How to Choose the Best Over-the-Counter Cough Medicine

Over-the-counter (OTC) cough medicine for adults comes in three main types:

• Expectorants
• Suppressants
• Combination medicines

They work differently from each other. So, which is the best cough medicine for you? That depends on many factors.

This article goes over how OTC cough medicines for adults work, things to consider when choosing one, what side effects to watch for, and other ways to treat a cough.

Expectorants

Expectorants help thin mucus so it's easier to cough it out of your lungs. These cough medicines are useful for adults who have thick congestion that's hard to expel.

When mucus sits in your lungs, it can contribute to bacterial infections, including pneumonia. Coughing can clear out the mucus and help prevent bacterial overgrowth, so it's possible that an expectorant could keep you from getting a serious illness.

The drug guaifenesin is the only expectorant approved by the U.S. Food and Drug Administration (FDA). It's available as a generic drug and in multiple brand-name products, including:

• Robitussin
• Mucinex
• Multi-symptom cold and flu formulas

Suppressants

Cough suppressants are supposed to help you stop coughing. The medical community debates the effectiveness and usefulness of this type of cough medicine for adults, and even more so for children.

First, there's little evidence they actually work. A growing body of research has found they aren't effective, especially in children. Plus, they can have serious side effects. Many healthcare providers believe they're not worth the risk.

Because a cough is your body's way of getting foreign substances out of your lungs, it is not always a good idea to stop a cough. If you decide to use a cough suppressant, know these medications are best used only at night when you are having trouble sleeping.

Some common cough suppressants available over the counter include:

• Delsym
• Robitussin Cough
• Dextromethorphan (generic)

Cough drops fall into this category. They slowly release medication as you suck on them.

However, as with other cough suppressants, there's little to no evidence that they work. Some healthcare providers say hard candy is just as effective as a cough drop.

Combination Cough Medicine for Adults

A lot of cough medicines for adults combine multiple kinds of medication in one product. They're sold as "multi-symptom" formulas and may contain:

• Expectorants
• Cough suppressants
• Decongestants
• Antihistamines (allergy drugs that may relieve some cold symptoms)
• Pain killers/fever reducers like Tylenol (acetaminophen) or Advil (ibuprofen)

These products are often not the right answer when you're treating a cough. Both decongestants and antihistamines have a drying effect. That can make your mucus even thicker and harder to clear from your airways.

Also, if you're not congested, you don't need a decongestant. If you don't have a fever or body aches, you don't need the Tylenol or Advil.

Because all medications come with risks and possible side effects, you shouldn't take the ones you don't need. You may be better off taking multiple medications separately, so they're better tailored to your symptoms.

Considerations

Cough medicines generally considered safe for adults aren't safe for everyone. It's best to be aware of what may preclude you or a loved one from taking such a product before choosing an OTC product.

Your Health

Talk to your healthcare provider before taking OTC cough medicines if you:

• Smoke
• Have had a cough with large amounts of phlegm
• Have a history of asthma, emphysema, chronic bronchitis, or other breathing problems
• Are pregnant, trying to get pregnant, or breastfeeding
• Are taking or recently stopped taking a drug classified as a monoamine oxidase (MAO) inhitibitor

Some OTC cough medicines are available as dissolving granules that you mix with water. These may not be safe if you have kidney disease or are on a low-magnesium diet. Talk to your healthcare provider before taking granules.

If you have phenylketonuria (PKU), be sure to check the ingredients of the dissolving granules to see if they contain aspartame.

In Children

Healthcare providers don't recommend OTC cough medicines for children under 6 due to the risk of accidental poisoning. Also, these medications haven't been proven effective in young children.

Side Effects

Potential side effects of cough medicine for adults include:

• Headache
• Nausea
• Vomiting
• Stomach pain
• Dizziness/lightheadedness
• Drowsiness
• Nervousness/restlessness

If you have side effects from these medications that are severe or don't go away, contact your healthcare provider.

Other Ways to Treat a Cough

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

• Drink a lot of fluids to thin and loosen mucus and soothe your throat
• Use extra pillows to elevate your head when you sleep
• Don't smoke
• Avoid airborne irritants such as smoke, pollution, or dust
• If you can't avoid irritants, wear a mask
• Use a humidifier to help keep your airways from drying out
• Breath in warm mist, such as from a shower
• For a hacking cough, try hot water, tea, or lemon juice with honey

Research suggests honey may be more effective than cough syrups.

Summary

Cough medicines for adults include cough suppressants, expectorants, and combination products.

Suppressants are aimed at reducing your cough, but mounting evidence suggests they don't work. Expectorants thin your mucus so you can cough it up better. Combination products may contain drugs you don't need, putting you at unnecessary risk of side effects or other problems.

Your health and medications you take need to be considered when choosing the best cough medicine for you. It's best to involve your healthcare provider in your decision.

Cough medicines are not safe in children under 6.

A Word From Verywell

It's important to be aware of when a cough could be a sign of a more serious problem. Sometimes a persistent cough can be a sign that you're not breathing as well as you should be.

This is especially true in children. If you're concerned about your cough or your child's, contact your healthcare provider.