Best Cold Remedies: The Experts Are Divided

With OTC remedies for colds crowding self-help shelves, experts are divided on the merits of single-symptom treatment over multi-symptom therapy.

The common cold is often characterized as coughing, wheezing, aching, seeing a health care professional for "something to help," and staying home from work. It is also associated with $40 billion in indirect and direct annual costs to the American economy.

A cough that lasts less than 3 weeks in duration tops the list of affected individuals' common complaints, but colds are intrinsically multi-symptom viral infections. Most patients experience concurrent stuffy or runny nose, sneezing, coughing, sore throat, mild fever, weakness, headaches, and aching joints.

The journal Lung published a summary of the debate over single- and multi-symptom treatment approaches, with 2 experts weighing in.

Ron Eccles of Cardiff University in Wales argued in favor of multi-symptom therapy, while Ronald Turner of the University of Virginia School of Medicine held the opposite view, claiming that targeted, single-component, single-symptom therapy is the ideal approach.

Widely available combined medication dosage forms increase adherence and decrease mis-dosing of cold medicines. This stance is supported by the World Health Organization (WHO) Expert Committee Report on fixed-dose combination medicinal products.

Advocates for this approach indicate that although patients who use combination products may be treating symptoms they don't have, OTC cold medicines' risks are limited.

One exception is acetaminophen. Patients often underestimate the risk of acetaminophen overdose, but they are no more likely to overdose using a combination cold product than when using single products or acetaminophen in combination with opioids.

Opponents to the use of combination products argue that any risk is excessive. However, they acknowledge that combination products are affordable and convenient options for the common cold.

Patients experience a variety of symptoms over the course of a cold. Because symptoms change, Turner argued it is impossible to target the most prominent complaints with fixed combination products.

Pharmacists can help educate patients on the risks and benefits, and most importantly, the risk of acetaminophen overdose.