Cold Meds

It’s been so long since I had a cold! Now I do, and I forget what’s good to take for what. With some smart friends who are inclined to stay kinda up on research (but not doctors), I came up with this:

  1. Acetaminophen/paracetamol is a good pain reliever and fever reducer (probably good to do) but not good for your liver, so take it iff you have a fever and pain. Don’t drink alcohol while taking it.
  2. Codeine is an even better painkiller/feel-good medicine, especially at night. You can’t get it over the counter in the US though.
  3. Dextromethorpan makes you cough less, take it if you’re coughing too much. (Also makes you sleepy) (EDIT: actually does nothing, or at least is worse than honey. (one study, meta-analysis)
  4. Guaifenesin makes you cough/runny more, take it if you’re congested and it’s not moving. Don’t take it if you’re already coughing or your nose is running too much?
  5. Phenylephrine is placebo, don’t bother
  6. Pseudoephedrine is the best decongestant if you can get it. Good if you’re congested. Can cause a congestion rebound, so don’t take it if you don’t need to.
  7. Doxylamine is an antihistamine that’ll make you sleepy; take it if you’re too runny or need to sleep
  8. Zinc is the one thing that actually shortens colds in medical trials. Note that if you see “homeopathic zinc” in like 13mg doses, there’s probably cheaper higher-dose plain-old-zinc in the supplement section. You want to take 75-95mg/day while you have a cold. (EDIT: and make sure it’s zinc acetate like the Life Extension brand, and maybe take it in lozenges so it coats your throat instead of just gets into your system (blog post, another post) (EDIT: sigh, actually, maybe Zinc doesn’t shorten colds; Hemilä et al 2020 study1)
  9. Vitamin c, echinacea, and everything else don’t actually shorten colds. (Regularly taking C can help prevent colds though! Same with D.)
  10. Diphenhydramine is an antihistamine, take it if you’re too runny. Also makes you sleepy. (interchangeable with doxylamine?)
  11. Ibuprofen is good for pain and sometimes for fever, but can irritate your stomach and cause ulcers if you take too much
  12. Aspirin is good for pain and sometimes for fever, but is a blood thinner so be careful with certain conditions.

Perhaps more usefully, sorted by conditions (all with caveats, check the above list):

Edit: someone made a better version of this post! We mostly agree but they have more info. Read that instead of this.

  1. from the study: “The zinc lozenge was a commercially available zinc acetate lozenge with 13 mg elemental zinc per lozenge (University Pharmacy, Helsinki, Finland). The lozenge weighed 0.9 g and had a diameter of 13 mm. The lozenges contained isomaltulose, sorbitol, magnesium stearate, orange and peppermint flavours and sucralose. The instruction of the commercial package for patients with common cold is to dissolve slowly six lozenges per day in the mouth, which totals to 78 mg/day of elemental zinc, at most for 5 days. The same instruction was used in this trial. Each package contained 30 lozenges.” So, looks like this study satisfies requirements 1, 4, and 7. And it probably fulfilled #2 (can’t promise they took it immediately on getting a cold but they did say “take when you have a cold”), fulfilled 72% (13/18) of req 3, probably about 75% of req 5 (if you take it every waking hour you could probably take 8 per day; study required 6), and probably req 6 (given “taste problems” from 24/46 ppl). So I’m giving this study a 3 + 4*75% = 6 out of 7 on fulfilling philh on lesswrong’s criteria. and I think demanding more is the Unreasonable Woo Claim Perfection Demand ("$thing didn’t work for you because you didn’t do it exactly right!") and considering zinc myth busted. ↩︎

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