Camphor/menthol
Place in Therapy
Place in Therapy
Vapor rubs containing aromatic agents (such as menthol, camphor and eucalyptus oil) for symptomatic relief of congestion associated with the common cold may be considered as adjunctive therapy for anyone greater than 2 years old (1). Although the literature for vapour rub is limited, the current evidence suggests these products can “trick” the brain and provide a perception of improved nasal breathing in the absence of any objective improvements in airflow (2,3). This finding supports the large anecdotal evidence for efficacy with these products.
Because vapor rubs provide subjective symptomatic relief without objective benefit, their place in therapy remains controversial. UpToDate (3) does not recommend its use because it was not shown to improve spirometry, considering other therapeutic options have clear objective benefit; On the other hand, RxFiles emphasizes the fact that a common cold is self-limiting and routine comfort measures should be recommended (4). Keep in mild, cough and cold products are not recommended for children less than 6 years old and therefore, vapor rubs are one of the few options available for symptomatic relief of congestion in this age group.
Overall, vapor rubs have a good safety profile and no significant drug interactions have been identified. Because these are meant for topical application, very little drug gets into the bloodstream. A sensation of burning of the skin, eyes and/or nose, is a commonly reported side effect (4). Vapor rubs should not be applied directly under the nose, especially in children, as they can act as a direct irritant and cause respiratory impairment (2). Toxicity can occur with the accidental ingestion of camphor containing rubs, and hence these products should be kept out of reach of children (2).
In conclusion, vapor rubs are able to improve discomfort from congestion associated with the common cold, however they do not provide objective improvement in nasal airflow measures and should therefore be considered as add-on therapy. Vapor rubs are well-tolerated in patients greater than 2 years of age when applied topically, avoiding application directly under the nose. These products are fairly inexpensive and are convenient to use.
References
1. Paul IM, Beiler JS, King TS, et al. Vapor Rub, Petrolatum, and No Treatment for Children with Nocturnal Cough and Cold Symptoms. Pediatrics 2010; 126(6):1-8.
2. Vicks VapoRub safety and children. Pharmacist’s Letter/Prescriber’s Letter 2009; 25(3):250306.
3. Pappas DE, Hendley JO. The common cold in children: Treatment and prevention. UpToDate, Waltham, MA. Accessed on March 17, 2014.
4. Bunka, D. Vapor Rub, Petrolatum and No Treatment for Children with Nocturnal
Vapor rubs containing aromatic agents (such as menthol, camphor and eucalyptus oil) for symptomatic relief of congestion associated with the common cold may be considered as adjunctive therapy for anyone greater than 2 years old (1). Although the literature for vapour rub is limited, the current evidence suggests these products can “trick” the brain and provide a perception of improved nasal breathing in the absence of any objective improvements in airflow (2,3). This finding supports the large anecdotal evidence for efficacy with these products.
Because vapor rubs provide subjective symptomatic relief without objective benefit, their place in therapy remains controversial. UpToDate (3) does not recommend its use because it was not shown to improve spirometry, considering other therapeutic options have clear objective benefit; On the other hand, RxFiles emphasizes the fact that a common cold is self-limiting and routine comfort measures should be recommended (4). Keep in mild, cough and cold products are not recommended for children less than 6 years old and therefore, vapor rubs are one of the few options available for symptomatic relief of congestion in this age group.
Overall, vapor rubs have a good safety profile and no significant drug interactions have been identified. Because these are meant for topical application, very little drug gets into the bloodstream. A sensation of burning of the skin, eyes and/or nose, is a commonly reported side effect (4). Vapor rubs should not be applied directly under the nose, especially in children, as they can act as a direct irritant and cause respiratory impairment (2). Toxicity can occur with the accidental ingestion of camphor containing rubs, and hence these products should be kept out of reach of children (2).
In conclusion, vapor rubs are able to improve discomfort from congestion associated with the common cold, however they do not provide objective improvement in nasal airflow measures and should therefore be considered as add-on therapy. Vapor rubs are well-tolerated in patients greater than 2 years of age when applied topically, avoiding application directly under the nose. These products are fairly inexpensive and are convenient to use.
References
1. Paul IM, Beiler JS, King TS, et al. Vapor Rub, Petrolatum, and No Treatment for Children with Nocturnal Cough and Cold Symptoms. Pediatrics 2010; 126(6):1-8.
2. Vicks VapoRub safety and children. Pharmacist’s Letter/Prescriber’s Letter 2009; 25(3):250306.
3. Pappas DE, Hendley JO. The common cold in children: Treatment and prevention. UpToDate, Waltham, MA. Accessed on March 17, 2014.
4. Bunka, D. Vapor Rub, Petrolatum and No Treatment for Children with Nocturnal