Honey, where is my Zicam?

We are all familiar with the common cold, rhinovirus, that is transmitted by direct contact or large aerosol particles (Turner, 2001)What you may not be familiar with is how rhinovirus infects you, causing you to feel sick. Rhinovirus enters the nasal cavity and further enters into the nasal epithelium via a cellular receptor adhesion molecule called ICAM-1 (Novick et al., 1996, 1997)ICAM-1 not only helps allows rhinovirus to enter the nasal epithelium but also that of white blood cells (Novick et al., 1997) ICAM-1 also plays a role in activating and sustaining inflammation (Bella et al., 1998; Novick et al., 1997).

Zicam is an over-the-counter (OTC) drug that contains the active ingredients Zinc Acetate & Zinc Gluconate (Zicam® Ultra RapidMelts® Cold Remedy for Common Cold Relief – Orange Cream Flavor, n.d.). The Zn+2 ion is thought to play a crucial role in competitively inhibiting ICAM-1 (Novick et al., 1996, 1997). Meaning the Zn+2 ion from Zinc Acetate & Zinc Gluconate binds to the ICAM-1 cellular receptor in place of the rhinovirus or white blood cells, decreasing the number of rhinoviruses that can enter the nasal epithelium and decreasing the amount of inflammation due to the decreased amount of invaded rhinoviruses and white blood cells (Novick et al., 1996, 1997).

While double-blind, randomized, placebo-controlled clinical trials have largely not provided consistent results on the efficacy of Zinc Acetate or Zinc Gluconate, two well-designed clinical trials have shown Zinc Gluconate to decrease the duration of the common cold only when administered within 24 hours of the onset of symptoms (Hirt et al., 2000; Hulisz, 2004; Mossad, 2003).

With how expensive OTC-drugs are is it ethical for companies to market and sell drugs with instructions to take and continue taking their products, like Zicam, every 2-3 hours throughout their entire cold with studies have shown largely inconclusive evidence of its efficacy and the only studies to show effectiveness of Zicam is when it is taken starting within the first 24 hours? I believe this a huge ethical issue has there is no solid evidence confirming the efficacy of the drugs that they are promising will help.  This deceit can cause many to fall vicitm to emptying their pockets for drugs like Zicam and various vitamins that significantly underdeliver on their promise to help individuals prevent illnesses.

Bella, J., Kolatkar, P. R., Marlor, C. W., Greve, J. M., & Rossmann, M. G. (1998). The structure of the two amino-terminal domains of human ICAM-1 suggests how it functions as a rhinovirus receptor and as an LFA-1 integrin ligand. Proceedings of the National Academy of Sciences of the United States of America, 95(8), 4140–4145. https://doi.org/10.1073/pnas.95.8.4140

Hirt, M., Nobel, S., & Barron, E. (2000). Zinc nasal gel for the treatment of common cold symptoms: A double-blind, placebo-controlled trial. Ear, Nose, & Throat Journal, 79(10), 778–780, 782.

Hulisz, D. (2004). Efficacy of Zinc Against Common Cold Viruses: An Overview. Journal of the American Pharmacists Association, 44(5), 594–603. https://doi.org/10.1331/1544-3191.44.5.594.Hulisz

Mossad, S. B. (2003). Effect of zincum gluconicum nasal gel on the duration and symptom severity of the common cold in otherwise healthy adults. QJM: Monthly Journal of the Association of Physicians, 96(1), 35–43. https://doi.org/10.1093/qjmed/hcg004

Novick, S. G., Godfrey, J. C., Godfrey, N. J., & Wilder, H. R. (1996). How does zinc modify the common cold? Clinical observations and implications regarding mechanisms of action. Medical Hypotheses, 46(3), 295–302. https://doi.org/10.1016/s0306-9877(96)90259-5

Novick, S. G., Godfrey, J. C., Pollack, R. L., & Wilder, H. R. (1997). Zinc-induced suppression of inflammation in the respiratory tract, caused by infection with human rhinovirus and other irritants. Medical Hypotheses, 49(4), 347–357. https://doi.org/10.1016/s0306-9877(97)90201-2

Turner, R. B. (2001). The treatment of rhinovirus infections: Progress and potential. Antiviral Research, 49(1), 1–14. https://doi.org/10.1016/s0166-3542(00)00135-2

Zicam® Ultra RapidMelts® Cold Remedy for Common Cold Relief – Orange Cream Flavor. (n.d.). Zicam.Com. Retrieved November 28, 2022, from https://www.zicam.com/our-products/cold-shortening/rapid-melts-citrus