Cold medicine

WorldBrand briefing

AI supplement

Original synthesis to sit alongside the encyclopedia article below. Not part of Wikipedia; verify facts on Wikipedia when precision matters.

Cold medicine is a broad category of over-the-counter and sometimes prescription pharmaceutical products developed to temporarily relieve symptoms of the common viral cold. No standard cold medicine formulation can eliminate the underlying viral infection or meaningfully shorten the duration of a cold episode, and most are designed to address multiple overlapping discomforts at once through combined active ingredients.

Key moments

Mid-20th centuryFirst mass-marketed over-the-counter multi-symptom cold combination products launch for general consumer use in North America and Western Europe
2008U.S. FDA issues formal public warnings against administering OTC cold and cough medications to children under 2 years old, following reports of life-threatening adverse reactions from inappropriate dosing
2010sRegulators across dozens of countries extend non-recommendation guidance for OTC cold medicines to all children under 6 years old, and introduce sales limits for formulations containing pseudoephedrine to reduce illicit methamphetamine manufacturing
2020sJurisdictions including China and the EU mandate stricter ingredient transparency labeling for cold medications, to reduce accidental overdose risks from duplicate active components across different products

Widespread Public Misconceptions About Efficacy

A large share of consumers incorrectly assume common cold medicines kill cold viruses or cure the illness entirely, rather than only masking symptomatic discomfort. This misunderstanding leads to widespread overconsumption, including dangerous practices such as mixing multiple cold medication products that share acetaminophen, which can cause severe, permanent liver damage at excessive cumulative doses.

Tradeoffs Between Illicit Substance Controls and Patient Outcomes

Global restrictions on over-the-counter pseudoephedrine access rolled out from the 2000s onward successfully reduced small-scale domestic methamphetamine production, but also pushed many drug manufacturers to reformulate cold congestion products with less effective decongestant alternatives that do not address severe symptoms for many users, creating an unrecognized public health tradeoff for ordinary cold sufferers.

Parallel Treatment Paradigms in East Asian Markets

In regions where traditional Chinese medicine is widely integrated with mainstream care, cold medicines are also split into separate formulations targeting distinct symptom profiles: wind-cold formulas for chills, clear runny nose and mild fever, and wind-heat formulas for sore throat, thick yellow mucus and high fever, offering a distinct, widely accepted alternate treatment framework separate from Western-style allopathic cold medications.

Cold medicines are a group of medications taken individually or in combination as a treatment for the symptoms of the common cold and similar conditions of the upper respiratory tract. The term encompasses a broad array of drugs, including analgesics, antihistamines and decongestants, among many others. It also includes drugs which are marketed as cough suppressants or antitussives, but their effectiveness in reducing cough symptoms is unclear or minimal.[1][2]

While they have been used by 10% of American children in any given week, they are not recommended in Canada or the United States in children six years or younger because of lack of evidence showing effect and concerns of harm.[3]

Society and culture

Brands

Some brand names include: Benylin, Sudafed, Robitussin and Vicks among others.[34] Most contain a number of active ingredients.[3] The Thai company Hatakabb produces the Takabb Anti-Cough Pill, which is a Chinese herbal medication.[35]

Sudafed is a brand owned by Kenvue.[36] Sudafed markets a variety of nasal decongestant products with different active ingredients in different countries. The original formulation contains the active ingredient pseudoephedrine. Other Sudafed-branded products contain phenylephrine,[37][38][39] oxymetazoline,[39][40] xylometazoline,[38] antihistamines, pain relievers, and other active ingredients. Product names and formulations vary by country. Restrictions on the sale of pseudoephedrine in the many countries has led to changes in which products are available over the counter without authorization from a pharmacist or prescriber. In 2016, Sudafed was one of the biggest selling branded over-the-counter medications sold in Great Britain, with sales of £34.4 million.[41]

Gee's Linctus is a cough medicine which contains opium tincture.[42] New Zealand in 2019 moved it to prescription only.[43]

Coricidin, Coricidin D, or Coricidin HBP, is the brand name of a combination of dextromethorphan and chlorpheniramine maleate (an antihistamine). Varieties may also contain acetaminophen and guaifenesin.

Codral is a brand name manufactured by Johnson & Johnson and sold primarily in Australia and New Zealand. Codral is the highest-selling cold and flu medication in Australia.[44]

Economics

In the United States, several billion dollars are spent on over-the-counter products per year.[45]

Poisoning

According to The New York Times, at least eight mass poisonings have occurred as a result of counterfeit cough syrup in which medical-grade glycerin has been replaced with diethylene glycol, an inexpensive, yet toxic, glycerin substitute marketed for industrial use. In May 2007, 365 deaths were reported in Panama, which were associated with cough syrup containing diethylene glycol.[46] In 2022, the deaths of 66 children in The Gambia were linked to four pediatric cough syrup medications that contained diethylene glycol and ethylene glycol.[47][48]

In 2022, the US Food and Drug Administration issued a warning against cooking foods in cough syrup after a video of someone preparing "NyQuil chicken", sometimes also called "sleepy chicken", became popular on social media. Cough syrup is designed to be stored at room temperature and its properties can change when it is heated, making it potentially deadly. Heated cough syrup can also vaporize, leading to inhalation hazards.[49]

Alternative medicine

A small study found honey may be a minimally effective cough treatment due to "well-established antioxidant and antimicrobial effects" and a tendency to soothe irritated tissue.[21] A Cochrane review found there was weak evidence to recommend for or against the use of honey in children as a cough remedy.[22] In light of these findings, the Cochrane study found honey was better than no treatment, placebo, or diphenhydramine but not better than dextromethorphan for relieving cough symptoms.[22] Honey's use as a cough treatment has been linked on several occasions to infantile botulism and accordingly should not be used in children less than one year old.[23]

Many alternative treatments are used to treat the common cold, though data on effectiveness is generally limited. A 2007 review states that, "alternative therapies (i.e., Echinacea, vitamin C, and zinc) are not recommended for treating common cold symptoms; however, Vitamin C prophylaxis may modestly reduce the duration and severity of the common cold in the general population and may reduce the incidence of the illness in persons exposed to physical and environmental stresses."[24] A 2014 review also found insufficient evidence for Echinacea, where no clinical relevance was proven to provide benefit for treating the common cold, despite a weak benefit for positive trends.[25] Similarly, a 2014 systematic review showed that garlic may prevent occurrences of the common cold but there was insufficient evidence of garlic in treating the common cold and studies reported adverse effects of a rash and odour.[26] Therefore, more research needs to be done to prove that the benefits outweigh the harms.

Evidence supporting the effectiveness of zinc is mixed with respect to cough.[12] A 2003 review concluded: "Clinical trial data support the value of zinc in reducing the duration and severity of symptoms of the common cold when administered within 24 hours of the onset of common cold symptoms."[27] Zinc gel in the nose may lead to long-term or permanent loss of smell. The FDA therefore discourages its use.[28]

Cold medicine

WorldBrand briefing

Widespread Public Misconceptions About Efficacy

Tradeoffs Between Illicit Substance Controls and Patient Outcomes

Parallel Treatment Paradigms in East Asian Markets

Types

Effectiveness

Medications

Adverse effects

History