The fall months bring bright colors, cool weather, and children returning to school. They also herald the annual return of the cold season, that yearly drama of coughing, sniffling, and generally feeling lousy. It is hard to escape cold season and modern medicine struggles to protect against it. Luckily, we are born champions at beating back cold viruses.
What is the common cold?
The common cold is a contagious viral infection of the upper respiratory tract, that is, the nasal passages, throat, and windpipe. The symptoms of a cold, mainly nasal stuffiness, runny nose, cough, sore throat, fever, and aches, typically last for seven to 10 days as the body fights off the infection. There is no cure for the common cold, just rest and symptom relief.
Also called acute upper respiratory tract infection (URI), the common cold is the most frequently-experienced illness throughout the developed world. It’s fair to say that everyone catches colds. On average, adults in the United States and other industrialized countries experience three to four colds each year. The average for children is six to eight colds a year. Nearly everyone who catches a cold will recover without treatment.
There is no one “cold” virus. Instead, many different viral infections are called “colds.” Most colds are caused by rhinovirus, but adenovirus, enterovirus, coronavirus (NOT the Covid virus), parainfluenza, and respiratory syncytial virus lie behind many colds, as well.
Cold viruses spread through nasal secretions and saliva. Breathing, talking, coughing, and sneezing can easily spread the virus when infected water droplets are breathed in through the nose. However, many people are infected by touching contaminated surfaces and then touching their faces. Handshakes, high-fives, and handling money are some of the most common ways people contaminate their hands with cold viruses.
Cold viruses first infect the tissues lining the inside of the nose. The infection then spreads to the back of the nasal passage, the throat (pharynx), tonsils, adenoids, windpipe (larynx), and sometimes the sinuses, causing swelling and mucus production. Symptoms typically begin 10 to 12 hours after the virus enters the nose.
While it is true that almost no-one comes through the cold season unscathed, there are risk factors that make catching a cold more likely. Close contact with children is the leading risk factor for the common cold, such as working in a daycare center or elementary school. Other risk factors include smoking, asthma, structural problems with the nose, or a compromised immune system.
How is the common cold diagnosed?
Most cases of the common cold are self-diagnosed and self-treated. A health care professional will diagnose a cold based entirely on the symptoms.
The symptoms of the common cold are well-known and widely experienced. They include:
Cough
Runny nose
Nasal congestion (“stuffy nose”)
Sore throat
Sneezing
Low fever
Feeling bad
Headache
Facial pressure
Sinus swelling (sinusitis)
Muscle aches
If the health care professional does not find any signs of pneumonia, bacterial infection (such as strep throat), or other respiratory illness, the symptoms are enough to make a cold diagnosis. Tests and imaging are not needed.
Common cold treatment options
The common cold cannot be cured. Treatment consists solely of relieving the severity and duration of symptoms. There are innumerable “treatments” for the common cold, but, unfortunately, only a few of them work to relieve or reduce symptoms.
Medications
For adults, the only proven medicines that help relieve symptoms are over-the-counter pain relievers, certain types of decongestants, antihistamines, and zinc. Over-the-counter pain relievers are considered the first and best medicine to take for a cold.
Buckwheat honey, geranium extract, nasal saline irrigation, humidifiers, and vapor rub have been shown to relieve symptoms in young children, but not adults.
For natural remedies, both Andrographis extract, geranium extract, and saline nasal sprays have some scientific evidence they may help with both the severity and duration of cold symptoms, but the results are not certain.
The bad news is that over-the-counter cold medicines really don’t work. OTC combination cold medications, cough medicines, expectorants, antihistamines, decongestants, vitamin C, vitamin D, echinacea, steroid nasal sprays, and steam have been shown in studies to be ineffective against cold symptoms. Some popular remedies, like vitamin E, make symptoms worse.
Prescription antibiotics are formulated to fight bacterial infections, so they can’t help with viral infections like the common cold. None of the existing antiviral medications are effective against any of the cold viruses. Prescription corticosteroids, bronchodilators (drugs that increase the width of airway passages), do not affect cold symptoms.
Cold medicines
Grocery stores and pharmacy shelves are filled to bursting with cold medications and natural cold remedies. Many are well-known household names. All of these drugs have been researched, and only a few effectively reduce symptoms or shorten symptom duration: over-the-counter pain relievers, some types of decongestants, antihistamines combined with decongestants, and zinc supplements.
Analgesics
The most effective cold medications are over-the-counter pain relievers such as acetaminophen and ibuprofen. These drugs reduce fever, soothe sore throat, and relieve headaches and body aches. They do not, however, help with a stuffy nose, runny nose, or cough. Most healthcare providers will advise an OTC pain reliever as the first-line therapy for riding out a cold.
Nasal decongestants
Decongestants reduce the swelling of blood vessels that causes nasal “stuffiness” by causing blood vessels to contract. Over-the-counter oxymetazoline, the active ingredient in Afrin, Dristan, and Vicks Sinex, has been shown to be the most consistently effective at reducing stuffy nose due to a cold. Although effective for nasal congestion due to allergies, popular decongestants such as pseudoephedrine and phenylephrine have not been shown to be effective cold medications.
Cough suppressants
Coughing is a reflex provoked by throat irritation. For a cold infection, throat irritation is caused by mucus flowing down into the throat. Cough medicines (antitussives) work by slowing down the part of the brain responsible for the cough reflex, so most cough suppressants are opioids. Both prescription and over-the-counter cough suppressants have not been found to effectively relieve cough due to cold, so it may be better to save your money.
Anticholinergics
Mucus secretion is controlled by involuntary nerves that communicate signals to glands through the chemical acetylcholine. Anticholinergics block acetylcholine and thus shut down mucus secretion. The most effective cold medicine is prescription ipratropium, a drug normally used to open tight airway passages. Taken as an oral inhalant, ipratropium cuts down mucus secretion and so helps to reduce a runny nose and cough caused by a runny nose. It does not relieve sneezing, fever, stuffy nose, or body aches.
Antihistamines
Antihistamines such as diphenhydramine, brompheniramine, or chlorpheniramine have only a short-term effect on cold symptoms such as coughing, watery eyes, and sneezing. They lose effectiveness after a day or two. Antihistamines are, however, more effective when combined with ipratropium or oxymetazoline. The most effective antihistamines, such as brompheniramine and chlorpheniramine, are also anticholinergics and help reduce mucus secretion and runny nose.
Expectorants
Expectorants such as guaifenesin loosen mucus to make it easier for the body to eliminate. Common in many cold and flu medications, expectorants have no value in treating colds.
Supplements
Zinc in the form of zinc sulfate or zinc gluconate has been shown in numerous studies to reduce both the duration and severity of cold symptoms. To be effective, zinc supplements must be taken daily in high doses as soon as cold symptoms first appear.
Daily vitamin C has been shown to shorten the severity and duration of cold symptoms if taken daily in the weeks and months before catching a cold. Taken after a cold has set in, vitamin C supplements do not affect the virus or cold symptoms.
What is the best medication for the common cold?
There are shelves full of cold medications, but the most effective medications are over-the-counter pain relievers, oxymetazoline, prescription ipratropium, antihistamines, and zinc supplements. How well any of these medications work depends on the situation, so there is no “best” medication for the common cold.
One 11 mg tablet every four hours for three to seven days
Bad taste, nausea, diarrhea
Many of the standard dosages above are from the U.S. Food and Drug Administration (FDA) and the National Institutes of Health (NIH). Dosage is determined by your doctor based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.
What are the common side effects of cold medicine?
Many cold medications are ineffective or barely effective, but they, like all other medications, have many side effects that vary depending on the type of medication. This is not a complete list of possible side effects due to cold medications. Consult with a healthcare professional if you have concerns or questions about your specific situation or the medications you’re taking.
Over-the-counter pain relievers are universally advised to treat cold symptoms because they are very safe when used over a short time. The most serious side effect of acetaminophen is overdose, and the most serious side effects of nonsteroidal anti-inflammatory drugs (NSAIDs) are bleeding problems. Stomach pain and bleeding are also experienced when taking NSAIDs over a period of time. Because of the risk of Reye’s syndrome, aspirin should not be given to children with a cold who are under the age of 19.
Outside of pain relievers, the most effective cold medication isipratropium, a prescription anticholinergic, as well as antihistamines, such as chlorpheniramine, that have anticholinergic properties. The most common side effects of anticholinergics are dry mouth, dry eyes, blurred vision, and dizziness.
Oxymetazoline is a vasoconstrictor, that is, it causes blood vessels to tighten. The most common side effects are site reactions such as burning, stinging, runny nose, and sneezing. The most serious side effects are due to the drug getting into the bloodstream and causing high blood pressure and speeding up the heart. These effects, however, are more likely if the drug is overused.
The high zinc doses needed to effectively treat cold symptoms should only be taken for a few days and then discontinued because of possible side effects. Overuse of zinc supplements often causes side effects such as a metallic taste in the mouth, nausea, vomiting, and diarrhea. If a patient experiences these side effects, zinc supplements should be discontinued. High doses of zinc taken over a long time can result in dangerously low levels of copper in the blood and lowered immunity.
What is the best home remedy for the common cold?
For nearly all patients, colds are treated at home. For symptom relief, most natural and home remedies don’t really help. There are, however, a few proven home remedies that genuinely relieve symptoms.
Use over-the-counter pain relievers
Study after study has shown that over-the-counter pain relievers such as acetaminophen and ibuprofen are the most effective way to manage cold symptoms.
Take zinc supplements
Zinc does relieve symptoms and reduce their duration, but the supplement has to be started as soon as symptoms appear and the doses have to be pretty high. Ask a healthcare professional before you start on zinc supplements. The side effects may be worse than the cold.
Rest
Rest does not affect the course of the infection, but you will feel a whole lot better if you get plenty of rest.
Drink plenty of fluids
The body does not effectively fight off illness without proper hydration, so drink at least eight glasses of water throughout the day.
Gargle with saltwater
The most effective remedy for sore throat is gargling with warm salt water every two or three hours. For natural sore throat remedies, try chamomile or peppermint tea. Sugary throat lozenges or cough syrups cause tissue swelling and may make the throat even sorer.
Don’t get a cold in the first place
The best treatment for a cold is to avoid the infection altogether. The proven way to prevent colds is through hand washing. Wash your hands several times a day for 15 to 30 seconds. Hand sanitizer is even more effective. Safe doses of vitamin C, zinc, and probiotics also help to reduce the risk of catching a cold.
Frequently asked questions about the common cold
What is the best treatment for the common cold?
The only real treatment for a common cold is to ride it out. The body will fight off the infection naturally within seven to 10 days. Over-the-counter pain relievers such as acetaminophen and ibuprofen provide the most effective symptom relief.
How do you get rid of a cold permanently?
Colds are caused by many different viruses. The viruses that cause the common cold mutate and change rapidly. The body effectively rids itself of a cold infection within a week or two, but it is still vulnerable to re-infection by different cold viruses and different strains. There is no way to be permanently free from colds.
What do doctors prescribe for a cold?
Doctors rarely prescribe medications for a cold. The body can successfully clear the infection in a few days. However, for people with more severe symptoms, doctors commonly prescribe ipratropium to relieve excess mucus production. Antibiotics only work against bacterial infections, and antiviral drugs are not effective against the viruses that cause the common cold.
What is the best medicine for a cough and cold?
Healthcare providers will nearly unanimously suggest over-the-counter pain relievers such as acetaminophen or ibuprofen to ease symptoms of a cold. These drugs relieve fever, headache, body aches, and, to a limited extent, help control the pain of a sore throat. They do not, however, reduce nasal congestion, runny nose, cough, or sneezing.
What is the fastest home remedy for a cold? / How do you get rid of a cold overnight?
There is no way to cure a cold, let alone cure it fast. The body must fight off the infection. The best medicine can do is provide symptom relief. Typically, it takes seven to 10 days for cold symptoms to subside.
What is the best food to get rid of a cold?
Unfortunately, there is no food that “cures” the common cold or provides known symptom relief. As with all other medical conditions, a nutritious and balanced diet is the best diet for a cold.
Kristi C. Torres, Pharm.D., is a 2005 graduate of The University of Texas at Austin. Her professional background includes academic teaching roles, district-level management for a nationwide pharmacy chain, and clinic-based pharmacy management. Dr. Torres has a wide range of experience in pharmacy operations and has traveled to many states to open and convert clinic-based pharmacies for one of the largest healthcare systems in the nation.
Currently, she works for Tarrytown Expocare Pharmacy in Austin, Texas, serving the intellectual and developmental disability community. There, she leads the order entry team, overseeing orders from across the country.
Dr. Torres began working in pharmacy at the age of 16 in a small East Texas town. She currently resides in Round Rock, Texas, with her daughter and a Shih-Tzu puppy.
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