Do nasal decongestants used alone relieve cold symptoms?

Colds, although not serious, are common illnesses responsible for many visits to family doctors and days lost from work and school. Cold symptoms may last up to two week and include runny nose, sore throat, and sneezing. There is no cure for colds; treatments only ease the symptoms. Many people use over-the-counter medicines such as nasal decongestants to treat cold symptoms.

A team of Cochrane authors based in Australia and Belgium worked with Cochrane Acute Respiratory Infections to investigate if nasal decongestants help ease congestion caused by colds. 15 trials with 1,838 participants were included; 14 included only adults aged 18 years or over. Six studies used a single-dose nasal decongestant and measured the effects on the day it was administered. Nine studies used multiple doses and the effects were measured between one and 10 days after first administration. Eleven studies used tablets or syrup and four studies used nasal sprays. Nine studies were funded by drug manufacturers or agencies with commercial interests in the study results. Funding sources were unclear in six studies. The quality of evidence was assessed to be low.

The Cochrane Review was unable to draw conclusions about single-dose nasal decongestants. There was a small benefit in the relief of nasal congestion from multiple doses, but it was unclear if this was beneficial for patients. No studies reported overall patient well-being. There was no difference in the numbers of adverse events between people who used a nasal decongestant and those who did not. It was not possible to determine if there was a difference in effects between decongestant tablets and nasal sprays. The results relate to adults; there was no evidence on the effectiveness or safety of nasal decongestants for children.

“Nasal decongestants, available as tablets, nasal sprays, or drops, are available over-the-counter without restrictions. Given how uncomfortable cold symptoms can be, many turn to nasal decongestants but just how effective and safe they are was unclear,“ says Dr. Laura Deckx  from The University of Queensland and lead author of the Cochrane Review. “Given the high consumption of nasal decongestants it was surprising that so little evidence is available. Based on the current limited evidence, we were unable to draw conclusions if using just nasal decongestants was effective and safe for adults – this is something consumers should consider when at the drug store looking to relieve their common cold symptoms.”

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