OTC Medications for Common Cold

Hundreds of over-the-counter (OTC) cold formulas claim to relieve every major cold symptom. Do they work? The actors in the commercials gain instant relief, but scientific investigations have produced decidedly mixed results. Antihistamines, in particular, have been attacked as useless.

Michael Smith, M.D., of Nova Scotia and William Feldman, M.D., of Toronto, reviewed 51 studies of OTC cold formulas published from 1950 to 1991. Their findings: Cold remedies do nothing to attack cold viruses, or boost the immune system’s fight against them, so they have no effect on the duration of colds. All they do is suppress symptoms, providing modest relief from nasal congestion, runny nose, and cough—but only for people over age five. In preschoolers, the researchers found that OTC cold formulas have no benefit at all. Of the five antihistamines commonly used to treat colds, Smith and Feldman concluded that only one actually helps dry a runny nose, chlorpheniramine.

Most doctors discourage shotgun cold formulas. Like the commercials say, they do, indeed, contain ingredients aimed at relieving every major cold symptom. But cold symptoms develop serially, not all at once, Dr. Sobel notes: “Why pay for a cough suppressant when what you have is a stuffed nose? And why risk side effects from medicines you may not need—jitters and insomnia from decongestants, and drowsiness from antihistamines. If you take OTC’s, he suggests, take single products for single symptoms: anesthetic lozenges for sore throat, a decongestant for congestion, an antihistamine with chlorpheniramine for runny nose, and for the hacking cough, a product containing the cough suppressant, dextromethorphan.

Red Flags and Warnings

Never treat children’s cold with aspirin or aspirin-like herbs. For fevers in children under 18 colds, flu, or chickenpox, do not give aspirin, or its herbal equivalents: willow bark, meadowsweet, or wintergreen. The combination of viral fevers and aspirin is associated with Reye syndrome, a rare, but potentially fatal illness that affects the brain and liver. Instead, place the child in a tepid bath. If you can’t resist medication, give acetaminophen (Tylenol, Panadol, St. Joseph Aspirin-Free, etc.). When in doubt, call your child’s physician.