Best Cough Medicine: A Complete Guide

The "best" cough medicine is ultimately based on the type of cough you haveas well as an evaluation of possible side effects.

The three main types of over-the-counter (OTC) medicines adults can use to treat a cough include cough suppressantsexpectorantsand combination medications. These may come in a variety of formsincluding syrupslozengesspraystabletsand capsules.

Cough suppressants containing dextromethorphan are a great choice for treating a dry coughwhereas expectorants containing guaifenesin are a better choice when treating a wetproductive cough.

Types of Over-the-Counter Cough Medicines

Over-the-counter cough medicines can help relieve symptoms in different ways. They include:

• Cough suppressants that temper the cough reflex
• Expectorants that break up mucus so you can cough it up
• Multi-symptom formulas that may include these and other OTC drugs

Cough Suppressants

Cough suppressantsalso known as antitussivesare a class of drugs that act on the brain to suppress the cough reflex. This medication works best for dry coughs.

There is one OTC antitussive approved for use in the United States called dextromethorphan. It is most commonly sold as a syrup but can be found as capsules and lozenges.

Dextromethorphan is the active ingredient in single-symptom medications such as:

• Delsym (syrup)
• Buckley's Mixture Cough Suppressant (syrup)
• Vicks 44 Custom Care Dry Cough (syrup)
• Robitussin Long-Acting CoughGels (capsules)
• Sucrets DM Cough Formula (lozenges)
• Dextromethorphan (generic)

Despite their popularitya growing body of research suggests that cough suppressants aren't particularly effectiveespecially in children's medications. Dextromethorphan can also cause significant and sometimes intolerable side effectsincluding:

• Drowsiness or dizziness
• Blurred vision
• Shakiness
• Restlessness and irritability
• Nausea and vomiting
• Confusion
• Slowed breathing
• Difficulty urinating

Expectorants

An expectorant is a type of drug that breaks up and thins respiratory mucus so that it is easier to cough up. An expectorant is used when you have a productive ("wet") cough with stubborn or heavy mucusrather than a non-productive ("dry") cough.

Guaifenesin is the only expectorant approved for use in the United States. As a single-symptom remedyit can be found over the counter as:

• Mucinex
• Guaifenesin (generic)

These medicines are sold as either immediate-release tablets taken every four hours or sustained-release tablets taken every 12 hours. Side effects are relatively mild and may include:

• Dizziness
• Headache
• Nausea
• Vomiting
• Rash

Combination Medicines

Dextromethorphan and guaifenesin are often combined into multi-symptom cough formulasmost often as syrups or capsules.

Additional drugs may be added to the formula to help ease accompanying symptomsincluding:

• Antihistamines like Benedryl (diphenhydramine) and chlorpheniramine to ease postnasal drip that contributes to coughing. If the cough is allergy-relatedmedications like ClaritinZyrtecor Allegra can provide relief.
• Decongestants like Sudafed (pseudoephedrine) and Sudafed PE (phenylephrine) ease the swelling of blood vessels in the nose that cause nasal stuffiness. Howeverwhile phenylephrine is a common ingredient in oral decongestantsit is not considered effective at clearing up congestion.
• Pain relievers like Tylenol (acetaminophen) to reduce body aches and feveras well as treat sore throat

There are many multi-symptom cold & cough formulas found on pharmacy and grocery store shelves:

As a general rulefind the formula that treats your symptoms. Taking unnecessary drugs increases your risk of side effects. Examples include:

• Antihistamines: Drowsinessdizzinessdry mouthnauseaconstipationheadachenervousnessloss of appetiteand vomiting
• Decongestants: Headachedry mouthrestlessnessinsomniashakinessdizzinessand rapid pounding heartbeat
• Acetaminophen: Nauseastomach painheadachehoarsenessloss of appetiteand itching

Risks and Considerations

Cough medicines are generally safe but aren't appropriate for everyone. There are certain people for whom the drugs may pose certain health risks.

Dextromethorphan should generally be avoided in people with severe asthmachronic obstructive pulmonary disease (COPD)or pneumonia. Doing so can lead to a worsening of symptoms by allowing mucus to pool in the lungs rather than being coughed up.

Guaifenesin should also be used with caution in people with severe asthma or COPD unless under the supervision of a healthcare provider.

The American Academy of Family Physicians advises against OTC cough medicines for children under 6 due to the risk of accidental poisoning. These drugs have not been proven to be particularly effective in young children.

When to Call a Healthcare Provider

While most coughs associated with colds and flu can be treated at homesome can get unexpectedly worse or be caused by something far more serious than a cold or flu.

Seek immediate medical care if you have a cough and develop these signs and symptoms:

• High fever with chills
• Shortness of breath (dyspnea)
• Coughing up greenish mucus
• Coughing up blood (hemoptysis)
• Bluish fingersskinor lips (cyanosis)
• Coughs with a whoopingbarkingor wheezing sound

Home Remedies for Cough

Whether you're avoiding cough medicines or need more relief than they offerthese tips may help alleviate your cough:

• Drink a lot of fluids to thin and loosen mucus and soothe your throat. For a hacking coughtry hot waterteaor lemon juice.
• Eat a spoonful of honey to help relieve a cough. Research suggests this natural remedy may be more effective than cough syrups.
• Lozenges or cough drops can help to relieve a dry cough.
• Try a saltwater gargle. Saline (salt water) has been shown to have antibacterial properties. Bacteria prefer an acidic environmentand salt water makes your mouth and throat more alkaline.
• Don't smoke. Smoking dries out the airways and introduces irritants to the throat and lungs.
• Avoid airborne irritants such as smokepollutionor dust. If you can't avoid irritantswear a mask.
• Use a humidifier to help keep your airways from drying out. You can also breathe in warm mist from a bathroom shower.
• Use extra pillows to elevate your head when you sleep.