Treatments
Treatments may reduce specific symptoms, but not shorten the duration of a cold. Antibiotics do not help; antibiotics are only used to treat illnesses caused by bacteria, not viruses. The symptoms of a cold typically resolve over time with only the use of self-care measures.
Medications
All over-the-counter, nonprescription medicines should be taken with consideration of your personal health history, medical conditions, and use of other medications. Carefully read the precautions and dosing instructions and consult with your health care provider or a pharmacist as needed.
Decongestants
Decongestants are medications that may improve nasal congestion and a cough due to postnasal drainage. Phenylephrine can be obtained off the shelf. No research-based evidence has shown it to be any more effective than a placebo for relief of nasal sinus congestion or postnasal drainage. It is found commonly in many “daytime” cold relief meds including DayQuil and Sudafed PE. Pseudoephedrine, on the other hand, is carried behind the drugstore counter, so it must be requested. It can be obtained without a prescription, though a government photo ID is required to purchase pseudoephedrine. There is evidence to suggest its efficacy for nasal sinus congestion and postnasal drainage.
Pseudoephedrine
Pseudoephedrine is found in Sudogest, Mucinex-D, and allergy medications such as Claritin-D. Oral decongestants can cause rapid heart rate, elevated blood pressure, a rise in blood sugar, and possible sense of mild to moderate anxiety, so consult your health care provider if any of these conditions apply to your underlying health status.
Antihistamines
Antihistamines are medications that may help a runny nose, sneezing, and a cough due to postnasal drainage. The combination of antihistamines and decongestants such as pseudoephedrine may be particularly helpful in controlling a cough due to postnasal drainage. All antihistamines can cause side effects such as drying of the eyes, nose, and mouth. The newer antihistamines such as Claritin, Allegra, and Zyrtec do not usually cause drowsiness, but may to some degree in certain individuals. The older antihistamines such as Benadryl and Chlor-Trimeton are likely to be sedating and must be used cautiously.
Nasal sprays
Nasal sprays come in several forms. They have minimal or unclear help for a cold. Cromolyn Sodium (NasalCrom) may relieve a runny nose, cough due to postnasal drainage, and sneezing. Nasal saline may moisturize and promote drainage. Other nasal sprays such as oxymetazoline (Afrin) or phenylephrine (Neo-Synephrine) may give temporary relief of nasal congestion. However, these sprays should not be used for more than THREE days as using longer can cause rebound, or worsening congestion. Nasal steroids such as Nasonex or Flonase may be used for allergies or chronic sinusitis, not for the common cold.
Pain relievers
Pain relievers such as acetaminophen (Tylenol) or a nonsteroidal anti-inflammatories (NSAIDs) can be used. Examples of NSAIDs are ibuprofen (Motrin, Advil) or naproxen (Aleve). These drugs may relieve a sore throat, headache, mild pain, or fever. Take after a meal and with a full glass of water.
Cough suppressants
Cough suppressants are primarily dextromethorphan found in Delsym and other cough syrups with “DM” added to the end of the product name. If the cough is caused by postnasal drainage, they may have little effect. The use of teaspoons of honey or honey in tea have been found to be more effective for cough due to upper respiratory congestion and postnasal drainage than most over-the-counter cough suppressants.
Expectorants
Expectorants are medications that thin mucous and have minimal or unclear benefit. The primary example is guaifenesin-containing products such as Mucinex or Humibid.
Lozenges
Lozenges such as benzocaine can provide temporary pain relief from sore throat. Menthol lozenges may temporarily help with nasal and sinus stuffiness. Zinc lozenges (Zicam) have uncertain benefit but may shorten duration of cold symptoms if used in the first 24 hours of illness symptoms. Follow directions closely. Avoid zinc products that are applied in the nose because they may cause loss of smell.
Alternative treatments
Alternative treatments including vitamin C and herbal products such as echinacea are advertised to treat or prevent the common cold. While none of these treatments are likely to cause harm, none has been proven to be effective in clinical trials; their use is not recommended.
Antibiotics do not treat the common cold
Antibiotics should not be used to treat an uncomplicated common cold or cough due to cold. As noted above, colds are caused by viruses. Antibiotics treat bacterial, not viral, infections.