Flu Treatment in Australia: Medications, Antivirals, and What to Avoid

Key Takeaways:

• Over-the-counter cold and influenza ‘flu’ medication helps with symptoms like fever and aches. It does not kill the flu virus or cut your illness short.

• Prescription antivirals (such as Tamiflu) are available by GP prescription and work best when started within 48 hours of symptoms beginning.

• Never give aspirin to children or teenagers with flu. It carries a risk of a serious condition called Reye's syndrome. Paracetamol or ibuprofen are the safe options.

• Antibiotics do not treat the flu. A GP may prescribe them only if a secondary bacterial infection like pneumonia develops.

• If you are in a high-risk group, including adults 65 and over, pregnant women, or young children, see a GP early.

Once you recognise your flu symptoms, the next question is what to actually do about them.

There are three main ways to treat flu in Australia:

1. Over-the-counter medication for symptom relief

2. Prescription antiviral medication for eligible patients

3. Rest and recovery at home.

Some medications are also best avoided altogether.

Over-the-Counter Flu Medication in Australia

The most important thing to know about over-the-counter (OTC) cold and flu medication is what it cannot do. It does not kill the flu virus, and it will not cut your illness short. What it can do is take the edge off individual symptoms: fever, body aches, congestion, and cough. This helps you feel more comfortable while your body does the work at fighting the flu virus.

Paracetamol and Ibuprofen

Paracetamol and ibuprofen are your two main options for bringing down a fever and easing aches and pains caused by the flu. Both work well for this.

Paracetamol is usually the better choice if you have a sensitive stomach or cannot take anti-inflammatory medicines. If you take ibuprofen, always take it with food to avoid stomach irritation. Always follow the dosing instructions on the label. Check with a pharmacist or GP if you are unsure whether you can safely take these medications.

Decongestants

Decongestants reduce the swelling in your nasal passages, making it easier to breathe through a blocked nose. They can be taken in an oral tablet or liquid form, or via a nasal spray formulation.

Use them for the short term only. Using nasal decongestant sprays for too long can cause rebound congestion, where your blocked nose comes back worse than before once you stop.

Combination Cold and Flu Tablets

Combination cold and flu tablets are the most commonly bought flu medicines over the counter in Australia. They bundle several ingredients (usually paracetamol, a decongestant, and an antihistamine) into a single tablet.

The main thing to watch out for is double-dosing on paracetamol. Many people take a combination tablet and then add paracetamol separately for pain relief, not realising the tablet already contains it. Always read the active ingredients on every product you are taking at the same time.

Cough Suppressants and Throat Lozenges

Cough suppressants and throat lozenges can provide some relief for specific symptoms (e.g., dry irritating cough, sore tickly throat). There is some evidence that drinking warm fluids with honey may soothe a cough and irritated throat.

Prescription Antiviral Medication for Flu

Prescription antiviral medication is the only treatment that works directly against the flu virus itself. Unlike OTC products, antivirals can reduce how severe your illness gets and, when started early enough, may shorten how long it lasts.

They are not prescribed for everyone who gets the flu. Antivirals are prescribed to people who are at a higher risk of serious complications.

Oseltamivir (Tamiflu) and Other Antivirals in Australia

Oseltamivir (Tamiflu) is the most commonly prescribed antiviral for the flu in Australia. It works by blocking the mechanism the flu virus uses to spread through your body, and is taken as a capsule.

According to the Immunisation Coalition's antiviral treatment guide, four antiviral medicines are registered in Australia for flu treatment: oseltamivir (Tamiflu), zanamivir (Relenza, inhaled), peramivir (Rapivab, given by intravenous infusion), and baloxavir marboxil (Xofluza, a single oral dose). Oseltamivir is the one most commonly used in GP clinics.

All antivirals work best when started within 48 hours of symptoms beginning. NSW Health's influenza factsheet advises that antivirals "may reduce severe illness, hospitalisation and death from influenza if taken early". If you are past the 48-hour window but are high-risk with severe or worsening symptoms, a GP may still consider antiviral treatment.

How to Get Antiviral Flu Treatment

Antivirals are prescription-only. You cannot purchase them over the counter. The earlier you see a GP after flu symptoms start, the better. Ideally within the first 24 to 48 hours.

If you cannot get to a clinic, telehealth is an option. A GP can assess your situation remotely and issue a prescription if antivirals are right for you.

Flu Medications to Avoid

Some medications that seem helpful for the flu can actually cause harm. Other medications will not do anything useful.

Aspirin (Especially in Children and Teenagers)

Aspirin must not be given to children or teenagers with the flu. NSW Health advises that "children under 16 years of age must not be given aspirin-containing medications" during a viral illness such as influenza.

The reason is Reye's syndrome, a rare but serious condition that can cause severe damage to the brain and liver. It has been linked to aspirin use in children and teenagers during a viral illness. Paracetamol or ibuprofen are the safe alternatives for this age group.

Adults can generally take aspirin for flu, but paracetamol or ibuprofen are just as effective and easier on the stomach for most people.

Antibiotics

Antibiotics do not treat the flu. The flu is caused by a virus, and antibiotics only work against bacterial infections. Taking them when you do not need them also contributes to antibiotic resistance, which is a growing public health problem.

A GP may prescribe antibiotics if the flu leads to a secondary bacterial complication, such as pneumonia. However, this decision is made on a case-by-case basis and is not a routine part of flu treatment.

Doubling Up on Paracetamol

Taking too much paracetamol is easier than people realise. If you are using a combination cold and flu tablet and then adding paracetamol on top for extra pain relief, you may already be exceeding a safe dose without knowing it.

The maximum safe daily dose of paracetamol for adults is 8 regular (500 mg) tablets per day. Before taking any additional paracetamol, check what is already in the other products you are using.

Codeine-Containing Products

Low-dose codeine products are no longer available over the counter in Australia. Products that once contained small amounts of codeine, including some cough and cold preparations, have been rescheduled and are now prescription-only.

If you relied on an OTC codeine product in the past, speak with a pharmacist or GP about what alternatives are available now.

What Helps at Home: Supportive Care for the Flu

For most healthy adults, the best treatment for the flu is rest, fluids, and time. According to Healthdirect, most people recover on their own within 7 to 10 days.

Here is what actually helps:

• Rest: Give your body the energy it needs to fight the infection. Take it easy, particularly in the first few days.

• Fluids: Drink plenty of water, clear broths, and electrolyte drinks. A fever causes your body to lose more fluid than usual, so staying hydrated is important.

• Honey for cough: Warm water or tea with honey is a recommended option for soothing a cough and throat irritation.

• Saline nasal rinse: Saline nasal sprays or rinses can help with a blocked nose without the risks that come with medicated decongestants.

• Steam inhalation: Breathing in steam can give temporary relief from congestion and may ease a sore throat.

Home care supports your recovery, but it does not replace medical advice. If symptoms are severe, getting worse, or you are in a high-risk group, see a GP.

When to See a GP for Flu Treatment

Most cases of the flu can be managed at home, but certain signs mean you should see a GP without delay. See a GP urgently if you or someone in your care experiences:

• A fever above 38.5 degrees Celsius that persists or comes back after initially improving

• Difficulty breathing or shortness of breath

• Chest pain

• Symptoms that improve and then suddenly get worse again (the "secondary dip")

• Confusion or unusual drowsiness, particularly in older adults

If you are in a high-risk group, do not wait for warning signs and see a GP early. Adults aged 65 and over, pregnant women, people with chronic conditions, young children, and Aboriginal and Torres Strait Islander people with health risk factors are among those NSW Health identifies as being at higher risk of severe flu illness.

Flu can sometimes lead to serious complications. For more detail, see flu and pneumonia. If you are pregnant, flu in pregnancy covers what you need to know. For older adults, see flu in older adults.

Getting the Right Flu Treatment This Season

Think of flu treatment in three layers: rest and home care as the foundation, over-the-counter medication for symptom relief on top of that, and prescription antivirals for eligible patients when needed. Most people only need the first two.

The key things to remember: OTC medication treats symptoms only, not the virus itself. Antibiotics will not help unless a bacterial infection develops. Aspirin must never be given to children or teenagers with the flu. And if you are in a high-risk group, see a GP early, as antivirals work best in the first 48 hours.

Vaccination is still the most effective protection against flu and its complications. Getting vaccinated each year before flu season is the single best step you can take. Learn more about flu vaccination at Myhealth.

Frequently Asked Questions

What is the best cold and flu medicine in Australia?

Paracetamol or ibuprofen are the most effective OTC options for managing fever and body aches. Decongestants help with a blocked nose. Combination cold and flu tablets address multiple symptoms at once. No OTC flu medicine shortens the flu duration. The right product depends on your symptoms. A GP can advise whether prescription antiviral medication is appropriate for your situation.

Is Tamiflu available over the counter in Australia?

No. Oseltamivir (Tamiflu) is prescription-only in Australia. Tamiflu works best when started within 48 hours of symptoms beginning. See a GP promptly if you think you may need it. Do not wait to see if symptoms improve on their own.

Should I take antibiotics for the flu?

No. The flu is caused by a virus, and antibiotics only work against bacterial infections. Taking them when they are not needed contributes to antibiotic resistance. A GP may prescribe antibiotics if you develop a secondary bacterial infection, such as bacterial pneumonia, during or after your flu illness.

What cold and flu medicine is safe in pregnancy?

Paracetamol is generally considered the safest option for managing flu symptoms during pregnancy. Healthdirect's guidance on cold and flu medicines notes that ibuprofen and decongestants should be avoided during pregnancy. Always speak with a GP before taking any medication when pregnant. See flu in pregnancy for more information.

How long does flu last with treatment?

Most people recover from the flu within 7 to 10 days. Antiviral medication such as oseltamivir, if started within 48 hours of symptoms beginning, may reduce the duration of fever by approximately one day, according to the Immunisation Coalition. Fatigue can linger for a week or two beyond apparent recovery, particularly in older adults.

Can I give children cold and flu tablets?

Many adult cold and flu products are not suitable for children. Aspirin must never be given to children or teenagers with flu due to the risk of Reye's syndrome. Paracetamol and ibuprofen are the main options for managing flu symptoms in children. Always check age and weight dosing on the label, or ask a pharmacist or GP. See flu in children for more guidance.