From the Guidelines
The common cold is best treated with rest, hydration, and over-the-counter medications to manage symptoms while the viral infection runs its course. For congestion, decongestants like pseudoephedrine (Sudafed) 30-60mg every 4-6 hours or nasal sprays like oxymetazoline (Afrin) can provide relief, though nasal sprays should not be used for more than 3 days to avoid rebound congestion.
Key Treatment Options
- For pain and fever, acetaminophen (Tylenol) 325-650mg every 4-6 hours or ibuprofen (Advil, Motrin) 200-400mg every 6-8 hours can help, as suggested by 1.
- Antihistamines like diphenhydramine (Benadryl) 25-50mg every 4-6 hours may reduce runny nose and sneezing but can cause drowsiness.
- Throat lozenges, warm salt water gargles, and honey in warm tea can soothe sore throats.
- A humidifier or steam from a hot shower can ease congestion.
- Drink plenty of fluids and get adequate rest to support your immune system.
- Zinc supplements, such as zinc acetate or zinc gluconate lozenges, at a dose of >=75 mg/day, taken within 24 hours of onset of symptoms, may reduce the duration of the common cold, as noted in 1.
Important Considerations
- Antibiotics are ineffective against colds since they're caused by viruses, not bacteria.
- Most colds resolve within 7-10 days, but see a doctor if symptoms worsen significantly, persist beyond two weeks, or if you develop high fever, severe headache, or difficulty breathing.
- Vitamin C may be useful for people exposed to brief periods of severe physical exercise, but routine vitamin C supplementation is not justified for the general population, as stated in 1.
From the FDA Drug Label
Uses • temporarily relieves sinus congestion and pressure • temporarily relieves nasal congestion due to the common cold, hay fever or other upper respiratory allergies Uses temporarily relieves • cough due to minor throat and bronchial irritation as may occur with the common cold or inhaled irritants • the impulse to cough to help you get to sleep
Treatment for cold may include:
- Pseudoephedrine (PO) to relieve sinus congestion and pressure, and nasal congestion due to the common cold 2
- Dextromethorphan (PO) to relieve cough due to minor throat and bronchial irritation as may occur with the common cold 3
From the Research
Treatment Options for the Common Cold
- Over-the-counter (OTC) medications can be used to treat cough and cold symptoms, but reliable guidance is needed to select the appropriate medication 4
- Decongestants such as phenylpropanolamine, pseudoephedrine, and phenylephrine can be effective in reducing nasal congestion, but their efficacy varies 5
- Treatments with proven effectiveness for cold symptoms in adults include OTC analgesics, zinc, nasal decongestants with or without antihistamines, and ipratropium for cough 6
- A fixed-dose combination of paracetamol, chlorphenamine, and phenylephrine has been shown to be safe and effective in the symptomatic treatment of the common cold or flu-like syndrome in adults 7
Safety and Efficacy of Specific Medications
- Pseudoephedrine is a drug with a long history of medical use, helpful in treating symptoms of the common cold and flu, but it also has central nervous system stimulant properties and can be misused 8
- Phenylephrine is subject to first-pass metabolism and is not bioavailable in currently recommended doses, making it a less effective decongestant 5
- Slow-release formulations of decongestants can allow for a longer dosing interval, but the in vitro dissolution of many of these products can differ, making it possible that some generic formulations are not bioequivalent to established brand-name products 5
Important Considerations
- Patients should be educated about available OTC medications to manage cough and cold symptoms, and the importance of reading package labeling for appropriate dosing and administration 4
- Potentially serious causes of cough and cold symptoms, such as influenza, asthma, or bronchitis, should be ruled out when symptoms do not resolve within a typical cold timeline 4
- Counseling patients about the importance of good hand hygiene is the best way to prevent transmission of cold viruses 6