Over-The-Counter Cough Medicines
By Roland Larrabee, M.D.
Choosing a cough medicine can be confusing. Do you need to get relief from the cough? Or do you need something to help you loosen the mucus? Or both?
Some coughs are dry and hacking. Some coughs are deeper, even painful sometimes, and the cough brings up mucus or phlegm. Health care providers call this a productive cough because it produces mucus. If you need relief from a dry, hacking cough, choose a cough suppressant such as DM (dextromethorphan). If you need to loosen mucus, choose an expectorant, such as guaifenesin.
Expectorants are used to thin and bring up mucus from the lungs when you cough. This relieves chest congestion and makes it easier to breathe. The drug most commonly used as an expectorant is guaifenesin. You can buy many forms of this medicine without a prescription. It comes in capsules, tablets, liquids, and cough syrups. They all work equally well, so choose which form you prefer to take.
Cough suppressants are medicines that lessen the urge to cough. If you have a dry, hacking cough and do not have mucus in your airways that needs to be coughed up, a cough suppressant can help you cough less and sleep better.
The active ingredient in most cough suppressants is dextromethorphan. Cough medicines with the initials DM have dextromethorphan in them. You can buy many forms of this medicine without a prescription under many brand names. Always follow label instructions on cough suppressants to avoid overuse and possible side effects.
You should watch out for the following when taking these medicines:
- Avoid choosing a cough syrup with an antihistamine in it, such as Benadryl (diphenhydramine). Antihistamines can make the mucus dry and hard to cough up. They can also be unsafe in the elderly, causing dizziness and falls.
- Some cough medicines also contain decongestants, such as Sudafed (pseudoephredrine). If you don’t have significant congestion, this won’t particularly help your cough. This can also be unsafe in the elderly and those with certain medical ailments, such as heart disease.
- Avoid using a cough suppressant if you have a cough with a lot of mucus that needs to be coughed up.
- Be sure to drink plenty of fluids while taking expectorants. Drinking a lot of water helps to keep the mucus watery and easier to cough up.
- If you are pregnant, consult your health care provider before taking any medicines.
- If you have a medical condition such as heart disease or diabetes, ask your pharmacist which cough syrups are safe to use with your other medicines. Some cough syrups have lots of sugar or glucose in them.
- Both expectorants, decongestants and cough suppressants should be used with caution in older adults.
Use them only when recommended by your health care provider.
If taken according to directions, these medicines are generally very safe and have few side effects. As always, more is not better, so take as directed. Many nonprescription cough and cold medicines contain several ingredients to treat many symptoms. Read the labels and buy only the ingredients that you need. If you are not sure which medicine is best, ask your pharmacist or healthcare provider.
Dr. Larrabee is Associate Director of Family and Community Medicine at the Walter L. Aument Family Health Center, 317 S. Chestnut St., Quarryville.
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