# Common Cold (viral URTI, adult and child) - Category: infectious - Review status: reviewed (every claim checked against a document named on this page) - Sources: Afrin 0.5 mg/ml nasal spray SmPC sections 4.1-4.3 - Dutch Medicines Evaluation Board (CBG-MEB), procedure NL/H/1971/001-004, Aug 2022 (afrin-oxymetazoline-smpc-cbg-nl-2022.txt): "Afrin 0,5 mg/ml neusspray, oplossing" and "Elke ml oplossing bevat 0,5 mg oxymetazolinehydrochloride", which is the 0.05% strength. · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · Iliadin Nose Drops / Nose Spray 0.05% Professional Information - South African Health Products Regulatory Authority (English cross-check) · MHRA Drug Safety Update 30 April 2026 - nasal decongestants containing xylometazoline / oxymetazoline: rebound congestion with overuse · Paracetamol 500mg capsule shaped tablets SmPC section 4.2 (eMC product 12154) · Saline Nasal Spray (sodium chloride 0.65%) US OTC Drug Facts (DailyMed SetID ed30a7f9-7132-42da-9bed-63a9b1c80ab2) · StatPearls: Ibuprofen (NCBI Bookshelf NBK542299) - Verified date: 2026-08 ## Verified against - Afrin 0.5 mg/ml nasal spray SmPC sections 4.1-4.3 - Dutch Medicines Evaluation Board (CBG-MEB), procedure NL/H/1971/001-004, Aug 2022 (afrin-oxymetazoline-smpc-cbg-nl-2022.txt): "Afrin 0,5 mg/ml neusspray, oplossing" and "Elke ml oplossing bevat 0,5 mg oxymetazolinehydrochloride", which is the 0.05% strength. - Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) - Iliadin Nose Drops / Nose Spray 0.05% Professional Information - South African Health Products Regulatory Authority (English cross-check) - MHRA Drug Safety Update 30 April 2026 - nasal decongestants containing xylometazoline / oxymetazoline: rebound congestion with overuse - Paracetamol 500mg capsule shaped tablets SmPC section 4.2 (eMC product 12154) - Saline Nasal Spray (sodium chloride 0.65%) US OTC Drug Facts (DailyMed SetID ed30a7f9-7132-42da-9bed-63a9b1c80ab2) - Upper Respiratory Tract Infections With Focus on The Common Cold - disease-level clinical article (common-cold-clinical.txt) - MSF Essential Drugs 2024 - paracetamol (oral) ## Treatment metadata - Paracetamol — 500 mg — oral.solid - Referral & safety-netting (no drug therapy) - Ibuprofen — 400 mg — oral.solid - Sodium chloride — nasal - Oxymetazoline — nasal ## Complete treatment card ```text COMMON COLD (VIRAL URTI, ADULT AND CHILD) Sources: Afrin 0.5 mg/ml nasal spray SmPC sections 4.1-4.3 - Dutch Medicines Evaluation Board (CBG- MEB), procedure NL/H/1971/001-004, Aug 2022 (afrin-oxymetazoline-smpc-cbg-nl-2022.txt): "Afrin 0,5 mg/ml neusspray, oplossing" and "Elke ml oplossing bevat 0,5 mg oxymetazolinehydrochloride", which is the 0.05% strength. · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · Iliadin Nose Drops / Nose Spray 0.05% Professional Information - South African Health Products Regulatory Authority (English cross-check) · MHRA Drug Safety Update 30 April 2026 - nasal decongestants containing xylometazoline / oxymetazoline: rebound congestion with overuse · Paracetamol 500mg capsule shaped tablets SmPC section 4.2 (eMC product 12154) · Saline Nasal Spray (sodium chloride 0.65%) US OTC Drug Facts (DailyMed SetID ed30a7f9-7132-42da-9bed-63a9b1c80ab2) · StatPearls: Ibuprofen (NCBI Bookshelf NBK542299) Review status: REVIEWED against Afrin 0.5 mg/ml nasal spray SmPC sections 4.1-4.3 - Dutch Medicines Evaluation Board (CBG-MEB), procedure NL/H/1971/001-004, Aug 2022 (afrin-oxymetazoline-smpc-cbg-nl-2022.txt): "Afrin 0,5 mg/ml neusspray, oplossing" and "Elke ml oplossing bevat 0,5 mg oxymetazolinehydrochloride", which is the 0.05% strength., Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560), Iliadin Nose Drops / Nose Spray 0.05% Professional Information - South African Health Products Regulatory Authority (English cross-check), MHRA Drug Safety Update 30 April 2026 - nasal decongestants containing xylometazoline / oxymetazoline: rebound congestion with overuse, Paracetamol 500mg capsule shaped tablets SmPC section 4.2 (eMC product 12154), Saline Nasal Spray (sodium chloride 0.65%) US OTC Drug Facts (DailyMed SetID ed30a7f9-7132-42da-9bed-63a9b1c80ab2), Upper Respiratory Tract Infections With Focus on The Common Cold - disease-level clinical article (common-cold-clinical.txt), MSF Essential Drugs 2024 - paracetamol (oral) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (5) - Sore throat is usually the first symptom, followed one to two days later by a runny nose and sneezing [runny nose · sneezing · sore throat] - Nasal blockage, hoarseness, and cough tend to develop shortly after the sore throat and runny nose begin [blocked nose · cough · hoarseness · runny nose · sore throat] - Feeling unwell, low-grade fever, muscle aches, and headache are common early in the illness [fever · headache · malaise · muscle pain] - Illness usually resolves within 7 to 10 days, though the cough can drag on for several weeks [cough] - A runny nose occurring together with cough strongly points toward a common cold [cough · runny nose] SIGNS - what you find (4) - Vital signs are usually normal, and any fever tends to stay low-grade [fever] - A high fever, tonsillitis, ear infection, or a productive cough with breathlessness suggest a complication or a different diagnosis rather than a plain cold [breathlessness · cough · fever] - Throat exam should check for redness, exudate, enlarged tonsils, or petechiae, and the neck for swollen nodes or thyroid masses [petechiae · redness] - Ears and chest should be examined to exclude otitis or lower respiratory involvement TESTS (2) - Most colds need no testing, since they are self-limited infections usually caused by rhinovirus or adenovirus - Testing for Group A strep should be considered when the clinical picture suggests bacterial throat infection Source StatPearls "Upper Respiratory Tract Infections With Focus on The Common Cold" - disease- level clinical article Status traced to the source above Rx: Main treatment | Pain and fever | Nasal congestion MAIN TREATMENT - choose one, plus any add-on marked below 1. PARACETAMOL [1st line] Adult 1 g 3 or 4 times daily (max. 4 g daily) for fever, sore throat, or body aches Peds 10-15 mg/kg/dose [child max 500 mg] (Child 1 month and over: 15 mg/kg 3 or 4 times daily (max. 60 mg/kg daily). Child under 1 month: 10 mg/kg 3 or 4 times daily (max. 40 mg/kg daily).) 3kg -> 30-45 mg/dose 4kg -> 40-60 mg/dose 5kg -> 50-75 mg/dose 6kg -> 60-90 mg/dose 7kg -> 70-105 mg/dose 8kg -> 80-120 mg/dose 9kg -> 90-135 mg/dose 10kg -> 100-150 mg/dose 11kg -> 110-165 mg/dose 12kg -> 120-180 mg/dose 13kg -> 130-195 mg/dose 14kg -> 140-210 mg/dose 15kg -> 150-225 mg/dose 16kg -> 160-240 mg/dose 17kg -> 170-255 mg/dose 18kg -> 180-270 mg/dose 19kg -> 190-285 mg/dose 20kg -> 200-300 mg/dose 21kg -> 210-315 mg/dose 22kg -> 220-330 mg/dose 23kg -> 230-345 mg/dose 24kg -> 240-360 mg/dose 25kg -> 250-375 mg/dose 26kg -> 260-390 mg/dose 27kg -> 270-405 mg/dose 28kg -> 280-420 mg/dose 29kg -> 290-435 mg/dose 30kg -> 300-450 mg/dose 31kg -> 310-465 mg/dose 32kg -> 320-480 mg/dose 33kg -> 330-495 mg/dose 34kg -> 340-500 mg/dose (upper capped) 35kg -> 350-500 mg/dose (upper capped) 36kg -> 360-500 mg/dose (upper capped) 37kg -> 370-500 mg/dose (upper capped) 38kg -> 380-500 mg/dose (upper capped) 39kg -> 390-500 mg/dose (upper capped) 40kg -> 400-500 mg/dose (upper capped) 41kg -> 410-500 mg/dose (upper capped) 42kg -> 420-500 mg/dose (upper capped) 43kg -> 430-500 mg/dose (upper capped) 44kg -> 440-500 mg/dose (upper capped) 45kg -> 450-500 mg/dose (upper capped) 46kg -> 460-500 mg/dose (upper capped) 47kg -> 470-500 mg/dose (upper capped) 48kg -> 480-500 mg/dose (upper capped) 49kg -> 490-500 mg/dose (upper capped) 50kg -> 500 mg/dose (capped) Source MSF Essential Drugs 2024 - paracetamol (oral) Why First-line symptomatic antipyretic and analgesic for viral upper respiratory tract infection in adults and children Caution Routine antibiotics are NOT indicated for uncomplicated viral upper respiratory tract infections. Do not exceed max daily dose (4 g/day adult; 60 mg/kg/day paediatric) due to hepatotoxicity risk. 500 mg is the per-dose ceiling used here for a child. 1000 mg is the adult dose and does not belong in a weight calculation - the daily 60 mg/kg limit is the one that binds first in any case. Egypt FEBRIMOL 500 MG 20 TAB. PHARCO 3.50 EGP (0.17/unit) CETAMOL 500 MG 20 TABS. MEMPHIS 8.00 EGP (0.40/unit) PARACETAMOL-MUP 500MG B.P. 20 TABS. MUP 13.00 EGP (0.65/unit) CETAL 500 MG 20 TABS. EIPICO 24.00 EGP (1.20/unit) ARKADOLOW 500 MG 30 F.C. TABS. UTOPIA 42.00 EGP (1.40/unit) PARAMOL 500MG 20 TAB. MISR 38.00 EGP (1.90/unit) ADOL 500MG 24 CAPLETS JULPHAR 32.00 EGP AUGICETAMIDE 500 MG 20 SACHETS AUG PHARMA 50.00 EGP FEBRIMOL ORAL DROPS 20 ML PHARCO 4.00 EGP -> ? strength differs, ? different route - not oral solid THERA-LO 3.2G/100ML ORAL SUSP. 100 ML PHAROPHARMA 5.00 EGP -> ? strength differs, ? different route - not oral solid 2. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Source Upper Respiratory Tract Infections With Focus on The Common Cold - disease-level clinical article (common-cold-clinical.txt) Why Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen. Caution RED FLAG - Some clinical findings (high fever, pharyngitis, tonsillitis, otitis, cervical adenopathy, wheezing, productive cough, or dyspnea) add complexity and warrant further investigation for complications or an alternative diagnosis. RED FLAG - Antibiotics ARE indicated for severe acute otitis media, sinusitis lasting more than 10 days, or sinus symptoms worsening after initial improvement - they are not routinely needed otherwise. 3. OXYMETAZOLINE [add-on - not a substitute] Adult 0.05% (0.5 mg/mL) nasal spray: 1-2 sprays into each nostril every 12 hours. No more than 8 sprays in any 24 hours. - Do not use for more than 5 consecutive days. Peds 6 to 10 years: 1 spray of the 0.05% strength into each nostril every 12 hours, maximum 4 sprays in 24 hours. Contraindicated under 6 years at this strength. Over 10 years: As for adults. (Licensed from 6 years at this 0.05% strength - not from 12. Children 6-10 years: 1 spray into each nostril every 12 hours, maximum 4 sprays in 24 hours; over 10 years, as for adults. Contraindicated under 6 years - Egypt registers separate 0.025% paediatric preparations (Iliadin paediatric, Afrin pediatric, Oxymet paed) for that age group; dose those from their own carton, no figure for them is quoted here.) Source Afrin 0.5 mg/ml nasal spray SmPC sections 4.1-4.3 - Dutch Medicines Evaluation Board (CBG-MEB), procedure NL/H/1971/001-004, Aug 2022 (afrin-oxymetazoline-smpc-cbg- nl-2022.txt): "Afrin 0,5 mg/ml neusspray, oplossing" and "Elke ml oplossing bevat 0,5 mg oxymetazolinehydrochloride", which is the 0.05% strength. Why Adrenergic topical decongestant that constricts nasal venous sinuses to relieve nasal obstruction in viral upper respiratory tract infection. Two regulator documents were opened and they differ on the ceiling: the 2022 CBG SmPC caps the day at 8 sprays, while the SAHPRA Iliadin Professional Information allows two to three sprays two to three times a day. The tighter and newer figure is printed. Caution Do not use for more than 5 consecutive days - the MHRA shortened this from 7 days on 30 April 2026 because of rebound congestion (rhinitis medicamentosa) and tachyphylaxis with overuse. The 2022 SmPC still says 7 days. Not for children under 6 years at the 0.05% adult strength; use a 0.025% paediatric preparation instead. Do not exceed 8 sprays in 24 hours (adults) or 4 (children). Contraindicated with MAO inhibitors or within 2 weeks of stopping them, in narrow-angle glaucoma, in acute coronary disease or cardiac asthma, in rhinitis sicca, and after transsphenoidal hypophysectomy. Use with care in coronary heart disease, hypertension, hyperthyroidism, diabetes, and prostatic enlargement causing difficulty passing urine. Egypt NASOPHARM 0.05% SPRAY MUP > EGYPTIA... 2.50 EGP ILIADIN 0.05 % ADULT NASAL SPRAY AMOUN > MERCK... 4.30 EGP ILIADIN 0.05 % ADULT NASAL SOLUTION 10 ML AMOUN > MERCK KGAA F.R.GERMANY 3.35 EGP OXYMET 0.05% ADULT NASAL DROPS 15 ML PHAROPHARMA 15.00 EGP ADOFRINAZ 0.05% NASAL DROPS 20 ML KAHIRA > ARAB DRUG COMPANY (ADCO) 24.00 EGP NORMIFRIN 0.5MG/ML NASAL SPRAY 20 ML MUP 26.00 EGP ILIADIN 0.025 % PAED. NASAL SOL. 10 ML AMOUN > MERCK KGAA F.R.GERMANY 3.20 EGP OXYMET 0.025% PAED.NASAL DROPS 15 ML PHAROPHARMA 15.00 EGP PAIN AND FEVER - give alongside 4. IBUPROFEN [add-on - not a substitute] Adult 200-400 mg every 6-8 hours PRN with food for fever, myalgia, or headache (max 1200 mg/day OTC) Peds 5-6.67 mg/kg/dose [child max 400 mg] (Every 8 hours PRN with food in infants >3 months (5-10 mg/kg/dose 3 times daily. Daily ceiling: the suspension's own label caps pain-and-fever use at 20 mg/kg/day, while the reference literature allows up to 40. Stay near 20 unless there is a reason to climb, never exceed 400 mg in a single dose, and note that 30-40 mg/kg/day is the juvenile arthritis range rather than an analgesic one.) 3kg -> 15-20 mg/dose 4kg -> 20-26.7 mg/dose 5kg -> 25-33.4 mg/dose 6kg -> 30-40 mg/dose 7kg -> 35-46.7 mg/dose 8kg -> 40-53.4 mg/dose 9kg -> 45-60 mg/dose 10kg -> 50-66.7 mg/dose 11kg -> 55-73.4 mg/dose 12kg -> 60-80 mg/dose 13kg -> 65-86.7 mg/dose 14kg -> 70-93.4 mg/dose 15kg -> 75-100 mg/dose 16kg -> 80-106.7 mg/dose 17kg -> 85-113.4 mg/dose 18kg -> 90-120.1 mg/dose 19kg -> 95-126.7 mg/dose 20kg -> 100-133.4 mg/dose 21kg -> 105-140.1 mg/dose 22kg -> 110-146.7 mg/dose 23kg -> 115-153.4 mg/dose 24kg -> 120-160.1 mg/dose 25kg -> 125-166.8 mg/dose 26kg -> 130-173.4 mg/dose 27kg -> 135-180.1 mg/dose 28kg -> 140-186.8 mg/dose 29kg -> 145-193.4 mg/dose 30kg -> 150-200.1 mg/dose 31kg -> 155-206.8 mg/dose 32kg -> 160-213.4 mg/dose 33kg -> 165-220.1 mg/dose 34kg -> 170-226.8 mg/dose 35kg -> 175-233.4 mg/dose 36kg -> 180-240.1 mg/dose 37kg -> 185-246.8 mg/dose 38kg -> 190-253.5 mg/dose 39kg -> 195-260.1 mg/dose 40kg -> 200-266.8 mg/dose 41kg -> 205-273.5 mg/dose 42kg -> 210-280.1 mg/dose 43kg -> 215-286.8 mg/dose 44kg -> 220-293.5 mg/dose 45kg -> 225-300.1 mg/dose 46kg -> 230-306.8 mg/dose 47kg -> 235-313.5 mg/dose 48kg -> 240-320.2 mg/dose 49kg -> 245-326.8 mg/dose 50kg -> 250-333.5 mg/dose Source Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) Why Adjunct NSAID added to supportive care for fever, myalgia, or headache in a viral cold; it treats symptoms only and does not shorten the viral illness itself. Caution Take with food to minimize gastric irritation. Avoid in active peptic ulcer disease, severe renal impairment, or NSAID-sensitive asthmatics. The 400 mg per-dose ceiling comes from the reference literature, not from the suspension label - that label's largest paediatric single dose is 200 mg. Below about 40 kg the weight calculation binds first and the ceiling never comes into it. Contraindicated in the last trimester of pregnancy. Egypt DAJUANOFEN 400 MG 20 F.C. TABS. COPAD PHARMA 5.00 EGP (0.25/unit) FLABU 400MG 10 F.C.TAB. DELTA PHARMA 3.75 EGP (0.38/unit) NOVA-PROFEN 400MG 30 F.C. TABLETS SANOFI 12.75 EGP (0.42/unit) IBUPROFEN 400 MG 10 TAB. SEDICO 6.00 EGP (0.60/unit) MAFO 400 MG 30 F.C.TABS EIPICO 42.00 EGP (1.40/unit) BRUFEN 400 MG 30 TABS. KAHIRA > ABBO... 78.00 EGP (2.60/unit) PROFUSOL 400MG 20 S.G CAPS. EUROPEAN EGYP... 31.00 EGP ANALGIPROF 400 MG 25 SACHETS EVA PHARMA 37.50 EGP NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML SANOFI 2.25 EGP -> ? strength differs, ? different route - not oral solid BRUFEMOL-N SUSP. 60 ML ARAB DRUG COM... 4.50 EGP -> ? strength differs, ? different route - not oral solid NASAL CONGESTION - give alongside 5. SODIUM CHLORIDE [add-on - not a substitute] Adult Squeeze bottle twice in each nostril, as often as needed, or as directed by doctor. Peds Squeeze bottle twice in each nostril, as often as needed, or as directed by doctor. Source Saline Nasal Spray (sodium chloride 0.65%) US OTC Drug Facts (DailyMed SetID ed30a7f9-7132-42da-9bed-63a9b1c80ab2) Why A drug-free saline that moistens the nasal passages instead of constricting them, so it carries none of the rebound risk that comes with a true decongestant. The label covers infants directly, giving a drop-based method for them, but it does not clear the product for pregnancy on its own authority - it tells the pregnant or breastfeeding user to check with a health professional first. Caution First choice in infants, where the label states the method directly - in the infant it is given as drops. It is not itself a decongestant: it adds moisture instead of constricting the mucosa, which is why it carries none of the rebound congestion (rhinitis medicamentosa) that follows the topical sympathomimetics. Keep nasal tip clean to prevent microbial contamination. The frequency here is conventional practice. The OTC label supports saline for dry and irritated nasal passages and says it is safe for frequent daily use, but prints no number of sprays and no schedule. Egypt SALINE 7.4MG/ML NASAL DROPS 15 ML PHARCO > EUROPEAN EGYPTIAN PHARM. IND. 3.25 EGP SODIUM CHLORIDE 0.9 % (EL NILE) I.V. INF. 100 ML (RUBBER CAP) EL NILE. 4.75 EGP SODIUM CHLORIDE 0.9% (OTSUKA) IRRIGATION SOLN. 1000 ML OTSUKA 12.00 EGP SODIUM CHLORIDE 0.9% (EL NASR) IRRIGAATION SOLN. 3000 ML EL NASR 22.50 EGP FREE NOSE NASAL SPRAY 30 ML (6+ YEARS) PHARMALINK S.L. > AUG PHARMA 75.00 EGP SOFIMER 0.9% ISOTONIC NASAL SPRAY 100 ML > SOFICOPHARM 290.00 EGP MARIMER ISOTONIC NASAL SPRAY 100ML LABORATOIRES GILBERT - FRANCE > UNITE... 385.00 EGP PHYSIOMER BABY MIST NASAL SPRAY 115ML LABORATOIRE DE LA MER > STAR INTER... 400.00 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)