Do You Need Prescription Medications for Cough or Cold?

After going through boxes of expectorants, antihistamines and other over-the-counter (OTC) a cough and cold medications, you're still sick--and maybe you're getting worse. Should you return to the drugstore for more of the same, or is your sneezing, wheezing and hacking serious enough to warrant prescription medication?​

Most of the time, coughs and colds go away on their own after several days; however, sometimes you need to see a physician for evaluation.

You need to see a physician when severe symptoms appear, including the following:

• Unusually severe sneezing or a runny nose
• Fever of 103 F or higher
• Sore throat lasting more than two days
• Earache
• Sinus headache--characterized by pain in the front of your head and face
• A cough that worsens as other cold symptoms get better
• Coughing up thick phlegm that's green or yellow
• Coughing up blood
• Painful cough
• A cough lasting more than three weeks
• Wheezing
• Unexplained weight loss
• Night sweats

After taking your medical history and performing a physical exam, your physician may order a chest x-ray and perform other exams to decide on your treatment.  A quick test can determine in 15 minutes whether your sore throat is strep (bacteria) and should be treated with Pen-Vee K (penicillin), Amoxil (amoxicillin) or Keflex (cephalosporin).  If your sinuses are infected or inflamed, your physician may prescribe nasal or oral steroids and antibiotics.

Stubborn coughs can be calmed with Tessalon Perles (benzonatate), which comes in capsules and pills.

Prolonged or serious coughing can be a symptom of conditions such as:

Asthma: This chronic lung disease, in which the airway becomes inflamed and narrowed, makes breathing difficult. It's treated with inhalers like Flovent (corticosteroid) to reduce inflammation and with quick-relief remedies such as short-acting inhalants like Ventolin (albuterol).

Bronchitis: This inflammation of the bronchial tubes, which carry air from your mouth to your lungs, produces a thick mucus that interferes with breathing. The cause is usually a virus, not bacteria, so antibiotics like Zithromax (azithromycin) are not often prescribed -- but asthma inhalers can reduce inflammation.

Emphysema: Irreversible damage to the walls of the lung's air sacs makes breathing difficult because it results in fewer, larger air sacs instead of many, smaller ones. Medications include inhaled or oral treatments like Flovent (corticosteroids) or Ventolin (albuterol) to open and relax air passages. Emphysema is a progressive disease that may ultimately result in oxygen dependence or surgery.

Original article content edited by Naveed Saleh, MD, MS, on 2/10/2016.