Drug Info

The best cough medicine

Cropped SingleCare logo By | December 13, 2019
Medically reviewed by Lindsey Hudson, APRN, NP-C, CDCES

cougCoughs are one of the most common reasons people see their primary healthcare provider. Since most coughs are caused by common colds or environmental factors, over-the-counter (OTC) cough medicines and at-home remedies usually fix the problem. However, it is important to visit your primary care physician to seek medical advice—and even prescription cough medicine—if a cough causes a fever or lasts longer than three weeks.

Causes of a cough

While an occasional cough is normal, a cough that persists may be a sign of an underlying medical condition. Coughs are a defensive reflex that aims to clear excessive secretions and foreign bodies from airways. However, severe and frequent coughing can significantly impact your quality of life.

These are the main reasons for a cough:

  • Common cold: The common cold is a viral infection of the nose and throat (upper respiratory tract). It’s usually harmless, although it might not feel that way. Most people recover from a common cold in seven to 10 days.
  • Viral upper respiratory tract infection: This is another name for the common cold. It most often occurs when a virus enters the body through the mouth or nose. Given the symptoms, it’s most commonly transmitted through touching, sneezing, or coughing.
  • Flu: Influenza is a viral infection that attacks your respiratory system. Influenza is commonly called the flu, but it’s not the same as “stomach flu” viruses that cause diarrhea and vomiting. Though the annual influenza vaccine isn’t 100% effective, it’s still your best defense against the flu.
  • Bronchitis: Bronchitis is an inflammation of the lining of your bronchial tubes, which are the main passages your body uses to carry air to and from your lungs. People who have bronchitis often cough up thick mucus, which can also be discolored. Bronchitis may be acute or chronic. It’s usually caused by a virus—often the same viruses that cause the common cold or flu—but in some select cases, it can be caused by bacteria.

Types of cough medicine

Various medications can be used to treat cough and cold symptoms, but only a few of them can quickly treat the symptoms. Here are the main types:

  • Cough suppressants (also called antitussives) block the cough reflex, making coughing less likely. Dextromethorphan (DM) is the most common active ingredient in cough suppressants. Cough suppressants should not be used if the cough is caused by smoking, emphysema, asthma, pneumonia, or chronic bronchitis. Antihistamines or decongestants can also dry the throat, making the mucus thicker and harder to move, resulting in a more severe cough.
  • Expectorants loosen or thin the mucus in the chest, making it easier to cough it up. One popular example is guaifenesin. Drinking extra fluids can also help.
  • Combination medicines contain a combination of expectorants, cough suppressants, and other active ingredients. They can include antihistamines, painkillers, and decongestants to treat multiple symptoms at once. To treat a cough from a common cold, a good choice is a cold medicine that contains both an antihistamine and a decongestant, as an antihistamine on its own may be ineffective.

What are the best over-the-counter cough medicines?

Most cases of the common cold can be treated without going to a healthcare provider, there are plenty of over-the-counter cough medicines you can pick up at your local drugstore without a prescription. Some of the more popular OTC, fast treatments for a cough include:

  • Pseudoephedrine: An OTC medicine that relieves nasal congestion. The most popular brand is Sudafed (Sudafed coupons | What is Sudafed?). Because it can increase blood pressure, Sudafed should be monitored in those with high blood pressure or other heart problems. Side effects include irritability, jitteriness, and hyperactivity. Note: There are a couple of states that require a prescription for this and every state keeps it behind the pharmacy counter. You must show ID to purchase.
  • Guaifenesin: Often known by its brand name Mucinex (Mucinex coupons | What is Mucinex?), guaifenesin is the only OTC expectorant available to help relieve symptoms from colds. It works to relieve chest congestion and is often combined with pseudoephedrine to relieve multiple symptoms. Guaifenesin is supposed to help thin mucus, making it easier to cough up mucus or phlegm, though reports vary as to how effective it may be. Drinking lots of fluids when sick with a cough due to an infection may be just as useful.
  • Dextromethorphan: A cough suppressant that affects the signals in the brain that trigger cough reflex. Dextromethorphan is used to treat a cough and is available over the counter in syrup, capsule, spray, tablet, and lozenge form. It is also present in many over-the-counter and prescription combination medications. The most common brand names include Robafen Cough (Robitussin) and Vicks Dayquil Cough. It is not recommended for young children under four years old. An adult dosage varies depending on whether the formulation is immediate- or extended-release. The maximum dosage is 120 ml in 24 hours.
  • Pain relievers: Tylenol (acetaminophen) (Tylenol coupons | What is Tylenol?) and Advil (ibuprofen) (Advil coupons | What is Advil?) can both help ease cold and flu symptoms, such as reducing fever and body aches.

RELATED: Sudafed vs Mucinex

If you find that OTC cough medicines are not working for you, and your symptoms worsen or persist, your doctor may prescribe medication to help. Considering that the most common causes of coughs are upper respiratory illnesses, and these are most commonly caused by viruses, it’s unlikely your GP will prescribe any antibiotics as a cough treatment. Antibiotics are only used for bacterial infections, such as strep throat.

If you have a cough that you just can’t shake and it lasts more than three weeks, see your doctor and explore the possibility of an underlying condition that may need to be treated with prescription medication.

What are the best prescription cough medicines?

Although, there are many prescription cough medications on the market here are some your healthcare provider may prescribe for fast cough and pain relief:

Best prescription cough medicine
Drug name Recommended for pregnant women? Approved for children? How it works
Codeine No. Baby can become dependent on opioids, and the drug can be passed through breast milk. No. As of 2018, codeine is contraindicated in children younger than 18 per the FDA. Opioid cough suppressant.
Tessalon Perles (benzonatate) N/A–FDA Pregnancy Category C (unknown if it can harm a fetus or if it contaminates breast milk). No, do not give to children under 10 years old without medical guidance. It can be fatal for children. It numbs areas of the lungs and throat, in turn reducing cough reflexes.
Tussionex PennKinetic (hydrocodone-chlorpheniramine) N/A–FDA Pregnancy Category C (unknown if it harms the fetus or if it passes to breast milk). Babies may become dependent on the drug. Speak to your doctor. No. Not to be used by persons under 18 years of age. Hydrocodone is a cough suppressant that reduces cough reflex signals in the brain. Chlorpheniramine is an antihistamine that reduces the effect of histamines in the body.
Promethegan (promethazine) N/A–FDA Pregnancy Category C (unknown if harm can come to the fetus or if it contaminates breast milk). Yes. It can be dosed with caution in children over 2 years of age. Cough suppressant and antihistamine.
Hydromet (hydrocodone-homatropine) No. Baby can become dependent on opioids, and medicine can be transmitted through breast milk. No. Not to be used by persons under 18 years of age. Opioid cough suppressant and antihistamine.
Phenergan with Codeine (promethazine-codeine) No. Baby can become dependent on opioids, and medicine can be transmitted through breast milk. No. Not to be used by persons under 18 years of age. Opioid cough suppressant and antihistamine.
Hydrocodone-acetaminophen No. Baby can become dependent on opioids, and medicine can be transmitted through breast milk. Yes. It can be dosed with caution in children over 2 years of age. Opioid cough suppressant and pain relief.

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We strongly recommend that you speak with your doctor before taking any medication while pregnant or breastfeeding, or before giving any medication to children under 12 years of age.

How to take cough medicine

Cough medicine is available in a variety of forms, including syrups, powders, pills, capsules, and nasal sprays. Often the form that’s best for you is just personal preference. For example, many children struggle to swallow tablets, especially when they have a sore throat, so a syrup may be the best option.

  • Cough syrup: Good for adults and children wanting faster relief than pills, for those who suffer from an extremely sore throat, and for children who have trouble swallowing pills.
  • Powder: Similar to syrups. It helps medication work faster and it’s easier for children to take orally.
  • Pills: Good for adults who need sustained relief throughout the day
  • Nasal sprays: For adults or children with sore throats that prevent them from ingesting pills or other oral forms easily.
  • Cough drops: Helps with cough suppression. Many cough drops reduce sore throat discomfort with added ingredients like menthol or honey.

What are the best home remedies for a cough?

While there are many medicines available to help ease your cough, there are also a number of things you can do at home that don’t require medication and can be very effective. Cough remedies include:

  • Fluids: Liquid helps thin the mucus in your throat. Warm liquids—such as broth, tea, or juice—can soothe your throat.
  • Cough drops: They may ease a dry cough and soothe an irritated throat. There are many natural varieties available, with menthol, lemon, zinc, vitamin C, and honey.
  • Honey: A teaspoon of honey may help loosen a cough. Add it to some warm water with lemon for an extra soothing effect.
  • Vaporizers or humidifiers: Adding moisture to the air makes it easier for you to breathe. You have a couple of options for doing so. In the morning, you can create your own steam room by closing the door to your bathroom and running hot water in the shower for several minutes until the mirrors fog. The steam can help unclog your nose and chest. In the evening, you can run a vaporizer or humidifier in your bedroom to avoid an interrupted night full of coughing.
  • Non-medicated saline drops: Spraying the inside of your nose with non-medicated saline drops can clear the mucus and relieve a stuffy nose. This prevents nasal drip which can lead to coughing.
  • Saltwater: Gargling salt water can reduce the phlegm and mucus in your throat that’s causing the coughing reflex.
  • Ginger: Known for its anti-inflammatory effects, ginger is thought to ease a cough. Try adding some thin slices into warm water to make ginger tea.

Most of the time over-the-counter and home remedies will effectively combat an irritating cough but if the cough persists or gets worse you should make an appointment with your healthcare provider. And it’s always a good idea to consult your healthcare provider when taking any medications, whether they are OTC or prescription, especially before giving them to children.