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. 2013 Jul 1;2013(7):CD008800.
doi: 10.1002/14651858.CD008800.pub2.

Acetaminophen (paracetamol) for the common cold in adults

Affiliations

Acetaminophen (paracetamol) for the common cold in adults

Siyuan Li et al. Cochrane Database Syst Rev. .

Abstract

Background: Acetaminophen is frequently prescribed for treating patients with the common cold, but there is little evidence as to whether it is effective.

Objectives: To determine the efficacy and safety of acetaminophen in the treatment of the common cold in adults.

Search methods: We searched CENTRAL 2013, Issue 1, Ovid MEDLINE (1950 to January week 5, 2013), EMBASE (1980 to February 2013), CINAHL (1982 to February 2013) and LILACS (1985 to February 2013).

Selection criteria: We included randomised controlled trials (RCTs) comparing acetaminophen to placebo or no treatment in adults with the common cold. Studies were included if the trials used acetaminophen as one ingredient of a combination therapy. We excluded studies in which the participants had complications. Primary outcomes included subjective symptom score and duration of common cold symptoms. Secondary outcomes were overall well being, adverse events and financial costs.

Data collection and analysis: Two review authors independently screened studies for inclusion, assessed risk of bias and extracted data. We performed standard statistical analyses.

Main results: We included four RCTs involving 758 participants. We did not pool data because of heterogeneity in study designs, outcomes and time points. The studies provided sparse information about effects longer than a few hours, as three of four included studies were short trials of only four to six hours. Participants treated with acetaminophen had significant improvements in nasal obstruction in two of the four studies. One study showed that acetaminophen was superior to placebo in decreasing rhinorrhoea severity, but was not superior for treating sneezing and coughing. Acetaminophen did not improve sore throat or malaise in two of the four studies. Results were inconsistent for some symptoms. Two studies showed that headache and achiness improved more in the acetaminophen group than in the placebo group, while one study showed no difference between the acetaminophen and placebo group. None of the included studies reported the duration of common cold symptoms. Minor side effects (including gastrointestinal adverse events, dizziness, dry mouth, somnolence and increased sweating) in the acetaminophen group were reported in two of the four studies. One of them used a combination of pseudoephedrine and acetaminophen.

Authors' conclusions: Acetaminophen may help relieve nasal obstruction and rhinorrhoea but does not appear to improve some other cold symptoms (including sore throat, malaise, sneezing and cough). However, two of the four included studies in this review were small and allocation concealment was unclear in all four studies. The data in this review do not provide sufficient evidence to inform practice regarding the use of acetaminophen for the common cold in adults. Further large-scale, well-designed trials are needed to determine whether this intervention is beneficial in the treatment of adults with the common cold.

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Conflict of interest statement

None known.

Figures

1
1
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
2
2
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.

Update of

  • doi: 10.1002/14651858.CD008800

References

References to studies included in this review

Bachert 2005 {published data only}
    1. Bachert C, Chuchalin AG, Eisebitt R, Netayzhenko VZ, Voelker M. Aspirin compared with acetaminophen in the treatment of fever and other symptoms of upper respiratory tract infection in adults: a multicenter, randomized, double‐blind, double‐dummy, placebo‐controlled, parallel‐group, single‐dose, 6‐hour dose‐ranging study. Clinical Therapeutics 2005;27(7):993‐1003. - PubMed
Graham 1990 {published data only}
    1. Graham NMH, Burrell CJ, Douglas RM, Debelle P, Davies L. Adverse effects of aspirin, acetaminophen, and ibuprofen on immune function,viral shedding, and clinical status in rhinovirus‐infected volunteers. Journal of Infectious Diseases 1990;162:1277‐82. - PubMed
Ryan 1987 {published data only}
    1. Ryan PB, Rush DR, Nicholas TA, Graham DG. A double‐blind comparison of fenoprofen, acetaminophen, and placebo in the palliative treatment of common nonbacterial upper respiratory infections. Current Therapeutic Research 1987;41(1):17‐23.
Sperber 2000 {published data only}
    1. Sperber SJ, Turner RB, Sorrentino JV, Connor RR, Rogers J, Gwaltney JM. Effectiveness of pseudoephedrine plus acetaminophen for treatment of symptoms attributed to the paranasal sinuses associated with the common cold. Archives of Family Medicine 2000;9:979‐85. - PubMed

References to studies excluded from this review

Eccles 2006a {published data only}
    1. Eccles R, Jawad M, Jawad S, Ridge D, North M, Jones E, et al. Efficacy of a paracetamol‐pseudoephedrine combination for treatment of nasal congestion and pain‐related symptoms in upper respiratory tract infection. Current Medical Research & Opinion 2006;22(12):2411‐8. - PubMed
Koytchev 2003 {published data only}
    1. Koytchev R, Vlahov V, Bacratcheva N, Giesel B, Gawronska‐szklarz B, Wojcicki J, et al. Evaluation of the efficacy of a combined formulation (Grippostad‐C) in the therapy of symptoms of common cold: a randomised, double‐blind, multicenter trial. International Journal of Clinical Pharmacology & Therapeutics 2003;41(3):114‐25. - PubMed
Sedinkin 2004 {published data only}
    1. Sedinkin AA, Balandin AV, Dimova AD. Results of an open prospective controlled randomised comparative trial of flurbiprofen and paracetamol efficacy and tolerance in patients with throat pain. Vestnik Otorinolaringologii 2004;1(5):52‐4. - PubMed

References to studies awaiting assessment

Blanco de la Mora 2000 {published data only}
    1. Blanco de la Mora E, Loose I. Efficacy and safety of loratadin, pseudoephedrine & acetaminophen new formulation design for the symptomatic treatment of common cold. Investigation Medical International 2000;27(1):14‐25.
Mizoguchi 2007 {published data only}
    1. Mizoguchi H, Wilson A, Jerdack GR, Hull JD, Goodale M, Grender JM, et al. Efficacy of a single evening dose of syrup containing paracetamol, dextromethorphan hydrobromide, doxylamine succinate and ephedrine sulfate in subjects with multiple common cold symptoms. International Journal of Clinical Pharmacology & Therapeutics 2007;45(4):230‐6. - PubMed
Schachtel 1999 {published data only}
    1. Schachtel BP, Loose I. Gastrointestinal tolerability of single doses of acetylsalicylic acid, paracetamol, and placebo in adults with upper respiratory tract infection. Gut 1999;45(Suppl V):A95.

Additional references

Arroll 2010
    1. Arroll B, Kenealy T. Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database of Systematic Reviews 2010, Issue 2. [DOI: 10.1002/14651858.CD000247.pub2] - DOI - PubMed
Botting 2000
    1. Botting RM. Mechanism of actions of acetaminophen: is there a cyclooxygenase 3?. Clinical Infectious Diseases 2000;31(Suppl):202‐10. - PubMed
Bower 2007
    1. Bower W, Johns M, Margolis H, Williams IT, Bell BP. Population based surveillance for acute liver failure. American Journal of Gastroenterology 2007;102:2459‐63. - PubMed
Burnett 2006
    1. Burnett I, Schachtel B, Sannerk Bey M, Grattan T, Littlejohn S. Onset of analgesia of a paracetamol tablet containing sodium bicarbonate: a double‐blind placebo‐controlled study in adult patients with sore throat. Clinical Therapeutics 2006;28:1273‐8. - PubMed
De Sutter 2012
    1. Sutter AIM, Driel ML, Kumar AA, Lesslar O, Skrt A. Oral antihistamine‐decongestant‐analgesic combinations for the common cold. Cochrane Database of Systematic Reviews 2012, Issue 2. [DOI: 10.1002/14651858.CD004976.pub3] - DOI - PubMed
Eccles 2006b
    1. Eccles R. Efficacy and safety of over‐the‐counter analgesics in the treatment of common cold and flu. Journal of Clinical Pharmacy and Therapeutics 2006;31(4):309‐19. - PubMed
Fendrick 2003
    1. Fendrick AM, Monto AS, Nightengale B, Sarnes M. The economic burden of non‐influenza‐related viral respiratory tract infection in the United States. Archives of Internal Medicine 2003;163:487‐94. - PubMed
Gwaltney 2002
    1. Gwaltney JM, Winther B, Patrie JT, Hendley JO. Combined antiviral‐antimediator treatment for the common cold. Journal of Infectious Diseases 2002;186(2):147‐54. - PMC - PubMed
Heikkinen 2003
    1. Heikkinen T, Jarvinen A. The common cold. Lancet 2003;361:51‐9. - PMC - PubMed
Hemilä 2013
    1. Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database of Systematic Reviews 2013, Issue 1. [DOI: 10.1002/14651858.CD000980.pub4] - DOI - PMC - PubMed
Higgins 2003
    1. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ 2003;327(7414):557‐60. - PMC - PubMed
Higgins 2011
    1. Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration. Available from www.cochrane‐handbook.org. Chichester, UK: John Wiley & Sons, 2011.
Kim 2009
    1. Kim Sy, Cho HM, Hwang YW, Moon YS, Chang YJ. Non‐steroidal anti‐inflammatory drugs for the common cold. Cochrane Database of Systematic Reviews 2009, Issue 3. [DOI: 10.1002/14651858.CD006362.pub2] - DOI - PubMed
Lefebvre 2011
    1. Lefebvre C, Manheimer E, Glanville J (editors). Chapter 6: Searching for studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration. Available from www.cochrane‐handbook.org. The Cochrane Collaboration, 2011.
Linde 2008
    1. Linde K, Barrett B, Bauer R, Melchart D, Woelkart K. Echinacea for preventing and treating the common cold. Cochrane Database of Systematic Reviews 2008, Issue 3. [DOI: 10.1002/14651858.CD000530.pub2] - DOI - PubMed
Lissiman 2012
    1. Lissiman E, Bhasale AL, Cohen M. Garlic for the common cold. Cochrane Database of Systematic Reviews 2012, Issue 3. [DOI: 10.1002/14651858.CD006206.pub3] - DOI - PubMed
Lucas 2005
    1. Lucas R, Warner TD, Vojnovic I, Mitchell JA. Cellular mechanisms of acetaminophen: role of cyclooxygenase. Journal of the Federation of American Societies for Experimental Biology 2005;19:625. - PubMed
Mizoquchi 2007
    1. Mizoquchi H, Wilson Jerdack GR, Hull JD, Goodale M, Grender JM, Tyler BA. Efficacy of a single evening dose of syrup containing paracetamol, dextromethorphan, hydrobromide, doxylamine succinate and ephedrine sulfate in subjects with multiple common cold symptoms. International Journal of Clinical Pharmacology and Therapeutics 2007;45:230‐6. - PubMed
Moore 2003
    1. Moore N, LeParc JM, Ganse E, Wall R, Schneid H, Cairns R. Tolerability of ibuprofen,aspirin and paracetamol for the treatment of cold and flu symptoms and sore throat pain. International Journal of Clinical Practice 2002;56:732‐4. - PubMed
Pickering 2006
    1. Pickering G, Loriot MA, Libert F, Eschalier A, Beaune P, Dubray C. Analgesic effect of acetaminophen in humans: first evidence of a central serotonergic mechanism. Clinical Pharmacology and Therapeutics 2006;79:371‐8. - PubMed
Reece 2008
    1. Reece A, Davles CG, Maher M, Hancock J. A systematic review of paracetamol for non‐specific low back pain. European Spine Journal 2008;1423:1430. - PMC - PubMed
RevMan 2012 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.2. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2012.
Schachtel 1988
    1. Schachtel BP, Fillingim JM, Thoden WR, Lane AC, Baybutt RI. Sore throat pain in the evaluation of mild analgesics. Clinical Pharmacology and Therapeutics 1988;44:704‐11. - PubMed
Shaheen 2000
    1. Shaheen SO, Sterne JAC, Songhurst CE, Burnery PGJ. Frequent paracetamol use and asthma in adults. Thorax 2000;55:266‐70. - PMC - PubMed
Shen 2006
    1. Shen H, Sprott H, Aeschlimann A, Gay RE, Michel BA, Gay S. Analgesic action of acetaminophen in symptomatic osteoarthritis of the knee. Rheumatology 2006;45:765‐70. - PubMed
Singh 2011a
    1. Singh M. Heated, humidified air for the common cold. Cochrane Database of Systematic Reviews 2011, Issue 5. [DOI: 10.1002/14651858.CD001728.pub3] - DOI - PubMed
Singh 2011b
    1. Singh M, Das RR. Zinc for the common cold. Cochrane Database of Systematic Reviews 2011, Issue 2. [DOI: 10.1002/14651858.CD001364.pub3] - DOI - PubMed
Treanor 2000
    1. Treanor JJ, Hayden FG. Viral infection. Textbook of Respiratory Medicine. Philadelphia, USA: WB Saunders, 2000.
Zhang 2009
    1. Zhang X, Wu T, Zhang J, Yan Q, Xie L, Liu GJ. Chinese medicinal herbs for the common cold. Cochrane Database of Systematic Reviews 2009, Issue 2. [DOI: 10.1002/14651858.CD004782.pub2] - DOI - PubMed

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