Acetaminophen (paracetamol) is commonly prescribed for treating patients with the common cold; however, the evidence of its efficacy is still scarce. The current study was conducted to evaluate the efficacy and safety of acetaminophen in the treatment of the common cold in adults.

The authors reviewed 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) for the study. Radomised controlled trials (RCTs) comparing acetaminophen to placebo or no treatment in adults with the common cold were included in the trial. More studies were incorporated if the trials used acetaminophen as one ingredient of a combination therapy. The exclusion criteria included studies in which the participants had complications. Primary outcomes included subjective symptom score and duration of common cold symptoms while secondary outcomes were overall well being, adverse events and financial costs. Standard statistical analyses were performed after the extraction of data.

The included four RCTs had 758 participants and these studies gave sparse information about effects longer than a few hours, as three of four included studies were short trials of only four to six hours. The outcome revealed that patients with common cold treated with acetaminophen showed remarkable improvements in nasal obstruction in two of the four studies. One study reported that acetaminophen was more effective than placebo in decreasing rhinorrhoea severity. However, it was not seen to be superior for treating sneezing and coughing. Additionally, it did not improve sore throat or malaise in two of the four studies. Two studies demonstrated that headache and achiness ameliorated more in the acetaminophen group in contrast to the placebo group, while one study displayed comparable efficacy between the acetaminophen and placebo group. None of the included studies showed the duration of common cold symptoms. Minor side effects of acetaminophen included gastrointestinal adverse events, dizziness, dry mouth, somnolence and increased sweating, which were reported in two of the four studies. One of the study used a combination of pseudoephedrine and acetaminophen.

To conclude, although acetaminophen may help resolve nasal obstruction and rhinorrhoea, it can not improve some other cold symptoms such as sore throat, malaise, sneezing and cough. The data obtained in this review lacks adequate evidence to fabricate any guideline while using acetaminophen for the common cold in adults in clinical practice. Thus, more large‐scale, well‐designed trials are warranted to assess whether this agent is potent in the treatment of adults with the common cold.

Source: Li S, Yue J, Dong BR, Yang M, Lin X, Wu T. Acetaminophen (paracetamol) for the common cold in adults. Cochrane Database Syst Rev. 2013;2013(7):CD008800. Published 2013 Jul 1.