Zinc gluconate and the common cold. Review of randomized controlled trials

OBJECTIVE: To examine the evidence of seven randomized controlled trials (RCT) on the therapeutic effectiveness of zinc gluconate lozenges for treating the common cold. DATA SOURCES: Using the MeSH headings common cold and zinc gluconate, MEDLINE was searched from 1966 on for all published RCTs evaluating use of zinc gluconate for treating the common cold. STUDY SELECTION: For this study, only double-blind RCTs were included. SYNTHESIS: Fair evidence suggests that zinc gluconate lozenges have a therapeutic effect in treating the common cold. Starting therapy with zinc gluconate lozenges within 24 to 48 hours of onset of cold symptoms reduces the duration and severity of the cold. Patients must suck lozenges every 2 hours while awake during the cold. Minimum effective dose appears to be 13.3 mg of elemental zinc per lozenge. Evidence suggests that compounds such as citric acid, sorbitol, and mannitol bind the free zinc ion in the mouth, and this could account for variations in therapeutic benefit. Bad taste and nausea are important side effects of zinc lozenges. CONCLUSION: Evidence supports use of zinc gluconate lozenges for reducing the symptoms and duration of the common cold, but the side effects, bad taste, and therapeutic protocol might limit patient compliance.