Choosing Effective Cough Treatments

Which cough medicines really work?

When you have a cough and you can't get rid of it, the choices at the pharmacy might seem overwhelming. Some meds are only available with a prescription; others are over-the-counter (OTC) and some are sold behind-the-counter. Making sense of it all can be daunting.

Doctor checking young patient's cough
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Cough Suppressants vs Expectorants

One of the most confusing things about cough medicines is understanding the difference between cough suppressants and expectorants.

  • Cough suppressants stop you from coughing. An example is Delsym (dextromethorphan).
  • Expectorants are intended to make coughing more effective by increasing mucus production in the lungs and airways. Mucinex (guaifenesin) is an example.

These medications aren't always effective and they can cause side effects and adverse reactions.

The FDA strongly advises against giving cough suppressants to kids under 2 years old and encourages drug manufacturers to voluntarily advise consumers not to give suppressants to kids under 4 years old.

Coughing is a complicated response to various factors, such as irritants, inflammation, mucus production, and food or fluid in the airways. Cough suppressants and expectorants are symptomatic treatments, but they don't treat the cause of a cough. You shouldn't use them unless your doctor recommends them for you.

Antihistamines and Allergic Cough

Often, allergic reactions will involve sneezing, itching, watery eyes, and a cough. Antihistamines aren't technically considered cough medicines, but if your cough is part of an allergic reaction, your doctor may recommend an antihistamine, such as Benadryl (diphenhydramine).

A note of caution about antihistamines: Some of them can cause drowsiness.

Sometimes this side effect may be beneficial if the cough is preventing you from sleeping, but the drowsiness can interfere with daytime activities (like driving and paying attention to your daily tasks). And for some people, antihistamine-induced drowsiness can be persistent even after a good night's sleep.

Ask your pharmacist to clarify the side effects and get an idea of how the medication affects you for a few days before you attempt to drive.

How to Treat a Cough From an Infection

Infections can cause coughing by increasing mucus or by causing swelling and inflammation in the nose, throat, windpipe, and bronchi. Croup is an example of a cough from a viral infection, but bacterial and other viral respiratory infections can cause coughing as well.

Generally, a cough that's related to a mild upper respiratory infection will resolve when the infection is treated. Sometimes your healthcare provider may recommend symptomatic treatment for your infection-induced cough, especially if the cough is severe or if the cough lingers after the infection has resolved.

Bacterial infections can be treated with antibiotics. Viral infections don't get any better with antibiotics, and many common cold viruses do not respond to antiviral medications. For that reason, healthcare providers don't give antiviral medications for common colds. Your practitioner may prescribe an antiviral medication for the flu if you come in early enough and test positive for influenza.

Pneumonia and Bronchitis

Two types of lung infection—pneumonia, and bronchitis—produce lots of mucus in the lungs. This mucus traps bacteria and small particles throughout the airways. Mucus from the lungs has to be cleared by coughing. This is where expectorants come in handy.

Cough suppressants won't be helpful, but expectorants can be beneficial. Expectorants will increase the production of mucus and make it more effective. The extra mucus may help clear the infection quicker.

Combination Drugs

Many cough medicines contain more than one active ingredient. For example, they can have a combination of an antihistamine, a decongestant, or a cough suppressant.

And most flu and cold medications treat several symptoms. If they list coughing as one of the symptoms they treat, they may have one or more types of cough medication in addition to the other active ingredients that treat the other symptoms.

It's important to be careful when using combination medicines. For example, taking one medicine for cold symptoms and another to treat cough could lead to an accidental overdose of cough medicine.

Don't take extra cough medicine if you're taking a medication that covers multiple problems, such as sniffling, sneezing, coughing, etc., or you risk an overdose and increased side effects.

Home Remedies

There are lots of home remedies for cough, and it is a good idea to incorporate simple at-home self-care when you have a cough.

Examples include:

  • Stay hydrated
  • Sip on warm or cold drinks to soothe your through (whichever makes you comfortable)
  • Breathe in steam, such as from a humidifier or in the shower
  • Get enough rest
  • Gargle salt water

While home remedies can be helpful, it is important to talk to a healthcare provider about your cough. The cause and type of cough you are having are important for directing the treatment. A dry cough, wet cough, allergic cough, infectious cough, and more are all managed differently.

Always call 911 or go to the emergency department if you're feeling short of breath, regardless of the cause.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  3. Oduwole O, Udoh EE, Oyo-Ita A, Meremikwu MM. Honey for acute cough in childrenCochrane Database Syst Rev. 2018;4(4):CD007094. doi:10.1002/14651858.CD007094.pub5

By Rod Brouhard, EMT-P
Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients.