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==Overview==
==Overview==
The mainstay of therapy for acute viral nasopharyngitis is symptomatic treatment.
The mainstay of therapy for acute viral nasopharyngitis is [[symptomatic treatment]].


==Medical Therapy==
==Medical Therapy==
Line 11: Line 11:
===Palliative Care===
===Palliative Care===
* Palliative measures as plenty of fluids, rest, and throat sprays help in alleviating the [[congestion]] and easing the symptoms.
* Palliative measures as plenty of fluids, rest, and throat sprays help in alleviating the [[congestion]] and easing the symptoms.
* [[Alcohol]] and caffeine-containing beverages should be avoided as they cause dehydration.
* [[Alcohol]] and caffeine-containing beverages should be avoided as they cause [[dehydration]].


===Antibiotics===
===Antibiotics===
* The [[antibiotics]] have no use in common cold as the disease is viral in origin.
* The [[antibiotics]] have no use in common cold as the disease is viral in origin.
* Haphazard use of antibiotics can cause the development of resistant strains of bacteria and the spread of [[antibiotic resistance]].
* Haphazard use of [[antibiotics]] can cause the development of [[Drug resistance|resistant]] [[strains]] of [[bacteria]] and the spread of [[antibiotic resistance]].


===Antivirals===
===Antivirals===
* There are no approved [[antiviral drug]]s for the common cold.
* There are no approved [[antiviral drug]]s for the common cold.
* [[ViroPharma]] and [[Schering-Plough]] are developing an [[antiviral drug]], [[pleconaril]] that targets [[Picornaviridae|picornaviruses]] and the [[Virus|viruses]] that cause the majority of common colds. [[Pleconaril]] has been shown to be effective in an [[Route of administration|oral]] form.<ref>{{cite journal
* [[ViroPharma]] and Schering-Plough are developing an [[antiviral drug]], [[pleconaril]] that targets [[Picornaviridae|picornaviruses]] and the [[Virus|viruses]] that cause the majority of common colds. [[Pleconaril]] has been shown to be effective in an [[Route of administration|oral]] form.<ref>{{cite journal
  | last = Pevear
  | last = Pevear
  | first = Daniel C.
  | first = Daniel C.
Line 43: Line 43:
  | pages = 1185
  | pages = 1185
}}</ref>
}}</ref>
* [[Schering-Plough]] is developing an [[Route of administration|intra-nasal]] formulation that may have fewer adverse effects.<ref name="CTgov">{{cite web
* Schering-Plough is developing an [[Route of administration|intra-nasal]] formulation that may have fewer adverse effects.<ref name="CTgov">{{cite web
| url = http://www.clinicaltrials.gov/ct/gui/show/NCT00394914
| url = http://www.clinicaltrials.gov/ct/gui/show/NCT00394914
| title = Effects of Pleconaril Nasal Spray on Common Cold Symptoms and Asthma Exacerbations Following Rhinovirus Exposure (Study P04295AM2)
| title = Effects of Pleconaril Nasal Spray on Common Cold Symptoms and Asthma Exacerbations Following Rhinovirus Exposure (Study P04295AM2)
Line 55: Line 55:
There are a number of effective treatments which, rather than treat the [[viral infection]], focus on relieving the symptoms. For some people, colds are relatively minor inconveniences and they can go on with their daily activities with tolerable discomfort. This discomfort has to be weighed against the price and possible side effects of the remedies.
There are a number of effective treatments which, rather than treat the [[viral infection]], focus on relieving the symptoms. For some people, colds are relatively minor inconveniences and they can go on with their daily activities with tolerable discomfort. This discomfort has to be weighed against the price and possible side effects of the remedies.
*[[analgesic]]s such as [[aspirin]] or [[paracetamol]] (acetaminophen)
*[[analgesic]]s such as [[aspirin]] or [[paracetamol]] (acetaminophen)
*[[Nasal decongestants]] such as [[pseudoephedrine]] or [[oxymetazoline]] which reduce the [[inflammation]] in the nasal passages by constricting local blood vessels
*[[Nasal decongestants]] such as [[pseudoephedrine]] or [[oxymetazoline]] which reduce the [[inflammation]] in the nasal passages by constricting local [[blood vessels]]
*[[cough medicine|Cough suppressants]] such as [[dextromethorphan]] which suppress the [[cough reflex]]
*[[cough medicine|Cough suppressants]] such as [[dextromethorphan]] which suppress the [[cough reflex]]
*First-generation [[anti-histamine]]s such as [[brompheniramine]], [[chlorpheniramine]], [[diphenhydramine]] and [[clemastine]] (which reduce mucus gland secretion and thus combat blocked/runny noses but also may make the user drowsy).  
*First-generation [[anti-histamine]]s such as [[brompheniramine]], [[chlorpheniramine]], [[diphenhydramine]] and [[clemastine]] (which reduce mucus gland secretion and thus combat blocked/runny noses but also may make the user drowsy).  
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====Vitamin C====
====Vitamin C====
* A well known supporter of the theory that [[Vitamin C megadosage]] prevented infection was Nobel Prize winner [[Linus Pauling]],<ref>{{cite web|url=http://www.pubmedcentral.nih.gov/pagerender.fcgi?artid=389499&pageindex=1#page|title=Pauling L, The Significance of the Evidence about Ascorbic Acid and the Common Cold, Proc Natl Acad Sci U S A. 1971 November; 68(11): 2678–2681.}}</ref> who wrote the bestseller ''Vitamin C and the Common Cold''.<ref name="isbn0-7167-0159-6">{{cite book | author = Pauling, Linus | title = Vitamin C and the common cold | publisher = W. H. Freeman | location = San Francisco | year = 1970 | pages = | isbn = 0-7167-0159-6 | oclc = | doi = }}</ref>  
* A well known supporter of the theory that [[Vitamin C megadosage]] prevented infection was Nobel Prize winner [[Linus Pauling]],<ref>{{cite web|url=http://www.pubmedcentral.nih.gov/pagerender.fcgi?artid=389499&pageindex=1#page|title=Pauling L, The Significance of the Evidence about Ascorbic Acid and the Common Cold, Proc Natl Acad Sci U S A. 1971 November; 68(11): 2678–2681.}}</ref> who wrote the bestseller ''Vitamin C and the Common Cold''.<ref name="isbn0-7167-0159-6">{{cite book | author = Pauling, Linus | title = Vitamin C and the common cold | publisher = W. H. Freeman | location = San Francisco | year = 1970 | pages = | isbn = 0-7167-0159-6 | oclc = | doi = }}</ref>  
* A [[meta-analysis]] published in 2005 found that "the lack of effect of prophylactic vitamin C supplementation on the incidence of common cold in normal populations throws doubt on the utility of this wide practice".<ref name="pmid15971944">{{cite journal | author = Douglas RM, Hemilä H | title = Vitamin C for preventing and treating the common cold | journal = PLoS Med. | volume = 2 | issue = 6 | year = 2005 | pmid = 15971944 | doi = 10.1371/journal.pmed.0020168}}</ref>
* A [[meta-analysis]] published in 2005 found that "the lack of effect of [[prophylactic]] [[vitamin C]] supplementation on the incidence of common cold in normal populations throws doubt on the utility of this wide practice".<ref name="pmid15971944">{{cite journal | author = Douglas RM, Hemilä H | title = Vitamin C for preventing and treating the common cold | journal = PLoS Med. | volume = 2 | issue = 6 | year = 2005 | pmid = 15971944 | doi = 10.1371/journal.pmed.0020168}}</ref>
* A follow-up meta-analysis supported these conclusions:  
* A follow-up meta-analysis supported these conclusions:  
** [[Prophylaxis|Prophylactic use]] "..of vitamin C has no effect on common cold incidence&nbsp;... [but] reduces the duration and severity of common cold symptoms slightly, although the magnitude of the effect was so small and its clinical usefulness is doubtful. Therapeutic trials of high doses of vitamin C&nbsp;... starting after the onset of symptoms, showed no consistent effect on either duration or severity of symptoms.&nbsp;... More therapeutic trials are necessary to settle the question, especially in children who have not entered these trials."<ref name="pmid17636648">{{cite journal | author = Douglas R, Hemilä H, Chalker E, Treacy B | title = Vitamin C for preventing and treating the common cold | journal = Cochrane Database of Systematic Reviews (Online) | volume = | issue = 3 | pages = CD000980 | year = 2007 | pmid = 17636648 | doi = 10.1002/14651858.CD000980.pub3 | url = http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD000980/frame.html}}</ref><ref>{{cite news | title = Vitamin C 'does not stop colds' | publisher = BBC | date = 2007-07-18 | url = http://news.bbc.co.uk/2/hi/health/6901405.stm}}</ref>  
** [[Prophylaxis|Prophylactic use]] "..of [[vitamin C]] has no effect on common cold incidence&nbsp;... [but] reduces the duration and severity of common cold symptoms slightly, although the magnitude of the effect was so small and its clinical usefulness is doubtful. Therapeutic trials of high doses of [[vitamin C]]&nbsp;... starting after the onset of symptoms, showed no consistent effect on either duration or severity of symptoms.&nbsp;... More therapeutic trials are necessary to settle the question, especially in children who have not entered these trials."<ref name="pmid17636648">{{cite journal | author = Douglas R, Hemilä H, Chalker E, Treacy B | title = Vitamin C for preventing and treating the common cold | journal = Cochrane Database of Systematic Reviews (Online) | volume = | issue = 3 | pages = CD000980 | year = 2007 | pmid = 17636648 | doi = 10.1002/14651858.CD000980.pub3 | url = http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD000980/frame.html}}</ref><ref>{{cite news | title = Vitamin C 'does not stop colds' | publisher = BBC | date = 2007-07-18 | url = http://news.bbc.co.uk/2/hi/health/6901405.stm}}</ref>  
* Most of the studies showing little or no effect employ doses of [[Vitamin C|ascorbate]] such as 100&nbsp; mg to 500&nbsp; mg per day, considered "small" by vitamin C advocates. Equally important, the [[Half-life|plasma half-life]] of high dose ascorbate above the baseline, controlled by renal resorption, is approximately 30 minutes,<ref>{{cite web|url=http://www.annals.org/cgi/content/full/140/7/533|title=Padayatty SL et al, "Vitamin C Pharmacokinetics: Implications for Oral and Intravenous Use," Ann Intern Med. 2004 Apr 6;140(7):533-7.}}</ref><ref>{{cite web|url=http://www.prweb.com/releases/2004/7/prweb139053.htm|title=Researchers Question Government Recommended Daily Allowance (RDA) for vitamin C, PR Web, July 7, 2004}}</ref> which implies that most high dose studies have been methodologically defective and would be expected to show a minimum benefit. Clinical studies of divided dose supplementation, predicted on pharmacological grounds to be effective, have only rarely been reported in the literature.
* Most of the studies showing little or no effect employ doses of [[Vitamin C|ascorbate]] such as 100&nbsp; mg to 500&nbsp; mg per day, considered "small" by [[vitamin C]] advocates. Equally important, the [[Half-life|plasma half-life]] of high dose [[ascorbate]] above the baseline, controlled by [[renal]] [[resorption]], is approximately 30 minutes,<ref>{{cite web|url=http://www.annals.org/cgi/content/full/140/7/533|title=Padayatty SL et al, "Vitamin C Pharmacokinetics: Implications for Oral and Intravenous Use," Ann Intern Med. 2004 Apr 6;140(7):533-7.}}</ref><ref>{{cite web|url=http://www.prweb.com/releases/2004/7/prweb139053.htm|title=Researchers Question Government Recommended Daily Allowance (RDA) for vitamin C, PR Web, July 7, 2004}}</ref> which implies that most high dose studies have been methodologically defective and would be expected to show a minimum benefit. Clinical studies of divided dose supplementation, predicted on pharmacological grounds to be effective, have only rarely been reported in the literature.


====Zinc Preparations====
====Zinc Preparations====
* [[Zinc]] is an essential element, necessary for sustaining life. Recommended daily intake has been established and results of [[zinc deficiency]] and toxicity have been well characterized.
* [[Zinc]] is an essential element, necessary for sustaining life. Recommended daily intake has been established and results of [[zinc deficiency]] and toxicity have been well characterized.
* [[Zinc acetate]] and [[zinc gluconate]] have been tested as potential treatments for the common cold, in various dosage form including [[Nasal spray|nasal sprays]], nasal gels, and [[lozenges]].<ref name="eby-1984">{{cite journal | author=Eby GA, Davis DR, Halcomb WW | title=Reduction in duration of common colds by zinc gluconate lozenges in a double-blind study | journal=Antimicrob Agents Chemother | year=1984 | pages=20-4 | volume=25 | issue=1 | id = PMID 6367635}}</ref><ref>{{cite journal | last = Macknin | first = ML | coauthors = | date = | year = 1999 | month = January | title = Zinc lozenges for the common cold | journal = Cleve Clin J Med | volume = 66 | issue = 1 | pages = 27-32 | pmid = 9926628}}</ref>
* [[Zinc acetate]] and [[zinc gluconate]] have been tested as potential treatments for the common cold, in various dosage form including [[Nasal spray|nasal sprays]], nasal gels, and [[lozenges]].<ref name="eby-1984">{{cite journal | author=Eby GA, Davis DR, Halcomb WW | title=Reduction in duration of common colds by zinc gluconate lozenges in a double-blind study | journal=Antimicrob Agents Chemother | year=1984 | pages=20-4 | volume=25 | issue=1 | id = PMID 6367635}}</ref><ref>{{cite journal | last = Macknin | first = ML | coauthors = | date = | year = 1999 | month = January | title = Zinc lozenges for the common cold | journal = Cleve Clin J Med | volume = 66 | issue = 1 | pages = 27-32 | pmid = 9926628}}</ref>
* Some studies have shown some effect of zinc preparations on the duration of the common cold, but conclusions are diverse.<ref>{{cite journal | author = Jeffrey L. Jackson, Emil Lesho and Cecily Peterson | title = Zinc and the Common Cold: A Meta-Analysis Revisited | journal = Journal of Nutrition | year = 2000 | pages = 1512-15 | volume = 130 | issue = Supplement | pmid = | url = http://jn.nutrition.org/cgi/content/full/130/5/1512S}}</ref><ref>{{cite journal | last = Hulisz | first = D | year = 2003 | title = Efficacy of zinc against common cold viruses: an overview | journal = J Am Pharm Assoc | volume = 44 | issue = 5 | pages = 594-603 | pmid = 15496046}}</ref><ref name="jackson-1997">{{cite journal | author=Jackson JL, Peterson C, Lesho E | title=A meta-analysis of zinc salts lozenges and the common cold | journal=Arch Intern Med | year=1997 | pages=2373-6 | volume=157 | issue=20 | id=PMID 9361579 | url=http://archinte.ama-assn.org/cgi/content/abstract/157/20/2373}}</ref>  
* Some studies have shown some effect of [[zinc]] preparations on the duration of the common cold, but conclusions are diverse.<ref>{{cite journal | author = Jeffrey L. Jackson, Emil Lesho and Cecily Peterson | title = Zinc and the Common Cold: A Meta-Analysis Revisited | journal = Journal of Nutrition | year = 2000 | pages = 1512-15 | volume = 130 | issue = Supplement | pmid = | url = http://jn.nutrition.org/cgi/content/full/130/5/1512S}}</ref><ref>{{cite journal | last = Hulisz | first = D | year = 2003 | title = Efficacy of zinc against common cold viruses: an overview | journal = J Am Pharm Assoc | volume = 44 | issue = 5 | pages = 594-603 | pmid = 15496046}}</ref><ref name="jackson-1997">{{cite journal | author=Jackson JL, Peterson C, Lesho E | title=A meta-analysis of zinc salts lozenges and the common cold | journal=Arch Intern Med | year=1997 | pages=2373-6 | volume=157 | issue=20 | id=PMID 9361579 | url=http://archinte.ama-assn.org/cgi/content/abstract/157/20/2373}}</ref>  
* Approximately half of studies demonstrate efficacy. Even studies that show clinical effect have not demonstrated the mechanism of action.<ref name="MedLinePlus_Zinc">{{cite web | url = http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-zinc.html | title = MedlinePlus Herbs and Supplements: Zinc}}</ref>  
* Approximately half of studies demonstrate efficacy. Even studies that show clinical effect have not demonstrated the mechanism of action.<ref name="MedLinePlus_Zinc">{{cite web | url = http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-zinc.html | title = MedlinePlus Herbs and Supplements: Zinc}}</ref>  
* The studies differ in the salt used, concentration of the salt, dosage form, and formulation, and some suffer from defects in design or methods. For example, there is evidence that the potential efficacy of [[zinc gluconate]] lozenges may be affected by other food acids ([[citric acid]], [[ascorbic acid]] and [[glycine]]) present in the [[lozenge]].<ref name="eby-2004">{{cite journal | author=Eby GA | title=Zinc lozenges: cold cure or candy? Solution chemistry determinations | journal=Biosci Rep | year=2004 | pages=23-39 | volume=24 | issue=1 | id=PMID 15499830}}</ref> Furthermore, interpretation of the results depends on whether concentration of total zinc or ionic zinc is considered.<ref>{{cite journal | last = Eby | first = George | coauthors = Halcomb WW | year = 2006 | title = Ineffectiveness of zinc gluconate nasal spray and zinc orotate lozenges in common-cold treatment: a double-blind, placebo-controlled clinical trial | journal = Altern Ther Health Med | volume = 12 | issue = 1 | pages = 34-38 | pmid = 16454145}}</ref><ref>{{cite web | url = http://www.uspharmacist.com/oldformat.asp?url=newlook/files/alte/feat2.htm | title = Zinc and the Common Cold: What Pharmacists Need to Know | author = Darrell T. Hulisz}}</ref>
* The studies differ in the salt used, concentration of the salt, dosage form, and formulation, and some suffer from defects in design or methods. For example, there is evidence that the potential efficacy of [[zinc gluconate]] lozenges may be affected by other food acids ([[citric acid]], [[ascorbic acid]] and [[glycine]]) present in the [[lozenge]].<ref name="eby-2004">{{cite journal | author=Eby GA | title=Zinc lozenges: cold cure or candy? Solution chemistry determinations | journal=Biosci Rep | year=2004 | pages=23-39 | volume=24 | issue=1 | id=PMID 15499830}}</ref> Furthermore, interpretation of the results depends on whether concentration of total zinc or ionic zinc is considered.<ref>{{cite journal | last = Eby | first = George | coauthors = Halcomb WW | year = 2006 | title = Ineffectiveness of zinc gluconate nasal spray and zinc orotate lozenges in common-cold treatment: a double-blind, placebo-controlled clinical trial | journal = Altern Ther Health Med | volume = 12 | issue = 1 | pages = 34-38 | pmid = 16454145}}</ref><ref>{{cite web | url = http://www.uspharmacist.com/oldformat.asp?url=newlook/files/alte/feat2.htm | title = Zinc and the Common Cold: What Pharmacists Need to Know | author = Darrell T. Hulisz}}</ref>


* There are concerns regarding the safety of long-term use of cold preparations in an estimated 25 million persons who are [[haemochromatosis]] [[heterozygote]]s.<ref name="barton-1997">{{cite journal | author=Barton JC, Bertoli LF | title=Zinc gluconate lozenges for treating the common cold | journal=Ann Intern Med | year=1997 | pages=738-9 | volume=126 | issue=9 | id=PMID 9139564}}</ref> Use of high doses of [[zinc]] for more than two weeks may cause [[copper]] depletion, which leads to [[anemia]].<ref name="PDRZinc">{{cite web | title = Zinc | work = PDRhealth | publisher = Thomson Healthcare | url = http://www.pdrhealth.com/drugs/altmed/altmed-mono.aspx?contentFileName=ame0182.xml&contentName=Zinc&contentId=345}}</ref>
* There are concerns regarding the safety of long-term use of cold preparations in an estimated 25 million persons who are [[haemochromatosis]] [[heterozygote]]s.<ref name="barton-1997">{{cite journal | author=Barton JC, Bertoli LF | title=Zinc gluconate lozenges for treating the common cold | journal=Ann Intern Med | year=1997 | pages=738-9 | volume=126 | issue=9 | id=PMID 9139564}}</ref> Use of high doses of [[zinc]] for more than two weeks may cause [[copper]] depletion, which leads to [[anemia]].<ref name="PDRZinc">{{cite web | title = Zinc | work = PDRhealth | publisher = Thomson Healthcare | url = http://www.pdrhealth.com/drugs/altmed/altmed-mono.aspx?contentFileName=ame0182.xml&contentName=Zinc&contentId=345}}</ref>
* Other adverse events of high doses of [[Zinc (element)|zinc]] include [[nausea]], [[emesis|vomiting]], [[Gastrointestinal tract|gastrointestinal discomfort]], [[headache]], [[drowsiness]], unpleasant taste, taste distortion, abdominal cramping, and [[diarrhea]].<ref name="MedLinePlus_Zinc" /><ref name="PDRZinc" />
* Other adverse events of high doses of [[Zinc (element)|zinc]] include [[nausea]], [[emesis|vomiting]], [[Gastrointestinal tract|gastrointestinal discomfort]], [[headache]], [[drowsiness]], unpleasant taste, taste distortion, [[abdominal cramping]], and [[diarrhea]].<ref name="MedLinePlus_Zinc" /><ref name="PDRZinc" />
* Some users of [[nasal spray]] applicators containing zinc have reported temporary or permanent loss of sense of [[smell]].<ref name="WashPostZinc&quot;">{{cite news | title = Paying Through the Nose: Maker of Cold Spray Settles Lawsuits for $12 Million but Denies Claim That Zinc Product Ruined Users' Sense of Smell | author = Sandra G. Boodman | publisher = The Washington Post | url = http://www.washingtonpost.com/wp-dyn/content/article/2006/01/30/AR2006013001240.html}}</ref>
* Some users of [[nasal spray]] applicators containing [[zinc]] have reported temporary or permanent loss of sense of [[smell]].<ref name="WashPostZinc&quot;">{{cite news | title = Paying Through the Nose: Maker of Cold Spray Settles Lawsuits for $12 Million but Denies Claim That Zinc Product Ruined Users' Sense of Smell | author = Sandra G. Boodman | publisher = The Washington Post | url = http://www.washingtonpost.com/wp-dyn/content/article/2006/01/30/AR2006013001240.html}}</ref>


* Although widely available and advertised in the United States as dietary supplements or homeopathic treatments, the safety and efficacy of [[zinc]] preparations have not been evaluated or approved by the [[Food and Drug Administration]]. Authoritative sources consider the effect of [[zinc]] preparations on the cold unproven.
* Although widely available and advertised in the United States as dietary supplements or homeopathic treatments, the safety and efficacy of [[zinc]] preparations have not been evaluated or approved by the [[Food and Drug Administration]]. Authoritative sources consider the effect of [[zinc]] preparations on the cold unproven.

Revision as of 20:28, 25 July 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]

Overview

The mainstay of therapy for acute viral nasopharyngitis is symptomatic treatment.

Medical Therapy

Common cold is a self-limiting disease even without treatment. Both humoral and cell-mediated immunity are capable of clearing the virus in seven days.

Palliative Care

  • Palliative measures as plenty of fluids, rest, and throat sprays help in alleviating the congestion and easing the symptoms.
  • Alcohol and caffeine-containing beverages should be avoided as they cause dehydration.

Antibiotics

Antivirals

Over-the-counter Symptom Medicines

There are a number of effective treatments which, rather than treat the viral infection, focus on relieving the symptoms. For some people, colds are relatively minor inconveniences and they can go on with their daily activities with tolerable discomfort. This discomfort has to be weighed against the price and possible side effects of the remedies.

Other

Vitamin C

  • A well known supporter of the theory that Vitamin C megadosage prevented infection was Nobel Prize winner Linus Pauling,[4] who wrote the bestseller Vitamin C and the Common Cold.[5]
  • A meta-analysis published in 2005 found that "the lack of effect of prophylactic vitamin C supplementation on the incidence of common cold in normal populations throws doubt on the utility of this wide practice".[6]
  • A follow-up meta-analysis supported these conclusions:
    • Prophylactic use "..of vitamin C has no effect on common cold incidence ... [but] reduces the duration and severity of common cold symptoms slightly, although the magnitude of the effect was so small and its clinical usefulness is doubtful. Therapeutic trials of high doses of vitamin C ... starting after the onset of symptoms, showed no consistent effect on either duration or severity of symptoms. ... More therapeutic trials are necessary to settle the question, especially in children who have not entered these trials."[7][8]
  • Most of the studies showing little or no effect employ doses of ascorbate such as 100  mg to 500  mg per day, considered "small" by vitamin C advocates. Equally important, the plasma half-life of high dose ascorbate above the baseline, controlled by renal resorption, is approximately 30 minutes,[9][10] which implies that most high dose studies have been methodologically defective and would be expected to show a minimum benefit. Clinical studies of divided dose supplementation, predicted on pharmacological grounds to be effective, have only rarely been reported in the literature.

Zinc Preparations

  • Zinc is an essential element, necessary for sustaining life. Recommended daily intake has been established and results of zinc deficiency and toxicity have been well characterized.
  • Zinc acetate and zinc gluconate have been tested as potential treatments for the common cold, in various dosage form including nasal sprays, nasal gels, and lozenges.[11][12]
  • Some studies have shown some effect of zinc preparations on the duration of the common cold, but conclusions are diverse.[13][14][15]
  • Approximately half of studies demonstrate efficacy. Even studies that show clinical effect have not demonstrated the mechanism of action.[16]
  • The studies differ in the salt used, concentration of the salt, dosage form, and formulation, and some suffer from defects in design or methods. For example, there is evidence that the potential efficacy of zinc gluconate lozenges may be affected by other food acids (citric acid, ascorbic acid and glycine) present in the lozenge.[17] Furthermore, interpretation of the results depends on whether concentration of total zinc or ionic zinc is considered.[18][19]
  • Although widely available and advertised in the United States as dietary supplements or homeopathic treatments, the safety and efficacy of zinc preparations have not been evaluated or approved by the Food and Drug Administration. Authoritative sources consider the effect of zinc preparations on the cold unproven.

Steam Inhalation

  • Many people believe that steam inhalation reduces symptoms of the cold.[23]
  • In a randomized double blinded controlled trial, steam inhalation was not effective in alleviating the symptoms of cold.[24]
  • On the other side, many cases of burns during steam inhalation have been reported in children.[25]

References

  1. ↑ Pevear, Daniel C. (1999). "Activity of Pleconaril against Enteroviruses". Antimicrobial Agents and Chemotherapy. 43 (9): 2109–2115. Unknown parameter |coauthors= ignored (help); Unknown parameter |month= ignored (help)
  2. ↑ McConnell, J. (2 October, 1999). "Enteroviruses succumb to new drug". The Lancet. 354 (9185): 1185. Check date values in: |date= (help)
  3. ↑ "Effects of Pleconaril Nasal Spray on Common Cold Symptoms and Asthma Exacerbations Following Rhinovirus Exposure (Study P04295AM2)". ClinicalTrials.gov. U.S. National Institutes of Health. 2007. Unknown parameter |month= ignored (help)
  4. ↑ "Pauling L, The Significance of the Evidence about Ascorbic Acid and the Common Cold, Proc Natl Acad Sci U S A. 1971 November; 68(11): 2678–2681".
  5. ↑ Pauling, Linus (1970). Vitamin C and the common cold. San Francisco: W. H. Freeman. ISBN 0-7167-0159-6.
  6. ↑ Douglas RM, Hemilä H (2005). "Vitamin C for preventing and treating the common cold". PLoS Med. 2 (6). doi:10.1371/journal.pmed.0020168. PMID 15971944.
  7. ↑ Douglas R, Hemilä H, Chalker E, Treacy B (2007). "Vitamin C for preventing and treating the common cold". Cochrane Database of Systematic Reviews (Online) (3): CD000980. doi:10.1002/14651858.CD000980.pub3. PMID 17636648.
  8. ↑ "Vitamin C 'does not stop colds'". BBC. 2007-07-18.
  9. ↑ "Padayatty SL et al, "Vitamin C Pharmacokinetics: Implications for Oral and Intravenous Use," Ann Intern Med. 2004 Apr 6;140(7):533-7".
  10. ↑ "Researchers Question Government Recommended Daily Allowance (RDA) for vitamin C, PR Web, July 7, 2004".
  11. ↑ Eby GA, Davis DR, Halcomb WW (1984). "Reduction in duration of common colds by zinc gluconate lozenges in a double-blind study". Antimicrob Agents Chemother. 25 (1): 20–4. PMID 6367635.
  12. ↑ Macknin, ML (1999). "Zinc lozenges for the common cold". Cleve Clin J Med. 66 (1): 27–32. PMID 9926628. Unknown parameter |month= ignored (help)
  13. ↑ Jeffrey L. Jackson, Emil Lesho and Cecily Peterson (2000). "Zinc and the Common Cold: A Meta-Analysis Revisited". Journal of Nutrition. 130 (Supplement): 1512–15.
  14. ↑ Hulisz, D (2003). "Efficacy of zinc against common cold viruses: an overview". J Am Pharm Assoc. 44 (5): 594–603. PMID 15496046.
  15. ↑ Jackson JL, Peterson C, Lesho E (1997). "A meta-analysis of zinc salts lozenges and the common cold". Arch Intern Med. 157 (20): 2373–6. PMID 9361579.
  16. ↑ 16.0 16.1 "MedlinePlus Herbs and Supplements: Zinc".
  17. ↑ Eby GA (2004). "Zinc lozenges: cold cure or candy? Solution chemistry determinations". Biosci Rep. 24 (1): 23–39. PMID 15499830.
  18. ↑ Eby, George (2006). "Ineffectiveness of zinc gluconate nasal spray and zinc orotate lozenges in common-cold treatment: a double-blind, placebo-controlled clinical trial". Altern Ther Health Med. 12 (1): 34–38. PMID 16454145. Unknown parameter |coauthors= ignored (help)
  19. ↑ Darrell T. Hulisz. "Zinc and the Common Cold: What Pharmacists Need to Know".
  20. ↑ Barton JC, Bertoli LF (1997). "Zinc gluconate lozenges for treating the common cold". Ann Intern Med. 126 (9): 738–9. PMID 9139564.
  21. ↑ 21.0 21.1 "Zinc". PDRhealth. Thomson Healthcare.
  22. ↑ Sandra G. Boodman. "Paying Through the Nose: Maker of Cold Spray Settles Lawsuits for $12 Million but Denies Claim That Zinc Product Ruined Users' Sense of Smell". The Washington Post.
  23. ↑ Braun BL, Fowles JB, Solberg L, Kind E, Healey M, Anderson R (2000). "Patient beliefs about the characteristics, causes, and care of the common cold: an update". The Journal of Family Practice. 49 (2): 153–6. PMID 10718693.
  24. ↑ Forstall, G. J. (13 April, 1994). "Effect of inhaling heated vapor on symptoms of the common cold". Journal of the American Medical Association (JAMA). 271 (14). Unknown parameter |coauthors= ignored (help); Check date values in: |date= (help)
  25. ↑ MA Akhavani (1 July, 2005). "Steam inhalation treatment for children". British Journal of General Practice. 55. Unknown parameter |coauthors= ignored (help); Check date values in: |date= (help)
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