From the Guidelines
Treatment for rhinovirus (the common cold) focuses on symptom management since there is no specific cure. The most recent and highest quality study, 1, published in 2020, emphasizes that antibiotics are not effective in the treatment of viral infectious diseases such as the common cold and acute postviral rhinosinusitis.
Key Points to Consider:
- Over-the-counter medications like acetaminophen (Tylenol) 325-650mg every 4-6 hours or ibuprofen (Advil, Motrin) 200-400mg every 4-6 hours can reduce fever and pain.
- Nasal congestion can be relieved with decongestants like pseudoephedrine (Sudafed) 30-60mg every 4-6 hours (avoid in hypertension) or phenylephrine.
- Antihistamines such as diphenhydramine (Benadryl) 25-50mg every 4-6 hours may help with runny nose and sneezing.
- Saline nasal sprays and humidifiers provide moisture to irritated nasal passages.
- Rest and adequate hydration (at least 8-10 glasses of water daily) are essential for recovery.
- Most rhinovirus infections resolve within 7-10 days without antibiotics, which are ineffective against viruses.
- These supportive measures work by reducing inflammation, thinning mucus, and supporting the body's natural immune response while it fights the viral infection.
- If symptoms worsen significantly or persist beyond two weeks, medical evaluation is recommended to rule out complications or secondary infections, as suggested by 1.
From the Research
Treatment Options for Rhinovirus
- Over-the-counter analgesics, zinc, nasal decongestants with or without antihistamines, and ipratropium for cough have proven effectiveness for cold symptoms in adults 2
- For children, established safe and effective treatments include acetylcysteine, honey (for children one year and older), nasal saline irrigation, intranasal ipratropium, and topical application of ointment containing camphor, menthol, and eucalyptus oils 2
- Antihistamines, such as chlorpheniramine maleate and diphenhydramine hydrochloride, have been found to have no significant effects on nasal symptoms or nasal mucus production in experimental rhinovirus colds 3
- There is currently no licensed vaccine for rhinovirus, but antiviral drugs and small molecule inhibitors of rhinovirus infection, as well as antiviral host defense peptides, are being researched as potential therapeutics 4
Effects of Common Medications on Rhinovirus Infection
- Aspirin and acetaminophen have been associated with suppression of serum neutralizing antibody response and increased nasal symptoms and signs in rhinovirus-infected volunteers 5
- The combination of pseudoephedrine hydrochloride and atropine sulfate has been found to attenuate nasal congestion, but also impairs nasal mucociliary clearance rate and causes anticholinergic side effects 6