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, especially since many OTC cough medicines aren't as effective we'd like them to be.

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 are supposed to do just that: suppress coughs. Expectorants, on the other hand, are supposed to make coughing more effective by increasing mucus production in the lungs and airways. Some medications purport to both suppress coughs while still increasing the mucus that makes you want to cough in the first place, which feels counterintuitive.

There is a growing body of evidence that cough suppressants aren't always effective. There is also a somewhat scary list of side effects and adverse reactions to the most commonly used cough suppressants.

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

Cough suppressants don't work any better in adults than they do in kids. It's probably a good idea to stay away from cough suppressants entirely unless your healthcare provider specifically tells you otherwise.

Coughing is a complicated response to various factors, such as irritants, inflammation, mucus production, and food or fluid in the airways. Suppressing a cough is not as easy as it sounds. The only surefire way to cure a cough is to get rid of whatever is causing it.

From Allergies

If an allergic reaction is to blame for your cough, the best medicine will be an antihistamine. One of the most popular antihistamines available is Benadryl. Often, allergic reactions will have sneezing, itching, and watery eyes in addition to a cough. Antihistamines aren't technically considered cough medicines, but they may be useful if an allergy is the culprit.

A note of caution about antihistamines: They can make you drowsy. Benadryl makes you so drowsy it is sold as a sleep aid. Look for nondrowsy antihistamines. Ask your pharmacist to clarify side effects. Coughing due to asthma needs to be treated according to your healthcare provider's orders.

From Infections

Infections can cause a cough 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 infections can cause coughing as well.

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.

Infections that lead to runny noses can cause a cough. When mucus from the nose—commonly called "snot"—drains back to the back of the throat and irritates the vocal cords, a cough is born. Medicines that clear up stuffy noses (decongestants) can sometimes help with this type of cough.

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 and is transported up to the throat by microscopic fingers on the walls of the airways. Once at the throat, mucus from the lungs has to be cleared by coughing. This is where expectorants come in handy.

Expectorants will increase the production of mucus and make it more effective. The extra mucus helps clear the infection quicker. Cough suppressants won't work in this situation, but expectorants do.

Combination Drugs

Many cough medicines contain more than one active ingredient. In other words, the liquid you're drinking or the capsule you're swallowing may have an antihistamine, a decongestant, and a cough suppressant. Most flu and cold medications list coughing as one of the symptoms they treat and may have active ingredients that are the same as drugs sold specifically for cough.

Combination medicines such as these can lead to problems when treating yourself or your family. Taking one medicine for cold symptoms and another to treat cough could lead to an accidental overdose of cough medicine. Some cough medicines have significant and potentially dangerous side effects that could be much worse in an overdose.

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, but the only one that seems to work is honey. While not a medication, honey actually did a better job than honey-flavored dextromethorphan, a cough suppressant, in one study.

Home remedies are often based on practices that work better than nothing at all. Sometimes, such as with croup, the treatment may work for an entirely different reason than we thought. Sometimes, it's all in our heads. Be willing to try things at home, but don't ignore significant illnesses. Always call 911 or go to the emergency department if you're feeling short of breath, regardless of the cause.

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3 Sources
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