Is Zicam Effective in Treating Colds?

Zicam is a homeopathic medication that claims to shorten the duration and severity of the common cold. The original nasal spray formulations were recalled after federal investigators found that they can cause the loss of smell. The new plant-based formulations are considered safer, although there remains a lack of evidence as to whether they can actually treat cold.

The theory behind the original Zicam Cold Remedy was that zinc placed in the nasal cavity would block or kill the cold virus (rhinovirus) at the point where it enters the human body.

There is some evidence to support this hypothesis. A 2017 study published Journal of the Royal Society of Medicine Open reported that zinc acetate and zinc gluconate lozenges shortened the duration of colds by on average by 33%.

Despite these findings, there are limitations to how zinc can be used. Studies have shown that the application of zinc to nasal passages may cause irreversible side effects, including the loss of smell.

The reformulated list of ingredients in Zicam nasal products are mostly plant-based and found in other homeopathic remedies for allergies and cold symptoms. Zicam oral products, including chewable tablets and oral mists, still contain zinc as their active ingredient.

According to the manufacturer, Zicam can be used by adults and children 12 and over. Children under 12 should only use Zicam under the direction of a pediatrician or family doctor. The manufacturer does not state what risks Zicam poses to younger children.

Generally speaking, all homeopathic products should only be used in adults or children after consultation with a qualified health professional. The drugs are not stringently regulated by the U.S. Food and Drug Administration (FDA) and should be avoided in children, pregnant women, and nursing mothers due to the lack of safety research.

Zicam Cold Remedy can be given as a nasal spray or a nasal swab. The gel-based spray is pumped into each nostril and then lightly massaged into nasal tissues with a finger for five seconds. The nasal swab is rubbed in each nostril and then massaged with a finger for five seconds. Both formulations can be used every four hours until symptoms resolve.

There is also a chewable tablet called Zicam Ultra RapidMelt (taken every three hours without food or drink) as well as a Zicam oral mist formulation (sprayed into the mouth every three hours without food or drink).

In June 2009, FDA warned consumers not to use Zicam nasal spray or gel swabs because they may cause a permanent loss of the sense of smell. The manufacturer, Matrixx Initiatives, recalled these products after the warning was issued.

The new formulations issued in 2015 contain highly diluted extracts of Galphimia glauca, Luffa operculata, and Sabadilla. While commonly used in homeopathy, there is little qualitative research to support their use in treating colds.

Zicam RapidMelt and Oral Mist both contain zinc in the form of zincum aceticum and zincum gluconicum (the homeopathic names of zinc acetate and zinc gluconate). When takien by mouth, zinc is considered safe if not overused.

Zicam continues to label its products as "clinically-proven to shorten colds." These claims were first made based on research into the effects of its zinc-based products.

Zicam lists two small studies, conducted in 2000 and 2003, to support its claims. Both were double-blind, placebo-controlled trials, the first of which included 213 participants and the second of which involved 80.

Despite evidence that Zicam nasal spray and gel shortened the duration of cold symptoms by over 65%, the side effects all but undermine the products' rationale for use.

Homeopathic products are based on the theory that "like cures like," meaning that highly diluted amounts of a substance are used to provoke a symptom in order to cure that symptom. The newer formulations of Zicam products follow this methodology.

Homeopathic products are minimally regulated as dietary supplements and do not undergo the same safety and efficacy testing as prescription and over-the-counter drugs.