Evidence-backed methods to treat your cold. Saline nasal sprays or irrigation can help alleviate congestion, while decongestants and cough suppressants provide additional relief. Consider zinc supplements (≥75 mg/day within 24 hours of onset) to reduce symptom duration and probiotics to help prevent future URTIs or shorten illness duration.
January 10, 2025

Common Cold: Get Better Quicker

Evidence-Based Over-the-Counter Guide

William Shen

William Shen

Co-founder & CPO

See all guides. Have more questions?

Colds are viral upper respiratory tract illnesses (URTI) characterized by congestion, fever, cough, and fatigue. They are typically treated supportively with hydration (6-10 glasses of fluid per day) and rest. 

Supplements:

  • Zinc: Significantly reduces symptoms of common cold in otherwise healthy people if given within 24 hours of onset of symptoms at a dose of ≥ 75 mg/day. Zinc supplement. 

  • Probiotics: Have been found to be better than placebo or no treatment in preventing acute URTIs and may reduce the average duration of an episode of acute URTI. Lactobacilli-predominant probiotic. 

Symptom-specific recommendations:

  • Acetaminophen or Ibuprofen: For fever and aches. Dose: Acetaminophen (FDA M013): 500-1000 mg every 6 hours as needed (max 3000 mg/day). Ibuprofen (FDA N021472): 200-400 mg every 4-6 hours as needed (max 1200 mg/day).

  • Saline nasal spray or irrigation: To alleviate nasal congestion. Neti Pot nasal cleanser.

  • Decongestants and cough suppressants: Dextromethorphan and doxylamine succinate. Often used in combination to reduce nasal swelling and post-nasal drip. We recommend DayQuil/NyQuil with VapoCOOL in caplet or syrup form (FDA M012) if cough is severe and interfering with sleep.

Not recommended: 

  • Antihistamines: Not affective in acute upper respiratory infection and may increase risk of developing acute sinusitis by drying out your nasal passages, making mucus thicker and harder to drain, potentially leading to further sinus congestion.

  • Oral phenylephrine and decongestant: Ineffective due to reduced absorption

Citations

DeGeorge KC, Ring DJ, Dalrymple SN. Treatment of the Common Cold. Am Fam Physician. 2019; 100(5): p.281-289. pmid: 31478634.

Singh M, Das RR. Zinc for the common cold. Cochrane Database Syst Rev. 2013. doi: 10.1002/14651858.cd001364.pub4

Zhao Y, Dong BR, Hao Q. Probiotics for preventing acute upper respiratory tract infections. Cochrane Database Syst. Rev. 2022; 2022(8). doi: 10.1002/14651858.cd006895.pub4

What OTC evidence is reviewed?

  • For each condition, we performed a literature review to find a recent widely cited expert group guideline published in the leading specialty-specific peer-reviewed journal or top general medical journal.

  • Based on the recommendations in the publication, we identify recommended active ingredients and devices that are available over-the-counter per FDA regulations.

What evidence is prioritized?

Levels of evidence considered:

  • Tier 1 (Safe and Definitely Effective): Professional field consensus or multiple randomized controlled clinical trials showing the same conclusion. Wherever possible, we use Tier 1 evidence for "first-line" recommendations.

  • Tier 2 (Safe and Probably Effective): Individual clinical trials which may be discordant or large-scale observational experience. Tier 2 evidence may inform "first-line", "second-line", or "supplement" recommendations.

  • Tier 3 (Safe and Maybe Effective): Mechanistic plausibility without high-quality clinical evidence of efficacy but high-quality evidence of safety. Tier 3 evidence may inform "second-line" or "supplement" recommendations.

How does MDandMe select recommended products?

  • Based on the top clinical recommendation, we evaluate products containing the recommended active agent with FDA-approved dosage based on price, average customer reviews, how often it is purchased, and how quickly it will ship to home. 

  • We provide public documentation of the active ingredients in our recommendations, using all 32 FDA monographs, Prescription-to-Nonprescription (Rx-to-OTC) Switches, as well as New Drug Application (NDA) approvals.

How does MDandMe select recommended devices?

  • Based on the top clinical recommendation, we evaluate devices that are FDA-cleared or comply with other medical guidelines (if not a FDA-regulated category) by reputability, price, and average customer reviews.

  • We provide public documentation of supporting evidence for each device.  

Where do I view other OTC guides?

Browse topic list here:

You can view all of our published OTC guides here.

Related Posts
How We Make OTC Guides
How We Make OTC Guides