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What Works for Cough?

by Dr. Sharon Orrange on February 12, 2018 at 12:40 pm

If you’re like everyone I’m seeing in the clinic these days, your cough may be keeping you up at night, and driving you and your coworkers crazy. Do any of the over-the-counter (OTC) or prescription medications really work for a cough? Let’s walk through it. 

First, let’s go through the OTC cough suppressants

  • Acute cough due to viral upper respiratory tract infection (URI) is the most common form of cough, and a ton of money is spent on prescription and non-prescription cough medications. You may be surprised to hear that studies show OTC cough suppressants like Robitussin aren’t any more effective than a placebo.  
  • A review of over-the-counter (OTC) medications for acute cough found fairly disappointing results for the effectiveness of Mucinex and antihistamine-decongestants (Dimetapp, Delsym), and concluded that there is no evidence for or against the effectiveness of those preparations for an acute cough.
  • Here’s a cool fact. Honey (specifically Buckwheat honey) can suppress a cough better than over the counter meds in children – and possibly adults – by forming a soothing film over irritated mucous membranes.

Still coughing? Moving on to prescriptions…

  • Benzonatate capsules are generic for Tessalon and they do work. How does it work? Benzonatate is a prescription non-narcotic cough capsule that acts by numbing the stretch receptors of nerves located in the alveoli (air sacs) of the lungs, the airways, and the pleura (lining of the lung). You can take it every 8 hours. Studies have also shown that Benzonatate in combination with Mucinex 600mg works even better. Benzonatate and Mucinex suppress a cough to a greater degree than one alone. 
  • What about adding inhalers when I have a cough? If your doctor hears wheezing with your cough, an Albuterol inhaler (Proventil, Proair) may be prescribed. Routine use of inhalers like Proventil and Proair, however, has not been shown to improve a cough or shorten the duration of a cough.
  • The big guns – codeine cough suppressants. If your cough is keeping you up at night, these will help. There are many opiate prescription cough syrups like promethazine/codeine that work well. Their daytime use is limited because you can’t afford to feel dopey during the day, and the codeine may make some folks nauseated. Oh, and it’s habit-forming. Codeine cough syrups are an option for short-term use in desperate times.

Hope this helps.

Dr O.

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