Is zicam bad for you?

Zicam Extreme Congestion Relief Side Effects

Generic Name: oxymetazoline nasal

Medically reviewed by Last updated on Dec 1, 2018.

  • Overview
  • Side Effects
  • Dosage
  • Interactions
  • Pregnancy
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Note: This document contains side effect information about oxymetazoline nasal. Some of the dosage forms listed on this page may not apply to the brand name Zicam Extreme Congestion Relief.

For the Consumer

Applies to oxymetazoline nasal: nasal spray

Along with its needed effects, oxymetazoline nasal (the active ingredient contained in Zicam Extreme Congestion Relief) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking oxymetazoline nasal:

  • Blurred vision
  • fast, irregular, or pounding heartbeat
  • headache, dizziness, drowsiness, or lightheadedness
  • high blood pressure
  • increase in runny or stuffy nose
  • nervousness
  • trembling
  • trouble in sleeping
  • weakness

Some side effects of oxymetazoline nasal may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

  • Burning, dryness, or stinging inside of nose
  • sneezing

For Healthcare Professionals

Applies to oxymetazoline nasal: nasal solution, nasal spray


Very rare (less than 0.01%): Tachycardia, palpitations, increased blood pressure


Very rare (less than 0.01%): Nausea


The most commonly reported side effects were discomfort or irritation in the nose, mouth or throat, and sneezing.

Nervous system

Very rare (less than 0.01%): Insomnia, nervousness, tremor, anxiety, restlessness, irritability, headache


Rare (less than 0.1%): Eye irritation, dryness, discomfort/redness


Rare (less than 0.1%): Discomfort or irritation in the nose, mouth or throat, sneezing

Frequency not reported: Rhinitis medicamentosa (after prolonged or heavy use)

1. Cerner Multum, Inc. “Australian Product Information.” O 0

2. Cerner Multum, Inc. “UK Summary of Product Characteristics.” O 0

3. “Product Information. Afrin (oxymetazoline nasal)” Schering-Plough, Liberty Corner, NJ.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer

More about Zicam Extreme Congestion Relief (oxymetazoline nasal)

  • During Pregnancy or Breastfeeding
  • Dosage Information
  • Drug Interactions
  • En Español
  • 3 Reviews
  • Drug class: nasal antihistamines and decongestants
  • FDA Alerts (5)

Consumer resources

  • Zicam Extreme Congestion Relief

Other brands: Afrin, Afrin Original, Vicks Sinex Severe Nasal Spray, Vicks Sinex 12-Hour Decongestant Nasal Spray, … +24 more

Related treatment guides

  • Nasal Congestion

FDA warns consumers to discard Zicam products

In an unusual move earlier this week, the Food and Drug Administration (FDA) alerted consumers that Zicam Cold Remedy products have been associated with long lasting or even permanent loss of smell. FDA recommends that consumers stop using these products and that they throw away any that might still be in their homes. The affected products include Zicam Cold Remedy Nasal Gel, Zicam Cold Remedy Nasal Swabs, and Zicam Cold Remedy Swabs, Kids Size (the last one is a previously discontinued product). The products had been sold by Matrixx Initiatives to reduce the duration and severity of cold symptoms; however, they have never been shown to be effective.

These products were formulated and sold for intranasal use and may have contained zinc, which is potentially toxic to the nasal membranes. The FDA emphasized that their advisory does not concern oral zinc tablets and lozenges that are taken by mouth. Ironically, oral zinc products have long been used as attempted treatments for anosmia, the medical term for loss of smell. But it is widely understood in the medical community that intranasal zinc administration can cause a variety of problems with the sense of smell, up to and including its complete loss.

What’s unclear about the Zicam products is how much, if any, zinc they actually contain. That’s because they are marketed as homeopathic remedies, which typically contain little to no actual active ingredient. As I’ve explained in detail in my earlier blog entitled “Homeopathy is a scam!” these products start with an original active substance and then dilute them significantly. The theory is that “like treats like” but only when present in vanishingly small amounts. Typical homeopathic remedies are diluted to a point where essentially none of the original material is still present. But in the case of the Zicam products the dilution factor is only 2X, which means that the original material was diluted to the level of 1 part in one hundred, meaning that it’s still quite detectable. The unproven principles of homeopathy say that the more diluted something is, the more effective and they are often diluted to 1 part in a million (6X) or much lower (100X or more). One popular influenza remedy called Oscillococcinum is actually 200C, which means that it was diluted 200 times, each at a 100 fold dilution (that’s one part taken to a 400 zeros-fold dilution).

This may be why only some people have developed loss of smell from the Zicam products and not everyone who has used them. The unfortunate few may have been especially sensitive to the effects of zinc. If the label is to be believed, Zicam does contain a very small amount of zinc (one part in 100 parts of whatever the diluent is). In an accompanying warning letter to Matrixx, the FDA said that they had received “more than 130 reports of anosmia.” But the letter went on to say that FDA “is aware that Matrixx appears to have more than 800 reports related to loss of sense of smell” associated with their Zicam products. The FDA has requested that Matrixx immediately submit all such reports to the agency. In addition, the FDA warned Matrixx that it was selling its products illegally because they are actually “drugs” according to the regulatory definition of a drug, which is a product “intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease.” Because Matrixx had not submitted data supporting the efficacy or safety of its products, once FDA classified them as “drugs,” they were no longer being marketed legally and were therefore subject to FDA seizure. On receipt of the warning letter, Matrixx voluntarily recalled its products although they said in a press release that “Matrixx Initiatives stands behind the science of its products and its belief that there is no causal link between its Zicam Cold Remedy intranasal gel products and anosmia.”

You might wonder how Matrixx was allowed to market its product in the first place (as well as all the other homeopathic remedies clogging the shelves)? It turns out that there’s an FDA policy on this with a guideline called “Conditions Under Which Homeopathic Drugs May be Marketed.” In general, all homeopathic products are allowed to be marketed with absolutely no testing of either their safety or their efficacy. None. In fact, even when the FDA determines there’s a safety problem, as it did with Zicam, it doesn’t use the enforcement discretion set forth in the guideline. Instead, it declares that the product is actually a “drug” and forces the company to withdraw it from the market and then either prove it’s safe and effective, with a new drug application, or else never market it again.

This is one of the reasons both homeopathic remedies and nutritional supplements, like herbs, vitamins and minerals, can be quite dangerous: They have not undergone any safety or efficacy testing. With all such products, you are at the mercy of the manufacturers and particularly the marketers who concoct these formulations and then sell them to an unsuspecting public. You basically have no idea what you are buying, whether it is either safe or effective, or bears any relationship whatsoever to the claims made on the label or in advertising. Anyone can throw together whatever mixture of herbs, vitamins and minerals they want and sell it essentially for whatever they want. That’s exactly how Airborne tablets, as one example, which I’ve railed about extensively in these pages, came into being. And they’re still proud of the fact that Airborne was developed by a second grade teacher with no medical or pharmacy background. She just believed that her particular formulation of herbs, vitamins and minerals would be effective (of course, it isn’t, but that doesn’t stop millions of people from falling for their scam).

If you’ve had problems from Zicam or any other homeopathic remedies or nutritional supplements, let us know by leaving a comment below so that others can learn from your experiences. We look forward to hearing from you.

The Healthy Skeptic: Homeopathic cold remedies

Despite all of the cold remedies that have been proposed through the years, people still somehow manage to sniffle and sneeze. The truth is, modern medicine has yet to conquer the common cold. Sure, you could take NyQuil Multi-Symptom or Alka-Seltzer Plus Cold & Cough to clear up your head, but such medications can cause drowsiness, nervousness, sleep problems and other side effects. And they won’t necessarily help your cold go away any faster, either.

Children’s colds are especially hard to treat, says Dr. James Taylor, professor of pediatrics at the University of Washington in Seattle. “Colds are a huge reason why parents bring their kids to a physician, and we have very little to offer,” he says. In 2010, the FDA recalled many children’s cold remedies — including syrups and drops from Tylenol, Motrin and Zyrtec — because of safety concerns.

Looking for relief without risks, many cold sufferers have turned to homeopathic pills and liquids, which are often heavily diluted — sometimes to the point where few to no molecules of the active ingredient remain.

Zicam RapidMelts, perhaps the most widely available homeopathic cold remedy, is sold at practically every drug store. According to the label, the single active ingredient, zincum gluconicum, has a 1X dilution. This means that one part of zincum gluconicum (a zinc compound) was diluted in 10 parts water before it was added to the lozenge. The label doesn’t say how much zinc is in the product, but a customer service representative reached by phone said each lozenge contains 10 mg. of zinc, a little less than you’d get from a typical multivitamin.


Users are instructed to dissolve one lozenge in the mouth as soon as they notice cold symptoms, then take another lozenge every three hours until the symptoms disappear. A bottle of 25 tablets costs about $13. According to the label, Zicam RapidMelts are recommended for adults and children ages 3 or older.

Zicam RapidMelts shouldn’t be confused with Zicam Nasal Gel or Zicam Swabs. Matrixx Initiatives, the company behind Zicam, voluntarily recalled these products in 2009 after the FDA warned that more than 130 users had lost their sense of smell.

Hyland’s Cold ‘n Cough 4 Kids, sold in many drug stores, follows the more traditional blueprint for homeopathic remedies. Homeopaths generally believe that dilution makes the active ingredients more effective — the greater the dilution, the greater the relief. Following that logic, Cold ‘n Cough 4 Kids is diluted to the extreme.

According to the label, all of the active ingredients have a dilution of at least 6X, which means one part ingredient per million parts water. Some of the ingredients, including sulphur, have a dilution of 12X, which is a million times less concentrated than the 6X dilution. In other words, don’t expect to get a whiff of rotten eggs when you open the bottle.


According to the label, Cold ‘n Cough 4 Kids is recommended for cold sufferers ages 2 and up. Children ages 2 to 5 can take a teaspoon every four hours. Children ages 6 to 12 can take two teaspoons every four hours, and children and adults over 12 can take 3 teaspoons every four hours. A 4-oz. bottle (24 teaspoons) costs about $5.

The claims. According to the label, Zicam RapidMelts will “reduce the duration and severity of a cold.” It also says you can “get over your cold faster with Zicam.” Representatives from Zicam were unavailable for comment.

The website for Hyland’s Cold ‘n Cough 4 Kids says the “100 percent natural formula offers safe and effective symptom relief from common cold symptoms, including sneezing, sore throat and congestion.” J.P. Borneman, chairman and chief executive of Hyland’s Inc., says that homeopathic products work by “stimulating the body’s natural healing process.” He adds that the company has received positive feedback from parents.

The bottom line: Homeopathy has its share of devoted followers, but the field doesn’t make scientific sense, says William Gleason, an associate professor of medicinal chemistry at the University of Minnesota in Minneapolis. Most products are so diluted, he says, that there’s “no longer any medicine in the medicine.”

Proponents of homeopathy often claim that heavily diluted solutions contain a “memory” of the active ingredients, but Gleason says that concept is ridiculous. As he explains, every molecule of water in our bodies has been enough other places — oceans, sewers, the bathtubs of ancient Greeks — to make any “memories” hopelessly jumbled.

In a 2010 report, the National Center for Complementary and Alternative Medicine, a division of the National Institutes of Health, said that the key concepts of homeopathy “are not consistent with the established laws of science.”

Much of the controversy around homeopathy doesn’t really apply to Zicam RapidMelts, Gleason says, because the product actually contains significant amounts of its active ingredient. But he also notes that zinc isn’t exactly a silver bullet (or even a zinc bullet) against colds.

A 2000 study found that lozenges containing 13.3 mg. of zinc (about 3 mg. more than found in Zicam RapidMelts) cut the length of a cold by about one day but didn’t affect symptoms. Other studies have found no benefits at all. After reviewing 14 previous studies, Stanford researchers reported in 2007 that the effectiveness of zinc lozenges had “yet to be established.”


Taylor is planning to enroll 400 children in a placebo-controlled study of Cold ‘n Cough 4 Kids. The study will be funded by Hyland’s. “If homeopathy works, it would have to work on a different pathway than anything we know about,” he says. “But I’m open-minded about it.”

Curious about a consumer health product? Send an e-mail to [email protected] Read more at

The U.S. Food and Drug Administration (FDA) issued a warning on June 16, 2009 about the risks of three over-the-counter cold remedies made by Matrixx Initiatives under the brand name Zicam. The products include:

  • Zicam Cold Remedy Nasal Gel
  • Zicam Cold Remedy Nasal Swabs
  • Zicam Cold Remedy Swabs, Kids Size (discontinued product)

This was not an official recall, but the company voluntarily removed these products from the shelves.

The product’s safety is being called into question after the FDA received reports that users lost their sense of smell. Some reported that the loss of smell occurred after just one dose, while others reported that it occurred after repeated use. Loss of smell poses a serious health risk because it prevents an individual from detecting toxic fumes, gas, smoke, spoiled food, and other environmental hazards. And, of course, losing sense of smell affects the quality of anyone’s life, especially the enjoyment of eating. When we taste something, our sense of smell is more responsible for that sensation than our actual taste buds.

What is Zicam, and What About it is Causing People to Lose Their Sense of Smell?

Zicam is marketed as “an over-the-counter homeopathic medicine” that will “reduce the duration and severity of the common cold when taken at the first sign of cold symptoms.” The nasal gel is applied directly inside the nostrils, as is the medication on the nasal swabs.

The active ingredient in these specific Zicam products is zinc gluconate. Some experts argue that the FDA should have seen this coming, because the compound’s damaging effects were discovered decades ago, when a group of doctors experimented with zinc gluconate as a preventative measure for polio in the 1930’s. In that experiment, not only was the treatment proven ineffective, but some of the patients lost their sense of smell.

Zicam and other zinc gluconate solutions can potentially be beneficial when ingested through the mouth, injected into the bloodstream, or applied on the skin. However, the compound can be toxic if it reaches certain cells or nerve receptors located inside the nasal cavity. It is possible for these cells and receptors to come into contact with zinc gluconate when using a product like Zicam, when either inserting the swab/spraying device too far into the nose, spraying too hard, or sniffing after the initial application. When zinc gluconate comes into contact with those cells, an intense burning sensation may occur, followed by a loss of smell and/or taste.

Perhaps most shocking, the FDA and the makers of Zicam have received hundred of complaints about these products since they were first sold in 1999. Additionally, Matrixx has settled hundred of lawsuits, 340 in 2006 alone.

If you have experienced any symptoms similar to those described here after using Zicam or other zinc gluconate containing products, you are advised to consult a physician promptly.

All articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff.

  1. U.S. Food and Drug Administration. “FDA Advises Consumers Not To Use Certain Zicam Cold Remedies.” Press release. FDA Advises Consumers Not To Use Certain Zicam Cold Remedies. 16 June 2009; 17 June 2009
  2. Zicam. 17 June 2009
  3. Fincannon, Joy, and Farrokh Sohrabi. “A Question of Taste–Or Is It Smell?” Health Encyclopedia. University of Rochester Medical Center, n.d. Web. 04 Aug. 2014
  4. Jafek, Bruce W., Miriam R. Linschoten, and Bruce W. Murrow. “Anosmia after Intranasal Zinc Gluconate Use.” American Journal of Rhinology 18 (2004): 137-41. 19 June 2009
  5. “Loss of Sense of Smell with Intranasal Cold Remedies Containing Zinc.” U S Food and Drug Administration Home Page. 19 June 2009
  6. Harris, Gardiner. “F.D.A. Warns Against Use of Popular Cold Remedy .” The New York Times. 16 June 2009. 19 June 2009

Zicam Extreme Congestion Relief

Generic Name: oxymetazoline nasal (ox ee me TAZ oh leen NAY sal)
Brand Name: 12 Hour Nasal, Afrin, Afrin No Drip Sinus, Allerest 12 Hour Nasal Spray, Dristan 12-Hour, Duramist Plus, Duration, Mucinex Full Force, Mucinex Moisture Smart, Nasal Mist, Neo-Synephrine 12 Hour, Nostrilla, NRS Nasal, Sinarest Nasal, Sinex Long-Acting, Sudafed OM Sinus Cold, Zicam Extreme Congestion Relief, Zicam Sinus Relief

Medically reviewed by on May 13, 2019 – Written by Cerner Multum

  • Overview
  • Side Effects
  • Dosage
  • Interactions
  • Pregnancy
  • More

What is Zicam Extreme Congestion Relief?

Oxymetazoline is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

Zicam Extreme Congestion Relief (for the nose) is for temporary relief of nasal congestion (stuffy nose) caused by allergies or the common cold.

Zicam Extreme Congestion Relief may also be used for purposes not listed in this medication guide.

Important Information

Zicam Extreme Congestion Relief (for the nose) is used for temporary relief of nasal congestion caused by allergies or the common cold.

Stop using Zicam Extreme Congestion Relief and call your doctor at once if you have ongoing or worsening symptoms, or if you have severe burning or stinging in your nose after using the nasal spray

Before taking this medicine

You should not use Zicam Extreme Congestion Relief if you are allergic to it.

Ask a doctor or pharmacist if it is safe for you to take this medicine if you have other medical conditions, especially:

  • heart disease, high blood pressure, coronary artery disease;

  • diabetes;

  • a thyroid disorder; or

  • enlarged prostate or urination problems.

FDA pregnancy category C. It is not known whether Zicam Extreme Congestion Relief will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether oxymetazoline nasal passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How should I use Zicam Extreme Congestion Relief?

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Using the medication too long or too often may worsen your symptoms or cause nasal congestion to clear up and come back.

Call your doctor if your symptoms do not improve after 3 days of treatment.

Do not share this medication with another person, even if they have the same symptoms you have. Sharing a nasal spray bottle can spread infection.

To use the nose drops (nasal solution):

  • Blow your nose gently. Tilt your head back as far as possible, or lie down and hang your head over the side of a bed. Hold the dropper over your nose and place the correct number of drops into your nose.

  • Sit up and bend your head slightly forward, then move it gently left and right. Stay seated with your head bent forward for a few minutes.

  • Avoid sneezing or blowing your nose for at least a few minutes after using the nose drops.

To use the nasal spray:

  • Blow your nose gently. Keep your head upright and insert the tip of bottle into one nostril. Press your other nostril closed with your finger. Breathe in quickly and gently spray the medicine into your nose. Then use the spray in your other nostril.

  • Do not blow your nose for at least a few minutes after using the nasal spray.

Do not use the nasal spray more than 2 times in 24 hours.

Wipe the tip of the spray bottle with a clean tissue but do not wash with water or soap.

Store at room temperature away from moisture and heat. Do not freeze. Keep the bottle tightly closed when not in use.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed the medication.

Keep Zicam Extreme Congestion Relief out of the reach of children. Certain nasal medications can cause serious medical problems in a young child who accidentally sucks on or swallows medicine from the nasal spray bottle.

What should I avoid while using Zicam Extreme Congestion Relief?

Follow your doctor’s instructions about any restrictions on food, beverages, or activity.

Zicam Extreme Congestion Relief side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using Zicam Extreme Congestion Relief and call your doctor at once if you have:

  • ongoing or worsening symptoms;

  • severe burning or stinging in your nose after using the nasal spray;

  • chest pain, fast or uneven heart rate; or

  • severe headache, buzzing in your ears, anxiety, confusion, or feeling short of breath.

Common side effects may include:

  • mild burning or stinging of the nose;

  • sneezing; or

  • runny nose.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Zicam Extreme Congestion Relief?

Ask a doctor or pharmacist if it is safe for you to use Zicam Extreme Congestion Relief if you are also using any of the following drugs:

  • an antidepressant–amitriptyline, clomipramine, desipramine, doxepin, imipramine, nortriptyline;

  • ergot medicine–ergotamine, dihydroergotamine, ergonovine, methylergonovine; or

  • an MAO inhibitor–isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, tranylcypromine.

This list is not complete and other drugs may interact with Zicam Extreme Congestion Relief. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2018 Cerner Multum, Inc. Version: 4.03.

Medical Disclaimer

  • Side Effects
  • During Pregnancy or Breastfeeding
  • Dosage Information
  • Drug Interactions
  • En Español
  • 3 Reviews
  • Drug class: nasal antihistamines and decongestants
  • FDA Alerts (5)

Other brands: Afrin, Afrin Original, Vicks Sinex Severe Nasal Spray, Vicks Sinex 12-Hour Decongestant Nasal Spray, … +24 more

  • Nasal Congestion

The FDA has ordered a ban on Zicam, a cold “remedy” that can permanently disable your sense of smell. The FDA moved after it received 130 reports of anosmia, long-lasting or permanent loss of smell. You’ll notice that Zicam was marketed as a cold cure without FDA approval — that’s because it’s an herbal supplement. As such it is not subject to FDA regulation.

  • UPDATED: Matrixx Claims Victim Status in Zicam Ban; Company Sat on 800 Complaints.

As BNET has explained before, herbal and diet supplements fall into a ridiculous hole in federal law which allows them to be marketed without any oversight from government — unlike food or drugs. The FDA can only step in after supplements actually kill or injure people. Most recently, that happened with Hydroxycut, the diet “aid” that killed one of its customers. The FDA told Zicam’s maker, Matrixx Initiatives, in a warning letter that We are not aware of any data establishing that the Zicam Cold Remedy intranasal products are generally recognized as safe and effective for the uses identified in their labeling. The FDA further added: FDA recommends that consumers stop using these products and throw them away (See more of FDA’s action and recommendations on Zicam here.) Although Zicam pills are not affected by the ban (only the intranasal products), the development nonetheless should be a lesson to that endless army of people who think they can cure or prevent colds with herbal products. Whether its zinc, echinacea, vitamin C or Airborne, there always seems to be someone in the office or neighborhood who thinks they have a sure thing that prevents cold or flu. They are wrong. Nothing cures or prevents colds or flu. It’s the human condition. Get used to it.

In addition to Zicam, you might want to check out that Airborne paid a $30 million fine for falsely claiming that it cures or prevents colds.

  • Previously:
  • Why Hydroxycut Had to Kill Someone Before the FDA Could Act

The F.D.A. does not have the power to order product recalls but must rely on manufacturers to do so voluntarily. Bills now moving through Congress would give the agency that power. Bush administration appointees said the F.D.A. did not need mandatory recall authority because companies always withdrew unsafe products when asked.

But the government sometimes negotiated for days or weeks before companies agreed to recalls, leading many more consumers to be put at risk. And the Zicam case demonstrates that aggressive enforcement action can lead to disagreements.

An F.D.A. warning letter sent to Matrixx on Tuesday states that Zicam Cold Remedy intranasal products “may pose a serious risk to consumers who use them” and are “misbranded.” Such language would normally describe a recall alert. The products have no proven benefits.

Matrixx has received more than 800 reports of Zicam users losing their sense of smell but did not provide those reports to the F.D.A., said Deborah M. Autor, director of compliance in the agency’s drug center. The law requires producers of approved drugs to forward to the F.D.A. all reports of product-related injuries, but Ms. Autor declined to say whether this reporting requirement applied to Matrixx.

“This disabling loss of one of the five senses may be long lasting or even permanent in some people,” Ms. Autor said. “People without the sense of smell may not be able to detect dangers such as gas leaks or smoke. They could lose much of the pleasure of eating, adversely impacting the quality of life.”

Dr. Charles E. Lee, a compliance officer in the agency’s drug center, said zinc could be toxic to nerve receptors in the nose. In the 1930s, intranasal zinc was tested as a polio preventative, and some patients suffered anosmia, Dr. Lee said.

Media channels are atwitter with the news that zinc can beat the common cold. CBS News, the L.A. Times, the Huffington Post, and hundreds of others are treating a quiet research report as big news that will have a life-changing effect. After reading the report and doing a little digging into the dark side of zinc, I’m not rushing out to stock up on zinc lozenges or syrup.

The latest hubbub about zinc was sparked by a report from the Cochrane Collaboration. This global network of scientists, patients, and others evaluates the evidence on hundreds of different treatments. In the latest review, on zinc for the common cold, researchers Meenu Singh and Rashmi R. Das pooled the results of 13 studies that tested zinc for treating colds. By their analysis, taking zinc within 24 hours of first noticing the signs of a cold could shorten the cold by one day. They also found that taking zinc made colds a bit less severe.

Sounds good so far. But instead of saying, “Hey, take zinc if you have a cold,” the researchers concluded like this: “People taking zinc lozenges (not syrup or tablet form) are more likely to experience adverse events, including bad taste and nausea. As there are no studies in participants in whom common cold symptoms might be troublesome (for example, those with underlying chronic illness, immunodeficiency, asthma, etc.), the use of zinc currently cannot be recommended for them. Given the variability in the populations studied (no studies from low- or middle-income countries), dose, formulation and duration of zinc used in the included studies, more research is needed to address these variabilities and determine the optimal duration of treatment as well as the dosage and formulations of zinc that will produce clinical benefits without increasing adverse effects , before making a general recommendation for zinc in treatment of the common cold.”

Not exactly a ringing endorsement.

Zinc isn’t something to mess around with. Two years ago, the FDA warned everyone to stop using zinc-containing nasal sprays to fight colds because these sprays had been linked to more than 100 cases of loss of smell. The Institute of Medicine set the tolerable upper limit for zinc at 40 milligrams a day for adults, less for teens and children. The tolerable upper limit is the highest daily intake “likely to pose no risk of adverse health effects for almost all individuals.” If you follow the directions on zinc-based cold remedies, you’ll get more than the tolerable upper limit.

The glowing media reports are sure to spark the next cold rush as supplement makers crank up their zinc output. I’m going to ignore it. I don’t like the taste of zinc lozenges, and don’t think it’s worth sucking on them for several day to knock a day off a cold.

At the first sign of a cold, I’m headed to the kitchen to make chicken noodle soup.

July 19, 2010 — Just over a year ago, the FDA warned that zinc-containing intranasal cold remedies might cause loss of sense of smell.

Now a researcher who has long argued that the sprays were harmful says he has scientific evidence to back up the claim.

Last summer, the FDA warned consumers to stop using three zinc-containing Zicam products: Zicam Cold Remedy Nasal Gel, Zicam Cold Remedy Swabs, and Zicam Cold Remedy Swabs for kids. The federal regulators cited 130 reports of loss of sense of smell among users of the products.

Zicam manufacturer Matrixx Initiatives pulled the three products from the shelves, but the company maintains that there is no link between their use and loss of smell.

In the newly reported analysis, researchers applied a statistical method used to establish a cause-and-effect link between an environmental exposure and development of a disease in an effort to confirm that zinc-containing nasal products can cause loss of sense of smell, known medically as anosmia.

University of California, San Diego professor Terence M. Davidson, MD, says the analysis supports the hypothesis.

He adds that the effectiveness of zinc-containing products for preventing or shortening the duration of colds has never been proven.

“Given that they do absolutely no good for colds and given that there is potential for harm, I see no point in putting any zinc gluconate products in the nose,” Davidson tells WebMD.

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