Over the counter (OTC) medicines may be defined as medicines that are freely available to the public without a prescription from a doctor. Self-medication for common cold is now encouraged by most government health authorities in order not to overload health resources in winter. This chapter examines the efficacy of the different groups of medicines for the relief of common cold symptoms (analgesics, decongestants, antihistamines, antitussives, menthol, expectorants and mucolytics, throat lozenges and sprays, multisymptom products, and hot drinks). Safety is the most important factor in any common cold medicine because of the widespread use of the medicines. Because of limitations in dose due to safety concerns many OTC medicines are used at the limits of efficacy and there is often little clinical data to support efficacy, and safety is often supported from a long history of safe use. Aspirin, paracetamol and ibuprofen are the most widely used analgesic treatments to alleviate pain and fever both as monotherapies and in combination with other cold medicines and their efficacy and safety is supported by data from trials on other pain models. The efficacy of nasal decongestants can be supported by clinical trials, and similarly the symptom relief provided by menthol for nasal congestion. The efficacy data for antihistamines, and antitussives is limited and controversial, and there is no real clinical support for the efficacy of expectorants and mucolytics. There is no doubt that all of the OTC common cold medicines are popular with consumers and that they do provide relief from symptoms that in some cases may be more due to a placebo effect than a pharmacological effect of an active ingredient. Multi-symptom medicines provide a safe and convenient way of treating the common cold syndrome of multiple symptoms but their use is sometimes criticised when not all symptoms need to be treated. Hot drinks can provide immediate and sustained relief from symptoms, especially cough and sore throat.