment, ideally within the first two days of symptoms. The sooner you start, the more they shorten your illness and reduce the risk of complications like pneumonia. If you’re otherwise healthy and your symptoms are already improving by the time you see a provider, you may not need one. But for people at higher risk of serious complications, the CDC recommends starting antivirals promptly, even before test results come back.
Who Should Prioritize Antivirals
Certain groups face a much higher chance of dangerous flu complications and should contact a provider as soon as symptoms appear. These include adults 65 and older, children under 2, pregnant women (including up to two weeks after delivery), and people with chronic conditions like asthma, COPD, diabetes, heart disease, kidney or liver disorders, and weakened immune systems. People with a BMI of 40 or higher, those who have had a stroke, and people living in nursing homes or long-term care facilities are also in this category.
Fever and Body Ache Relief
Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) are the go-to options for bringing down fever and easing the muscle aches that make the flu miserable. You can use either one, and some people alternate between them. The key safety limit for acetaminophen is 4,000 milligrams in 24 hours. This is easy to exceed accidentally because acetaminophen is an ingredient in many combination cold and flu products. Before stacking medications, check every label.
One critical rule: do not give aspirin to children or teenagers with the flu. Aspirin during a viral illness in this age group is linked to Reye’s syndrome, a rare but serious condition that causes swelling in the liver and brain. Stick with acetaminophen or ibuprofen for anyone under 19.
Cough and Congestion Medications
Which cough medication you reach for depends on the type of cough. A dry, hacking cough that keeps you up at night responds best to a cough suppressant like dextromethorphan (found in products labeled “DM”). If your cough is producing thick mucus, an expectorant like guaifenesin helps thin it out so you can clear it more easily. Many combination products contain both.
For nasal congestion, be aware that oral phenylephrine, the decongestant found in most cold products on pharmacy shelves, doesn’t actually work. An FDA advisory committee voted unanimously that oral phenylephrine is ineffective at reducing nasal congestion at the standard dose. Pseudoephedrine (the active ingredient in original Sudafed) does work but is kept behind the pharmacy counter in most states. You’ll need to ask for it and show ID. Nasal spray decongestants are another option, though they shouldn’t be used for more than three days to avoid rebound congestion.
Zinc Lozenges
Zinc lozenges are one of the few supplements with real clinical evidence behind them, though most of the research involves the common cold rather than influenza specifically. A meta-analysis of zinc acetate lozenge trials found that colds were shortened by an average of three days, roughly a 36% reduction in illness duration. The effective dose appears to be around 80 milligrams of elemental zinc per day, and doses above that range don’t seem to add benefit. Like antivirals, zinc works best when started as soon as possible after symptoms begin.
Not all zinc lozenges are equally effective. Look for zinc acetate or zinc gluconate as the active ingredient. Flavored lozenges sometimes contain ingredients that bind to zinc and reduce its availability, so simpler formulations tend to perform better in studies.
Staying Hydrated and Resting
This sounds basic, but dehydration is one of the most common complications of the flu, especially when fever, sweating, and reduced appetite are all working against you. Water, broth, and electrolyte drinks help more than you might expect. Fever alone can increase your fluid needs significantly, and dehydration makes headaches, fatigue, and dizziness worse. Rest isn’t just comfort advice. Your immune system works harder during sleep, and pushing through the flu tends to prolong it.
What Not to Take
Antibiotics do nothing for the flu. Influenza is a virus, and antibiotics only treat bacterial infections. Your provider might prescribe antibiotics if you develop a secondary bacterial infection like bacterial pneumonia, but they won’t help with the flu itself.
Avoid giving over-the-counter cough and cold products to children under 4, as these carry risks of serious side effects in young kids without proven benefit. And again, skip any product containing aspirin or salicylates for anyone under 19 during a flu illness.
Emergency Warning Signs
Most people recover from the flu within one to two weeks. But certain symptoms signal that something more dangerous is happening. In adults, watch for difficulty breathing, persistent chest or abdominal pain, confusion or dizziness that won’t resolve, not urinating, seizures, and severe weakness. A fever or cough that improves and then suddenly returns or worsens is another red flag, as it can indicate a secondary infection.
In children, the warning signs include fast or labored breathing, bluish lips or face, ribs pulling in visibly with each breath, refusal to walk due to muscle pain, and signs of dehydration like no urine for eight hours, dry mouth, or no tears when crying. For babies under 12 weeks, any fever during flu season warrants immediate medical attention.