| Acetaminophen | 500 to 1,000 mg | Single dose | Cochrane review without data pooling of 4 low- to moderate-quality trials with outcome assessment at 3 to 6 hours found improvement in nasal obstruction and rhinorrhea but not in other symptoms; no numeric data provided22 |
| Antihistamine plus decongestant | Varies | Variable | Cochrane review of 12 trials, including 6 placebo controlled with pooled data, found odds ratio of treatment failure = 0.27 (95% CI, 0.15 to 0.50); number needed to treat = 4, but 41% favorable response in placebo group23 |
| Inhaled ipratropium (Atrovent) | 4 20-g puffs 4 times per day | 3 weeks | One small, randomized, double-blind crossover trial (N = 14) found significant reduction in persistent cough24 |
| Intranasal oxymetazoline | 2 sprays (0.05%) per nostril 1 or 2 times per day | Up to 10 days | Cochrane review of 15 trials (N = 1,838) found no improvement in nasal congestion with single use, but small improvement vs. placebo after multiple doses (SMD = 0.49; 95% CI, 0.07 to 0.92)25 |
| Lactobacillus casei (for older adults) | 200 g per day of fermented dairy product containing L. casei | 3 months | RCT of 1,072 older adults found significant improvement in duration of colds and in cumulative days with colds when taken daily26 |
| Nonsteroidal anti-inflammatory drugs | Varies | Varies from single dose to 7 days | Cochrane review of 9 moderate-quality RCTs (N = 1,069) found no effect on total symptom score or cough, but improved sneezing (SMD = −0.44; 95% CI, −0.75 to −0.12), headache (SMD = −0.65; 95% CI, −1.11 to −0.19), and ear, muscle, and joint pain (SMD = −0.40; 95% CI, −0.77 to −0.03) vs. placebo27 |
| Zinc acetate or gluconate | Varies; typically 80 to 92 mg per day | Start within 3 days of symptom onset and continue as long as symptoms persist | 3 systematic reviews and meta-analyses found similar improvement in symptom duration (by about one-third) and mixed conclusions on symptom severity 28–30 |
