Most people with COVID-19 recover at home with over-the-counter medications for fever, body aches, and cough. If you’re at higher risk for severe illness, a prescription antiviral taken within the first five days of symptoms can significantly reduce your chance of hospitalization. What you should take depends on your symptoms, your risk factors, and how quickly you act.
Over-the-Counter Basics for Mild Symptoms
For the majority of people, COVID-19 feels like a bad cold or flu and resolves on its own. The CDC recommends treating symptoms with acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to manage fever, headaches, and body aches. Either one works. Acetaminophen tends to be gentler on the stomach, while ibuprofen also reduces inflammation. You can alternate between the two if one alone isn’t keeping your fever down, but don’t exceed the dosing instructions on the label.
For cough, the type matters. COVID is known for causing a dry, persistent cough. A cough suppressant containing dextromethorphan (found in brands like Delsym or Robitussin DM) is the better match for that. If your cough is wet and producing mucus, an expectorant like guaifenesin (Mucinex) helps thin the mucus so you can clear it more easily. Sore throat sprays, lozenges, and saline nasal rinses can also take the edge off upper respiratory symptoms.
Staying Hydrated While Sick
Fever, sweating, and reduced appetite can dehydrate you faster than you realize. Drink water, broth, herbal tea, or electrolyte drinks in small, frequent sips throughout the day, especially if you’re running a fever. If plain water feels unappealing, diluted juice or popsicles count too. The goal is steady intake rather than forcing large amounts at once, which can trigger nausea.
Watch for signs of dehydration: dry mouth, dark urine, dizziness when standing, or urinating much less than usual. These are signals to push fluids more aggressively. If you can’t keep liquids down for more than several hours, that warrants medical attention.
Prescription Antivirals for High-Risk Patients
If you have risk factors for severe COVID, such as being over 65, having diabetes, heart disease, obesity, a weakened immune system, or chronic lung disease, antiviral treatment can make a meaningful difference. The key constraint is timing: treatment needs to start as soon as possible and within five to seven days of your first symptoms.
The first-choice prescription is Paxlovid, a five-day course of pills taken twice daily. It’s approved for adults and authorized for adolescents 12 and older who weigh at least 88 pounds. Paxlovid works by blocking the virus from replicating, and clinical trials showed it substantially reduced hospitalizations in high-risk patients. The catch is that it interacts with a long list of other medications, including certain blood thinners, heart rhythm drugs, some cholesterol medications, and even some hormonal contraceptives. Your doctor or pharmacist will need to review everything you’re currently taking. Some medications can be paused for the five-day treatment course, but others create hard conflicts. People with severe kidney or liver problems aren’t candidates.
If Paxlovid isn’t an option because of drug interactions or other reasons, there are alternatives. Remdesivir is a three-day IV treatment given at an infusion center, started within seven days of symptom onset. It’s the second-preferred option. A third choice, molnupiravir, is an oral antiviral available when neither Paxlovid nor remdesivir is accessible or appropriate. It’s less effective, reducing the risk of hospitalization or death by about 30% compared to placebo in clinical trials. But for patients who can’t take Paxlovid due to medication conflicts, it fills an important gap.
To get any of these, you need a prescription. Many telehealth services and pharmacies with test-to-treat programs can prescribe them quickly. Don’t wait to see if you get worse first. The drugs work best when started early.
What About Vitamins and Supplements?
Vitamin C, zinc, and vitamin D were widely discussed early in the pandemic, but the clinical evidence has been disappointing. A 2021 randomized study gave people with mild COVID-19 high-dose vitamin C (8,000 mg per day), zinc (50 mg per day), both together, or neither. The researchers found no improvement in symptoms and no faster recovery in any of the supplement groups compared to people who took nothing. A separate randomized controlled trial of high-dose vitamin D in people with moderate to severe COVID also showed no benefit.
That doesn’t mean these nutrients are worthless for general health. If you’re deficient in vitamin D, correcting that deficiency is still worthwhile for your immune system overall. But taking megadoses of supplements once you’re already sick with COVID is unlikely to change the course of your illness. Your money and energy are better spent on rest, hydration, and getting an antiviral prescription if you qualify.
Reducing Your Risk of Long COVID
One finding worth knowing about: a large randomized trial published in The Lancet Infectious Diseases found that metformin, a common and inexpensive diabetes drug, reduced the incidence of long COVID when started early in infection. The effect was strongest when metformin was started within three days of symptom onset, cutting the risk of developing long COVID by about 63% in that subgroup. The study enrolled adults aged 30 to 85 who were overweight or obese. Metformin isn’t currently a standard recommendation for COVID treatment, but it’s a conversation worth having with your doctor if you fall into that demographic and are concerned about lingering symptoms.
Warning Signs That Need Emergency Care
Most COVID cases stay mild, but certain symptoms signal that your body is struggling and you need immediate help:
- Difficulty breathing or shortness of breath at rest
- Persistent chest pain or pressure
- New confusion or difficulty thinking clearly
- Inability to stay awake or difficulty being roused from sleep
- Pale, gray, or bluish color in your skin, lips, or nail beds
If you have a pulse oximeter at home, an oxygen reading consistently below 94% is a reason to seek care. Readings below 90% are an emergency. These symptoms can develop suddenly, even after several days of feeling like you’re managing fine. People living alone should check in with someone daily so changes don’t go unnoticed.
A Practical Game Plan
The moment you test positive, take stock of your situation. If you have any risk factors for severe illness, contact a healthcare provider that same day to discuss antiviral options. Time is the most important variable. While you wait, start managing symptoms with acetaminophen or ibuprofen, stay hydrated, and rest. Keep a thermometer and pulse oximeter nearby if you have one.
For otherwise healthy people with mild symptoms, the playbook is simpler: treat your symptoms, drink plenty of fluids, isolate to protect others, and monitor yourself for any of the warning signs above. Most people feel significantly better within a week to ten days, though fatigue and a lingering cough can hang around longer. Sleep as much as your body asks for. Recovery isn’t the time to push through.