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Medical procedures often generate sharps and other medical waste, so being prepared with a compliant process for disposing of those used needles, red-bag waste, and spill cleanup materials is important for your team, patients, and community. 

Medical Waste Management in Contemporary Clinics

Thirty years ago, a simple but powerful idea took shape: ask the pharmacists. Not the manufacturers. Not the marketers. The pharmacists—the health care professionals standing at the counter every day, fielding questions, guiding decisions, and earning the trust of patients, 1 interaction at a time. 

®, and this year, we mark its 30th edition. What began as a modest survey has grown into one of the most trusted barometers of frontline pharmaceutical expertise in the country. Each year, practicing pharmacists across the nation share their firsthand knowledge of which OTC products they recommend most. The result is a resource built not on advertising budgets or brand recognition, but on real-world clinical experience and patient outcomes.

In 3 decades, much has changed. The OTC landscape has expanded dramatically, with dozens of prescription-strength therapies now available without a prescription. Consumer health literacy has risen. Digital tools have transformed how patients research their symptoms before ever reaching the pharmacy counter. And the role of the pharmacist has evolved alongside all of it—from dispenser to counselor, from back-of-store professional to frontline health care provider.

What hasn’t changed is the pharmacist’s unique position of trust. Study after study confirms that Americans regard their pharmacist as among the most accessible and reliable sources of health care guidance. The 

 exists to honor and amplify that expertise.

This milestone edition reflects the input of hundreds of pharmacists who took time from their demanding schedules to share their recommendations. Their collective voice is what gives this guide its authority and enduring value—to patients, to the broader health care community, and to the industry professionals who rely on it each year.

As we celebrate the 30th anniversary, we do so with deep gratitude to every pharmacist who has contributed over the years. You are the reason this guide matters. You are the reason it has lasted.

Here’s to the next 30 years, and to the patients who are better served because of your dedication.

What began as a modest survey has grown into one of the most trusted barometers of frontline pharmaceutical expertise in the country.

OTC Guide: Thirty Years Strong

The rapid rise of glucagon-like peptide-1 (GLP-1) receptor agonists has transformed the treatment landscape for patients with obesity and type 2 diabetes. GLP-1 is an incretin hormone secreted by intestinal L-cells in response to nutrient intake.

 It promotes glucose-dependent insulin secretion, suppresses glucagon release, slows gastric emptying, and contributes to appetite regulation through central nervous system pathways.

GLP-1 receptor agonists are designed to directly activate this pathway in a durable and clinically measurable way.

Medications such as semaglutide (Wegovy, Ozempic; Novo Nordisk) and tirzepatide (Zepbound; Eli Lilly) have demonstrated clinically significant weight reduction and cardiometabolic benefits in large clinical trials.

 Newer agents are also expanding the field, including orforglipron (Foundayo; Eli Lilly), an oral small-molecule GLP-1 receptor agonist, highlighting continued innovation in this therapeutic class.

As public awareness of GLP-1 therapy has increased, so has consumer interest in OTC products marketed as GLP-1 boosters. These supplements are often promoted in pharmacies, online, and through social media as natural alternatives that can increase satiety, improve metabolism, or support weight loss. Compared with GLP-1 receptor agonists, these supplements generally do not directly activate GLP-1 receptors to the same extent. For community pharmacists, this creates an important counseling opportunity for patients who ask about products similar to GLP-1 receptor agonists.

Common ingredients found in OTC products marketed as GLP-1 boosters include berberine, chromium picolinate, resveratrol, dietary fiber, green tea extract, and probiotics. Some may have modest metabolic effects, but none should be considered equivalent to GLP-1 receptor agonists. This distinction is especially important because the FDA has warned that many weight loss products marketed as supplements may contain hidden drug ingredients, may be falsely advertised as natural products, and can pose serious health risks.

 The National Institutes of Health’s Office of Dietary Supplements also emphasizes that weight-loss supplements vary widely in ingredients, mechanisms, evidence, and safety profiles.

Berberine is one of the most promoted ingredients in “natural Ozempic” messaging.

 Evidence suggests that berberine may improve lipid parameters, with 1 systematic review and meta-analysis finding reductions in total cholesterol, low-density lipoprotein cholesterol, and triglycerides.

However, the authors noted high clinical heterogeneity and generally low methodological quality among included trials, meaning the findings should be interpreted cautiously.

 From a safety perspective, berberine was generally associated with mild adverse effects such as constipation, flatulence, nausea, headache, and transaminase elevation, with no serious adverse events reported in the reviewed trials.

 Pharmacists should still screen for gastrointestinal intolerance, pregnancy status, liver disease, and potential drug interactions.

Chromium picolinate is another common ingredient promoted for glucose metabolism and insulin sensitivity. A systematic review and meta-analysis in patients with diabetes found that chromium supplementation improved glycemic control and did not significantly increase adverse events compared with placebo.

 Reported adverse events included watery stool, dizziness, headache, nausea, constipation, and flatulence.

 However, this evidence is more relevant to glycemic outcomes in diabetes than to weight loss. Pharmacists should be cautious when patients use chromium alongside insulin or other glucose-lowering therapies because of the risk of additive glucose-lowering effects.

Resveratrol is a polyphenol marketed for its effects on metabolic health, antioxidant activity, and weight management.

 However, human evidence for weight loss remains inconsistent. A review of resveratrol obesity trials found substantial heterogeneity in study design, including differences in dose, duration, delivery method, participant characteristics, and outcomes measured.

 Additionally, a literature review reported that resveratrol may have dose-related adverse effects, possible cytochrome P450 interactions, and potential interaction with drugs such as warfarin, which could increase bleeding risk.

 High doses have also been associated with gastrointestinal symptoms such as diarrhea and nausea.

Dietary fiber may be the most clinically reasonable ingredient to discuss as an adjunctive, nonprescription option, although not as a GLP-1 substitute. Fibers such as glucomannan, psyllium, and inulin may promote satiety, delay gastric emptying, and support modest weight reduction when combined with energy restriction.

 In a randomized controlled study of adults with overweight or obesity and traits of metabolic syndrome, fiber supplementation with energy restriction improved body weight, body mass index, fat mass, visceral fat, lipid profile, and inflammatory markers.

 Safety counseling should focus on bloating, flatulence, diarrhea, constipation, adequate water intake, and separation from other medications to reduce the risk of impaired absorption.

Green tea extract is often marketed for thermogenesis and “fat burning.” A Cochrane review found that green tea preparations produced a small, statistically nonsignificant weight loss in adults with overweight or obesity and that the amount of weight loss was unlikely to be clinically meaningful.

Safety concerns include gastrointestinal symptoms, caffeine-related effects such as insomnia or palpitations, and hepatotoxicity, particularly with concentrated extracts.

 The same review noted that reported adverse events were generally mild to moderate, although adverse event reporting was inconsistent across studies.

Probiotics are increasingly included in weight-management supplements due to growing interest in the gut microbiome. A 2024 systematic review found that probiotics showed a trend toward preventing weight gain and reducing body weight in individuals with excess weight or obesity, with combinations of 

 Pharmacists should avoid generalizing the effects of a single probiotic strain or combination to all probiotic products. Although probiotics are generally well tolerated, caution is warranted in immunocompromised patients or those with significant underlying illness.

When counseling patients, pharmacists should clearly state that these products may have limited supportive metabolic data and do not replicate the pharmacologic action or clinical outcomes of GLP-1 receptor agonist therapies.

Community pharmacists are well-positioned to respond to patient questions in a practical, nonjudgmental way. The first step is to identify the patient’s goal: weight loss, appetite control, glycemic improvement, or avoidance of prescription therapy due to cost, lack of access, or fear of injections. Pharmacists should then review current medications, pregnancy status, history of liver or kidney disease, diabetes history, anticoagulant use, immunocompromising conditions, and prior adverse reactions to medications.

Pharmacists should also assess patients’ expectations for these products and clarify that OTC supplements do not produce effects comparable to those of semaglutide or tirzepatide. Counseling should include discussion of potential adverse effects, drug-supplement interactions, variability in supplement quality, and situations in which referral to a primary care clinician or specialist may be appropriate. This approach allows pharmacists to move beyond “Does it work?” and toward “Is it appropriate and safe for this patient?”

Clinical recommendations should emphasize evidence-based care. Patients with obesity, diabetes, cardiovascular risk, or obesity-related complications may benefit from referral to a primary care clinician, dietitian, or specialist. For patients interested in OTC options, fiber may be a reasonable adjunct when used appropriately, but it should be paired with nutrition, physical activity, and realistic expectations. Other supplements should be approached cautiously, especially when evidence is inconsistent or safety concerns exist.

OTC GLP-1 boosters reflect both the excitement surrounding modern obesity pharmacotherapy and the vulnerability of patients to marketing claims. Although some ingredients may have varying degrees of metabolic evidence, none should be considered a substitute for FDA-approved GLP-1 receptor agonists. As demand for weight-loss therapies grows, pharmacists play a critical role in distinguishing evidence-based treatments from marketing-driven alternatives.

Rosen CJ, Ingelfinger JR. GLP-1 receptor agonists. 

 2026;394(13):1313-1324. doi:10.1056/NEJMra2500106

Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity. 

 2021;384(11):989-1002. doi:10.1056/NEJMoa2032183

Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. 

 2023;389(24):2221-2232. doi:10.1056/NEJMoa2307563

Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide once weekly for the treatment of obesity. 

2022;387(3):205-216. doi:10.1056/NEJMoa2206038

Packer M, Zile MR, Kramer CM, et al. Tirzepatide for heart failure with preserved ejection fraction and obesity. 

 2025;392(5):427-437. doi:10.1056/NEJMoa2410027

Wharton S, Aronne LJ, Stefanski A, et al. Orforglipron, an oral small-molecule GLp-1 receptor agonist for obesity treatment. 

 2025;393(18):1796-1806. doi:10.1056/NEJMoa2511774

FDA approves first new molecular entity under National Priority Voucher Program. News release. FDA. April 1, 2026. Accessed May 19, 2026. 

https://www.fda.gov/news-events/press-announcements/fda-approves-first-new-molecular-entity-under-national-priority-voucher-program

Weight loss product notifications. FDA. Updated July 22, 2025. Accessed May 19, 2026. 

https://www.fda.gov/drugs/medication-health-fraud-notifications/weight-loss-product-notifications

Dietary supplements for weight loss. National Institutes of Health Office of Dietary Supplements. Updated May 18, 2022. Accessed May 19, 2026. 

https://ods.od.nih.gov/factsheets/WeightLoss-HealthProfessional/

What to know about berberine, the so-called “nature’s Ozempic.” UCLA Health. October 22, 2025. Accessed May 19, 2026. 

https://www.uclahealth.org/news/article/what-know-about-berberine-so-called-natures-ozempic

Feng X, Sureda A, Jafari S, et al. Berberine in cardiovascular and metabolic diseases: from mechanisms to therapeutics. 

 2019;9(7):1923-1951. doi:10.7150/thno.30787

Ju J, Li J, Lin Q, Xu H. Efficacy and safety of berberine for dyslipidaemias: a systematic review and meta-analysis of randomized clinical trials. 

 2018;50:25-34. doi:10.1016/j.phymed.2018.09.212

Tian H, Guo X, Wang X, et al. Chromium picolinate supplementation for overweight or obese adults. 

 2013;2013(11):CD010063. doi:10.1002/14651858.CD010063.pub2

Suksomboon N, Poolsup N, Yuwanakorn A. Systematic review and meta-analysis of the efficacy and safety of chromium supplementation in diabetes. 

 2014;39(3):292-306. doi:10.1111/jcpt.12147

Hillsley A, Chin V, Li A, McLachlan CS. Resveratrol for weight loss in obesity: an assessment of randomized control trial designs in ClinicalTrials.gov. 

Shaito A, Posadino AM, Younes N, et al. Potential adverse effects of resveratrol: a literature review. 

2020;21(6):2084. doi:10.3390/ijms21062084

Pražnikar ZJ, Mohorko N, Gmajner D, Kenig S, Petelin A. Effects of four different dietary fibre supplements on weight loss and lipid and glucose serum profiles during energy restriction in patients with traits of metabolic syndrome: a comparative, randomized, placebo-controlled study. 

 2023;12(11):2122. doi:10.3390/foods.12112122

Jurgens TM, Whelan AM, Killian L, Doucette S, Kirk S, Foy E. Green tea for weight loss and weight maintenance in overweight or obese adults. 

 2012;12(12):CD008650. doi:10.1002/14651858.CD008650.pub2

Torres B, Sánchez MC, Virto L, Llama-Palacios A, Ciudad MJ, Collado L. Use of probiotics in preventing and treating excess weight and obesity: a systematic review. 

OTC GLP-1 boosters are marketed for weight loss, but pharmacists should help patients distinguish evidence-based care from supplement claims.

GLP-1 Boosters: Responding to Supplement Marketing Claims and Safety Questions

Growing scientific evidence shows that the gut microbiome, a complex and diverse ecosystem, plays a fundamental role in human health by influencing numerous physiological systems.

 When the gut microbiome is balanced, it supports metabolic regulation, immune function, and gastrointestinal stability. However, disruptions in its composition and activity, known as microbial dysbiosis, are strongly correlated with health-related complications, including gastrointestinal, metabolic, immunological, and neurological diseases.

Probiotic supplements are frequently used to restore and/or maintain a healthy gut microbiome, particularly when microbial balance is disrupted by antimicrobial therapy, illness, or dietary factors.

 Emerging evidence also supports their use in immune regulation, urogenital health, and adjunctive therapy for conditions influenced by microbiome‑immune interactions.

According to the International Scientific Association for Probiotics and Prebiotics (ISAPP), the definitions of a probiotic and a prebiotic are as follows

A probiotic is a live microorganism that, when administered in adequate amounts, confers a health benefit.

A prebiotic is a substrate that is selectively utilized by host microorganisms, conferring a health benefit on the host.

The ISAPP notes that the health benefits of certain probiotic strains may arise from their ability to influence the composition or activity of the gut microbiota, whereas prebiotics, by definition, exert their beneficial effects through targeted modulation of the gut microbial community.

 The use of probiotic supplements continues to gain popularity due to their easy accessibility, perceived safety, and consumer confidence that they promote gut health.

American Journal of Pharmacotherapy and Pharmaceutical Sciences

 indicate that an estimated 33.3% of survey respondents reported taking or having taken probiotics daily, and an additional 29% indicated considering future use. Among daily users, 64% were taking probiotics without guidance from a health care provider, and only 6% sought counseling from a pharmacist when selecting OTC supplements.

Key Benefits of Prebiotics and Probiotics

Research has shown that probiotics provide several clinically meaningful benefits, including support for digestive function, modulation of immune activity, and maintenance of a diverse and balanced gut microbiota, an indicator of overall health. Specific strains have demonstrated efficacy in reducing the duration and severity of diarrhea, improving symptoms such as bloating and abdominal discomfort, and enhancing mucosal immune defenses. Probiotics may also influence systemic health by reducing inflammatory markers and improving certain metabolic parameters through gut‑mediated mechanisms, including short‑chain fatty acid production and interactions along the gut-brain axis.

In addition to aiding digestion, probiotics play another essential role by promoting a healthy immune system and preventing chronic diseases. Research shows that probiotics can provide protective effects in the treatment and prevention of conditions such as gastrointestinal tract infections, irritable bowel syndrome, lactose intolerance, allergies, cystic fibrosis, urogenital infections, diarrhea, hyperlipidemia, eczema, and certain cancers. Probiotics may also support dental health by helping treat and prevent tooth decay and periodontal disease.

The ISAPP indicates that prebiotics selectively nourish beneficial gut microbes, improving digestive regularity, boosting short‑chain fatty acid production, strengthening the gut barrier, supporting immune function, and helping maintain a resilient, balanced microbiome that benefits overall metabolic health and provides anti-inflammatory benefits.

The National Institutes of Health (NIH) Office of Dietary Supplements says that “probiotics are identified by their genus, species, and strain designation; some probiotics also receive subspecies names.” In addition, “probiotic products often contain microbial organisms from the genera 

Bifidobacterium, Saccharomyces, Streptococcus, Enterococcus, Escherichia, and Bacillus

Lactobacillus acidophilus, Lactobacillus rhamnosus, Lactobacillus casei, and Lactobacillus plantarum

Bifidobacterium longum and Bifidobacterium breve,

 are some of the most-researched probiotics

Probiotic supplements are available for adults and pediatric patients in various dosage forms, including capsules, gummies, chewable tablets, and powders, and some are also formulated in combination with prebiotics.

 Some supplements are formulated for specific needs to support digestive health and metabolic/weight support, immune health, women’s health, and men’s health.

Pharmacists can assist patients in selecting the appropriate OTC probiotic by aligning specific strains and dosages with patients' needs and by evaluating safety considerations, such as immune status, medical history, potential contraindications, and drug/supplement interactions. Pharmacists can also provide education regarding proper usage, including timing, anticipated benefits, and potential adverse effects. By providing evidence-based guidance, pharmacists can ensure that probiotics are used safely and effectively, with realistic expectations.

Patients, especially those with medical conditions, should consult their health care provider before initiating supplements. Pregnant or breastfeeding women should also seek medical advice to ascertain appropriateness, although no harmful effects have been reported in late pregnancy or lactation. Patients should also be advised to use only reputable brands and adhere to recommended doses.

According to the National Institutes of Health (NIH) and an International Scientific Association for Probiotics and Prebiotics consensus statement, probiotics should be taken at least 2 hours apart from antibiotics or antifungals. Mild flatulence or bloating may occur but often improves, and gradual dose increases can reduce discomfort. Changes in stool frequency, including loose stools, may occur after initiating probiotics and should be monitored, especially in pediatric patients.

The NIH recommends that individuals with weakened immune systems avoid probiotics due to increased infection risk, and that those with serious health conditions be monitored closely while using them.

 During counseling, pharmacists can recommend adopting supportive habits, such as balanced nutrition and adequate fiber, to optimize results.

1. Levy M, Kolodziejczyk AA, Thaiss CA, Elinav E. Dysbiosis and the immune system. 

 2017;17(4):219-232. doi:10.1038/nri.2017.7

2. Ma ZF, Lee YY. The role of the gut microbiota in health, diet, and disease with a focus on obesity. 

 2025;14(3):492. doi:10.3390/foods14030492

3. Sanders ME, Merenstein DJ, Reid G, Gibson GR, Rastall RA. Probiotics and prebiotics in intestinal health and disease: from biology to the clinic. 

 2019;16(10):605-616. doi:10.1038/s41575-019-0173-3

4. Gibson GR, Hutkins R, Sanders ME, et al. Expert consensus document: the International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. 

 2017;14(8):491-502. doi:10.1038/nrgastro.2017.75

5. Probiotics, prebiotics, synbiotics, postbiotics, and fermented foods defined. ISAPP. 2024. Accessed May 5, 2026. 

https://isappscience.org/wp-content/uploads/2021/07/DefinitionsInfographic.pdf

6. Ozdener-Poyraz AE, Rivkin A, Iwuchukwu OF, Cassino D. Bridging the gap between evidence-based practice and probiotic utilization among US adults: results from a national survey. 

7. Ford AC, Harris LA, Lacy BE, Quigley EMM, Moayyedi P. Systematic review with meta-analysis: the efficacy of prebiotics, probiotics, synbiotics and antibiotics in irritable bowel syndrome. 

 2018;48(10):1044-1060. doi:10.1111/apt.15001

8. Cryan JF, O’Riordan KJ, Cowan CSM, et al. The microbiota-gut-brain axis. 

 2019;99(4):1877-2013. doi:10.1152/physrev.00018.2018

9. Wilhelm S. Prebiotics and probiotics. In: Krinsky D, Berardi R, Ferreri S, et al, eds. 

. 21st ed. American Pharmacists Association; 2024.

10. Probiotics fact sheet for health professionals. National Institutes of Health Office of Dietary Supplements. Updated March 25, 2025. Accessed May 5, 2026. 

https://ods.od.nih.gov/factsheets/Probiotics-HealthProfessional/

11. Probiotics. Cleveland Clinic. Updated October 30, 2023. Accessed May 5, 2026. 

https://my.clevelandclinic.org/health/treatments/14598-probiotics

12. Hill C, Guarner F, Reid G, et al. Expert consensus document: the International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. 

2014;11(8):506-514. doi:10.1038/nrgastro.2014.66

Probiotic and prebiotic supplements shape the gut microbiome and boost gastrointestinal health and immunity.

The Expanding Power of Probiotics and Prebiotics in Overall Health

It is that time of year again, when health care providers see an increase in patient volume because no one has time to be sick. Ah yes, the common

cold that can keep children out of school, athletes out of games, adults out of work, and elderly individuals out of commission and basically disrupt life as we know it. There are more than 100 strains of rhinoviruses that cause the majority of colds.

The common cold typically starts with a sore throat, turns into nasal congestion, a runny nose, and sneezing, and then finishes off with a nagging cough that can last up to 2 weeks. Who has time for this?

The first step in educating patients: Tell them to try not to catch the common cold in the first place. They should be aware that hands carry cold viruses and those viruses can stay on skin surfaces for up to 2 hours. People need to cough into the bend of their elbows and not their hands. And if they do touch their hands, they should not touch their eyes, noses, or mouths. In addition, they should wash their hands before they eat, as cold viruses can live on surfaces such as doorknobs, faucet handles, phones, armrests, and tray tables on planes. And those who happen to stand next to a person with a cold virus who coughs or sneezes a droplet into their eyes, nose, or mouth likely won’t be feeling well within the next 48 to 72 hours.

Treatment is all about controlling the symptoms, and an antibiotic isn’t going to help. Let’s look at this from the patient’s perspective. They head to the OTC cold-and-cough section, only to be met by all sorts of cards to take to the pharmacy for pseudoephedrine, multiple rows of phenylephrine, as well as nasal sprays, antipyretics, and cough medicine. They are asking themselves, “Do I need just guaifenesin or guaifenesin with dextromethorphan or just dextromethorphan? Is it combined with acetaminophen and/or phenylephrine? Do I need something for day and something for night?” Let’s not mention the rows of antihistamines. Health care providers can help patients sort through the multiple available OTC options to treat symptoms of the common cold. Let’s educate patients regarding

treatment options for the most common acute illness in the United States, which is responsible for about 37 million doctor’s office visits every year.

Nasal decongestants, such as pseudoephedrine and phenylephrine, are used for short-term relief of nasal congestion and sinus pressure. What is the deal with pseudoephedrine, and why is it available only behind the counter at a pharmacy? Pseudoephedrine has been used illegally to produce methamphetamine, a highly addictive stimulant. The Combat Methamphetamine Epidemic Act of 2005, which was incorporated into the Patriot Act in 2006, mandated that retailers sell pseudoephedrine behind the counter only, require a photo ID, limit quantities purchased, and keep per- sonal information about the customers for at least 2 years.

Different states have different limitations. State governments have issued additional regulations because of the misuse of methamphetamine. I recently visited Arkansas and had a cold, and I could not purchase pseudoephedrine without identification from that state and was told by the pharmacist that I would need a prescription. Furthermore, certain pharmacies have additional regulations requiring a prescription, no matter what state a person is from. When recommending pseudoephedrine for patients, be aware of the state and pharmacy regulations. Waiting in line at the pharmacy for an OTC medication that can’t be purchased can be frustrating for patients with the common cold. As for effectiveness, results from studies have shown pseudoephedrine to be more effective than phenylephrine in reducing nasal congestion.

Keep in mind that alternative options may be preferred for patients with heart disease, hypertension, thyroid disease, diabetes, an enlarged prostate, or glaucoma.

Dextromethorphan (DXM) is a cough suppressant that is one of the more commonly abused cough and cold medicines. Misused at high doses, it can cause hallucinations and euphoria, referred to by teenagers and young adults as robotripping or skittling.

Interestingly, many brands combine DXM with guaifenesin. However, guaifenesin at high doses

induces nausea; needless to say, the combination brand is avoided by those with the intent to misuse. Patients should not take DXM with antidepressants because of the risk of serotonergic syndrome, which can be life-threatening.

Guaifenesin is an expectorant that works to thin mucous and clear congestion. Patients should know that if they drink a lot of water, this medication will be even more effective.

Saline nasal sprays are a safe and effective remedy to clear nasal congestion. Nasal sprays that contain a decongestant, such as phenylephrine, are also available. Tell the patient that decongestant nasal sprays should not be used for longer than 3 days, to avoid rebound nasal congestion. Very little research has been done on the effectiveness of nasal corticosteroids for the common cold. In my opinion, it may take several days for optimal symptom control, by which time the common cold will have resolved.

Antihistamines block histamine, which is responsible for allergic symptoms that are very similar to the symptoms of the common cold caused by a virus. This prompts the question, “Do antihistamines help relieve symptoms of the common cold?” Let’s review the evidence from 18 trials with 4342 participants reported in 17 different publications.

In adults, there was a benefit on the first or second day of treatment, with 45% feeling better versus 38% on placebo. But there was no difference over the remaining days. The trials in children were smaller and of lower quality, lacking evidence of effectiveness.

We will get through this season together, one cough at a time. Prevention is key. But educating patients about the appropriate OTC treatment options for them specifically can help improve symptoms and reduce the disruptions caused by the common cold.

, is a doctorally prepared family nurse practitioner with 9 years of experience in the retail health clinic industry.

She is the manager of clinic education and professional development at Walmart Care Clinic.

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uptodate.com/contents/the-common-cold-in-adults-beyond-the-basics

. Updated March 1, 2016. Accessed November 1, 2017.

2.     Common cold: epidemiology. BMJ Best Practice website

bestpractice.bmj.com/best-practice/monograph/252/basics/epidemiology.html. Accessed November 1, 2017.

3.     Legal requirements for the sale and purchase of drug products containing pseudoephedrine, ephedrine, and phenylpropanolamine. US Food and Drug Administration website.

fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm072423.htm

. Updated on September 13, 2016. Accessed November 1, 2017.

4.     Horak F, Zieglmayer P, Zieglmayer R, et al. A placebo-controlled study of the nasal decongestant effect of phenylephrine and pseudoephedrine in the Vienna Challenge Chamber.

2009;102(2):116-120. doi: 10.1016/S1081-1206(10)60240-2.

5.     Cough and cold medicine abuse. National Institute on Drug Abuse website.

drugabuse.gov/publications/drugfacts/cough-cold-medicine-abuse

. Updated May 2014. Accessed November 1, 2017.

6. Drug Enforcement Administration. Dextromethorphan.

deadiversion.usdoj.gov/drug_chem_info/dextro_m.pdf

. Published March 2014. Accessed November 1, 2017.

7. De Sutter AIM, Saraswat A, van Driel ML. Antihistamines for the common cold.

cochrane.org/CD009345/ARI_antihistamines-common-cold

. Published November 28, 2015. Accessed November 1, 2017.

It is that time of year again, when health care providers see an increase in patient volume because no one has time to be sick. 

Jan Harris, MPH, BSDH

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