498 Insufficient evidence for antihistamines for the common cold

December 20, 2016

written by Brian R McAvoy

Clinical question
How effective are antihistamines for the common cold?

Bottom line
In adults, there was a short-term beneficial effect on the severity of overall symptoms on the first or second day of treatment (45% felt better versus 38% with placebo), but there was no difference between antihistamines and placebo in the mid to long term. There was no clinically significant effect on nasal obstruction, rhinorrhoea or sneezing. Although side effects were more common with sedating antihistamines, the difference was not statistically significant. There was no evidence of effectiveness of antihistamines for the common cold in children.

In a number of trials, data were insufficiently reported, or were not in the appropriate format to enter into a meta-analysis. The meta-analyses mostly included only some of the available trials and provided an incomplete assessment of the quality of the evidence. Many of the included trials were conducted in the 1980s and 1990s, with the most recent trial from 2001. All trials received financial support from pharmaceutical companies.

The common cold affects people of all age groups and, although, in most cases, it is self-limiting, it causes significant morbidity. Antihistamines are available over the counter and may be used by patients affected by the common cold.

Cochrane Systematic Review
De Sutter An IM et al. Antihistamines for the common cold. Cochrane Reviews, 2015, Issue 11. Art. No.: CD009345.DOI: 10.1002/14651858. CD009345.pub2. This review contains 18 studies involving 4342 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.