What are effective over-the-counter (OTC) medications for the common cold?

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Last updated: February 15, 2025View editorial policy

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From the Guidelines

Effective over-the-counter (OTC) medications for the common cold include antihistamines, decongestants, and pain relievers.

Symptomatic Relief

  • Antihistamines have a limited short-term beneficial effect on severity of overall symptoms in adults, but not in the mid to long term 1.
  • Decongestants may have a small positive effect on subjective measures of nasal congestion in adults with the common cold without increasing the risk of adverse events in adults in the short term 1.
  • Pain relievers such as paracetamol and NSAIDs can help relieve nasal obstruction, rhinorrhoea, and discomfort or pain caused by the common cold 1.
  • Antihistamine-analgesic-decongestant combinations have some general benefit in adults and older children, but their benefits must be weighed against the risk of adverse effects 1.

Additional Options

  • Vitamin C may be useful for people exposed to brief periods of severe physical exercise, and it may be worthwhile for common cold patients to test on an individual basis whether therapeutic vitamin C is beneficial for them 1.
  • Zinc administered as zinc acetate or zinc gluconate lozenges at a dose of >=75 mg/day and taken within 24 hours of onset of symptoms significantly reduces the duration of common cold, but the likely benefit has to be balanced against side effects 1.
  • Nasal saline irrigation has possible benefits for relieving the symptoms of acute URTIs 1.
  • First-generation antihistamine-decongestant preparations can be used to treat cough associated with the common cold, with benefits seen within days to 2 weeks of initiation of therapy 1.

From the Research

Effective OTC Medications for the Common Cold

The following are some effective over-the-counter (OTC) medications for the common cold:

  • Antihistamine-decongestant combinations, which have been shown to have a general benefit in adults and older children 2
  • Antihistamine-analgesic combinations, which have been found to have some global benefit in adults and older children 2
  • Analgesic-decongestant combinations, which have been shown to be effective in reducing symptoms of the common cold 2
  • Antihistamine-analgesic-decongestant combinations, which have been found to have some general benefit in adults and older children 2
  • Paracetamol, which is a commonly recommended OTC medication for the common cold 3, 4
  • Dayquil/Nyquil, which have been found to be as effective as Actifed DM plus paracetamol in controlling the symptoms and signs of the common cold, but with fewer adverse effects 5

Considerations for OTC Medication Use

When using OTC medications for the common cold, it is essential to consider the following:

  • The most bothersome symptom(s) and recommend the most appropriate OTC active ingredient(s) for treatment 6
  • Underlying medical conditions and medications, which may interact with OTC medications 6
  • The importance of reading package labeling for appropriate dosing and administration 6
  • Potentially serious causes of cough/cold symptoms, such as influenza, asthma, or bronchitis, which should be ruled out when symptoms do not resolve within a typical cold timeline 6

Safety and Efficacy of OTC Analgesics

OTC analgesics, such as aspirin, paracetamol, and ibuprofen, are generally safe and effective for the treatment of colds and flu symptoms 4

  • There is no evidence that these medicines prolong the course of colds and flu by any effect on the immune system or by reducing fever 4
  • However, it is crucial to follow the recommended dosage and administration instructions to minimize the risk of adverse effects 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Oral antihistamine-decongestant-analgesic combinations for the common cold.

The Cochrane database of systematic reviews, 2012

Research

Treatment of the common cold.

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2003

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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