Colds  
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This Care Guide Covers:

  • Runny or stuffy nose or congestion from a cold
  • Nasal discharge may be clear, cloudy, yellow, or green

If not, see these topics
When to Call Your Doctor

Call 911 Now (you may need an ambulance) If
  • Severe trouble breathing (struggling for each breath or cannot speak)
  • Very weak (can't stand)
  • You think you have a life-threatening emergency
Call Your Doctor Now (night or day) If
  • You feel weak or very sick
  • Trouble breathing, and is not from a blocked or stuffy nose
  • Fever of 103°F (39.4°C) or higher
  • Fever of 100.5°F (38.1°C) or higher and over 60 years old
  • Fever and have diabetes
  • Fever and have a weak immune system from:
    • HIV positive
    • Cancer chemo
    • Long-term steroid use
    • Splenectomy
  • Fever and are bedridden (nursing home patient, stroke, chronic illness, or recovering from surgery)
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think you need to be seen
  • Fever and sinus pain (not just pressure or fullness)
  • Fever lasts more than 3 days
  • Fever returns after being gone for over 24 hours, and symptoms are worse or not better
  • Sore throat lasts more than 5 days
Call Your Doctor During Weekday Office Hours If
  • You have other questions or concerns
  • Sinus pain (not just pressure or fullness) lasts more than 24 hours, after using nasal washes
  • Sinus pressure or fullness lasts more than 10 days
  • Runny nose lasts more than 10 days
Self Care at Home If
  • Mild cold
Causes & Health Information

Some Basics...

Symptoms

The most common symptoms of a cold are a runny or stuffy nose. Other symptoms include:

Does Honey Help Treat a Cough?

CARE ADVICE

Instructions for Treating a Cold
  1. What You Should Know:
    • Colds are very common and may make you feel uncomfortable.
    • Colds are caused by viruses. They cannot be cured with a drug or shot. Antibiotics do not help.
    • Colds are usually not serious.
    • You can treat a cold at home.
    • Here is some care advice that should help.
  2. For a Very Runny Nose: Blow the Nose.
    • Runny noses help to wash viruses and bacteria out of the nose.
    • Blowing the nose is all that is needed.
    • The skin around your nostrils may get irritated. You can rub a tiny amount of petroleum ointment on it 1-2 times a day.
  3. For a Stuffy Nose - Use Nasal Washes:  
    • Salt water washes are a good way to treat colds. You can pour, spray, or squirt salt water into your nose. Then let the water run back out.
    • How It Helps: The salt water rinses out mucus, dust, and allergens. It also keeps the nose moist.
    • Methods: There are a few ways to do nasal washes. You can use a:
      • Saline nasal spray bottle (sold over-the-counter)
      • Rubber ear syringe
      • Medical syringe without the needle
      • Neti Pot
    Step-By-Step Instructions: 
    • Step 1: Lean over a sink.
    • Step 2: Gently squirt or spray warm salt water into one of your nostrils.
    • Step 3: Some of the water may run into the back of your throat. Spit this out. If you swallow the salt water it will not hurt you.
    • Step 4: Blow your nose to clean out the water and mucus.
    • Step 5: Repeat steps 1-4 for the other nostril. Do this 2 or 3 times a day if it helps you.
    How to Make Salt Water Nasal Wash:
    • You can make your own salt water nasal wash.
    • Add 1/2 tsp of table salt to 1 cup (8 oz.; 240 ml) of warm water.
  4. Treatment for Cold-Related Symptoms:
    • For muscle aches, headaches, or fever (over 101°F; over 38.9°C): Take acetaminophen every 4 hours.
    • Sore throat: Try throat drops, hard candy, or warm chicken broth.
    • Cough: Use cough drops.
    • Hydrate: Drink liquids.
  5. Humidifier: If the air in your home is dry, use a cool mist humidifier.
  6. How It Is Spread:
    • The cold virus is in your nasal secretions.
    • Cover your nose and mouth with a tissue when you sneeze or cough.
    • Wash your hands often with soap and water.
    • You can return to normal activities after your fever is gone. This includes work and school.
  7. What to Expect:
    • Fever may last 2-3 days.
    • Runny nose may last 7-14 days.
    • Cough may last 2-3 weeks.
  8. Call Your Doctor If:
    • Trouble breathing
    • Fever lasts more than 3 days
    • Runny nose lasts more than 10 days
    • Cough lasts more than 3 weeks
    • You get worse
Over-the-Counter Medicines for a Cold
  1. Medicines for a Stuffy or Runny Nose:
    • Most cold drugs that are sold over-the-counter (OTC) are not helpful.
    • Antihistamines are only helpful if you also have nasal allergies.
    • If you still think you need medicine, try using a nasal decongestant.
  2. Nasal Decongestants for a Very Stuffy or Runny Nose:
    • Nasal decongestants can help you breathe better and reduce the amount of nasal drainage. They may be taken as pills by mouth or as a nasal spray.
    • Most people do NOT need to use these medicines.
    • Pseudoephedrine (Sudafed): This is sold OTC in pill form. Normal adult dose is two 30 mg tablets every 6 hours.
    • Pheylephrine (Sudafed PE): This is sold OTC in pill form. Normal adult dose is one 10 mg tablets every 4 hours.
    • Oxymetazoline Nasal Drops (Afrin): These are sold OTC. Blow your nose to clean out the mucus before using. Spray each nostril once. Wait one minute, and then spray a second time.
    • Phenylephrine Nasal Drops (Neo-Synephrine): These are sold OTC. Blow your nose to clean out the mucus before using. Spray each nostril once. Wait one minute, and then spray a second time.
    • Read all package instructions.
  3. Caution - Nasal Decongestants:
    • Do not take these drugs if you have high blood pressure, heart disease, an enlarged prostate, or an overactive thyroid.
    • Do not take these drugs if you are pregnant.
    • Do not take these drugs if you have taken a MAO inhibitor drug in the past 2 weeks. Life-threatening side effects can occur. Examples of MAO drugs include isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).
    • Do not use nasal decongestants for more than 3 days.
  4. Cough Medicines:
    • OTC Cough Syrups: Some people find that cough syrups help decrease coughing. Dextromethorphan is the most common cough suppressant in OTC cough syrups. Often the letters "DM" appear in the name.
    • OTC Cough Drops: Cough drops can help a lot. They work best for mild coughs. They soothe the tickling feeling in the back of the throat. Cough drops are easy to carry with you.
    • Home Remedy - Hard Candy: Hard candy works just as well as OTC cough drops. Diabetics should use sugar-free candy.
    • Home Remedy - Honey: Honey has been shown to help decrease coughing at night. The adult dose is 2 teaspoons (10 ml) at bedtime.
  5. OTC Cough Syrup - Dextromethorphan (DM):
    • Cough syrups with DM in them may help your cough. Cough syrups work best for coughs that keep you awake at night. They can help with a dry, hacky cough at the end of a cold. They can be used along with cough drops.
    • Examples: Benylin, Robitussin DM, Vicks 44 Cough Relief
    • Read all package instructions.
  6. Caution - Dextropmethorphan (DM):
    • Do not try to stop coughs if you are coughing up phlegm. Coughing is helpful in bringing up mucus from the lungs. This helps you from getting pneumonia.
    • Research Notes: Some research shows DM helps a cough get better. Other research shows it has little to no effect.
    • Drug Abuse: DM has become a drug of abuse.
    • Do not take DM if you have taken a MAO inhibitor in the past 2 weeks. These include: isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate).
    • Do not take this drug if you are taking venlafaxine (Effexor).
  7. Pain and Fever Medicines:
    • For pain or fever relief, take acetaminophen or ibuprofen.
    • Treat fevers above 101°F (38.3°C).
    • The goal of treating a fever is to bring it down. These medicines most often lower fever about 2-3°F (1-1.5°C).
    • You can take one of the drugs listed below if you have pain or a fever.
    • They are over-the-counter (OTC) drugs. You can buy them at the drugstore.
    Acetaminophen (Tylenol):
    • Regular Strength: Take 2 pills (650 mg) every 4-6 hours. Each Regular Strength pill has 325 mg of acetaminophen.
    • Extra Strength: Take 2 pills (1,000 mg) every 8 hours. Each Extra Strength pill has 500 mg of acetaminophen.
    • Do not take more than 3,000 mg of this drug per day.
    Ibuprofen (Motrin, Advil):
    • Motrin and Advil: Take 2 pills (400 mg) every 6 hours. Each Motrin or Advil pill has 200 mg of ibuprofen.
    • A second choice is to take 3 pills (600 mg) every 8 hours.
    Extra Notes:
    • Use the lowest amount of a drug that makes your pain feel better.
    • Your doctor might tell you to take more than what is shown above. That is because your doctor knows you and your health problems.
    • Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old. Acetaminophen is in many OTC and prescription drugs. It might be in more than one drug you are taking. Be careful how much you take. Too much of this drug can hurt the liver.
    • Caution- Acetaminophen: Do not take it if you have liver disease.
    • Caution- Ibuprofen:
      • Do not take ibuprofen if you are pregnant.
      • Do not take this drug if you have stomach problems or kidney disease.
      • Do not take this drug for more than 7 days without checking with your doctor.
    • Read all package instructions.
Mineral and Vitamin and Herbal Supplements
  1. Zinc:
    • Some studies show zinc gluconate lozenges may help with a cold.
    • Dose: Taken by mouth. Follow package instructions. You should take this with food to avoid an upset stomach.
    • Side Effects: Some people complain of an upset stomach and bad taste in their mouth.
    • Important Note About Zicam: Zicam is also sold over-the-counter. There have been a number of lawsuits claiming that Zicam causes loss of smell. It is not clear whether this truly happens. You should not use this drug.
  2. Vitamin C:
    • A number of experts promote taking high doses of this vitamin for a cold.
    • Research shows that Vitamin C has little effect on a cold. It cannot be recommended as a treatment.
    • Vitamin C is most likely harmless in standard doses (less than 2 grams daily).
  3. Echinacea: There is no proven benefit of using it for a cold. In fact, research suggests that it does not help.
  4. Read all package instructions.
Neti Pot for Sinus Symptoms
  1. Neti Pot
    • The Neti Pot is a small pot with a thin spout. It looks like a small tea pot.
    • How It Helps: You can use the Neti Pot for a nasal wash. The salt water rinses out mucus, dust, and allergens. It also keeps the nasal cavity moist.
    • Indications: Neti Pots are used to help colds, sinus infections, and nasal allergies.
    • Adverse Reactions: None. Though, not all people like the feeling of pouring water into their nose.
    • See Internet videos for instructions, such as: http://www.youtube.com/watch?v=j8sDIbRAXlg
  2. Neti Pot STEP-BY-STEP Instructions:
    • Step 1: Follow the directions on the salt package to make warm salt water.
    • Step 2: Lean forward and turn your head to one side over the sink. Keep your forehead slightly higher than your chin.
    • Step 3: Gently insert the spout of the Neti Pot into the higher nostril. Put it far enough so that it forms a comfortable seal.
    • Step 4: Raise the Neti Pot slowly. The salt water flows in your higher nostril and out the lower nostril. Breathe through your mouth.
    • Step 5: When the Neti Pot is empty, blow your nose. This will clean out the water and mucus.
    • Step 6: Some of the water may run into the back of your throat. Spit this out. If you swallow the salt water, it will not hurt you.
    • Step 7: Refill the Neti Pot and repeat on the other side. Again, breathe out strongly to clear the nose.
    How to Make Salt Water Nasal Wash:
    • You can make your own salt water nasal wash.
    • Add 1/2 tsp of table salt to 1 cup (8 oz.; 240 ml) of warm water.

Remember! Call your doctor if any of the "When to Call" symptoms occur.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: David A. Thompson, M.D.

Last Reviewed: 9/1/2012

Last Revised: 11/14/2012

Content Set: Adult Symptom Checker

Copyright 2000-2012. Self Care Decisions LLC; LMS, Inc.