Key takeaways:
Corticosteroid medications, also known as steroids, don’t make most coughs from colds and viruses go away faster.
Steroids can help if your cough is from asthma, chronic obstructive pulmonary disease (COPD), or a flare-up of these conditions. They might also help with a long-term cough after a respiratory infection.
Steroids come in many forms. Both oral and inhaled steroids play a role in treating coughs from asthma and COPD flares.
Have you ever had a cough that you thought would never go away? A cough is often the last symptom to resolve after a cold or viral respiratory infection. Coughs are more than annoying. They can stop you from sleeping, make eating difficult, and cause chest wall pain.
It’s natural to look for a quick fix for a cough. And you might have heard that corticosteroids — or steroids for short — can make a cough quickly disappear.
But unless your cough is related to asthma, chronic obstructive pulmonary disease (COPD), or side effects from a respiratory illness, steroids are unlikely to help. Plus, they can do more harm than good. Here’s what you need to know about taking steroids for your cough.
Steroids work by calming down your immune system and lowering inflammation. When you’re sick with a respiratory illness, steroids calm the inflammation in the parts of your body that cause a cough.
The lining of your nose and throat gets inflamed when you have a cold or upper respiratory tract infection. This can cause symptoms like congestion and runny nose, which cause post-nasal drip and coughing. Steroids help calm this inflammation, which can improve cough and other cold symptoms.
If you have a lower respiratory tract infection — like bronchitis or pneumonia — your lungs and airways become inflamed. This causes a cough. People experiencing asthma or COPD flares also have inflammation around their lungs and airways, which leads to coughing. Steroids calm the inflammation in your lungs and airways, and this improves a cough.
Steroids come in many forms:
Inhalers
Sprays
Liquids
Pills
For a cough, inhaled (inhalers) and/or oral (pill, liquid) steroids are the most common.
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Inhaled steroids are often prescribed over oral steroids since they stay localized to your lungs and can have fewer side effects. These can be prescribed alone, such as:
Budesonide (Pulmicort Respules)
Fluticasone (Flovent)
Beclomethasone (Qvar RediHaler)
Asmanex (mometasone)
Inhaled steroids also come as combination medications with a bronchodilator, like:
Fluticasone / salmeterol (Advair)
Budesonide / formoterol (Symbicort)
Fluticasone / vilanterol (Ellipta)
Oral steroids that can be used to treat a cough include:
In theory, steroids should help improve a cough triggered by inflammation in your respiratory tract. But in real life, steroids only help stop coughs in specific situations. Here are three situations where steroids can stop coughs and help people recover from their illness.
“Asthma is a condition involving airway inflammation, which usually causes wheezing and poor airflow,” says Dr. Baljinder S. Sidhu, pulmonologist and co-owner of Pacific Coast Critical Care Group in Southern California.
Daily inhaled steroids can help keep inflammation under control so people don’t experience asthma symptoms. Steroids also play an important role in treating asthma flares. Most people need to take at least a few doses of steroids by mouth during an asthma flare. This stops inflammation and relieves asthma symptoms like cough, shortness of breath, and trouble breathing.
COPD is a lung condition that makes it hard to breathe. People with COPD have inflammation around their airways, causing swelling, coughing, and increased mucus production.
Daily inhaled steroids help keep COPD symptoms under control, making it easier to breathe. Oral steroids also play a role in treating COPD flares. People need to take several days of oral steroids during a flare to calm inflammation and keep symptoms from getting worse.
It’s common to have a lingering cough after a respiratory illness. But sometimes this cough can last for months. This is called a post-infectious cough, triggered by a virus or bacteria causing an upper or lower respiratory tract infection. The cough continues even after you have otherwise fully recovered.
“This is a condition that occurs following recovery from a viral or bacterial respiratory infection,” Dr. Sidhu said. “This can last up to 3 to 6 months due to inflammation.”
According to Dr. Sidhu, steroids can help this cough finally go away. But it can be tricky to know if steroids will help in these situations. That’s because other things — like reflux or allergies — can contribute to a lingering cough, and steroids won’t help if these things are playing a major role.
Steroids aren’t used to treat coughs from viral upper respiratory tract illness — like colds and sinusitis — caused by:
Respiratory syncytial virus (RSV)
Steroids also aren’t routinely used to treat viral bronchitis, says Dr. Sidhu, because they aren’t proven to help improve symptoms. Research shows that oral steroids don’t help cough duration or severity in people without lung disease. There’s also a risk of side effects, he says.
But there are exceptions.
If you have asthma or COPD and become sick with a viral respiratory tract infection, your doctor may ask you to take oral steroids or increase your daily inhaled steroids. This can help prevent a flare.
If your viral upper respiratory tract infection leads to a more serious illness, like a lower respiratory tract infection, your primary care provider or pulmonologist may prescribe steroids too. People who require hospital care for an illness that started as an upper respiratory tract infection may also need steroids.
But if you just have a regular cold, mild flu, COVID, or RSV illness, you don’t need steroids for your cough.
With so many possible causes, it can be tough to know when to seek help for a cough. The good news is, most coughs go away on their own. But it’s best to get medical attention if you have any of the following:
A fever for more than 2 days
Worsening or persistent cough after 10 days
Extreme fatigue
Trouble breathing
There isn’t a single “best” choice for cough medicine, unfortunately. There are a lot of over-the-counter (OTC) options available, but the evidence isn’t clear that they work. Prescription cough medicine may also not be the right choice for everyone. This comparison between OTC and prescription cough medicines can help you choose.
Certain home remedies, like honey and humidifiers, can help soothe your cough. If you’re sick with a respiratory illness, rest and hydration can also go a long way.
Steroids don’t make coughs from colds or upper respiratory tract infections go away faster. But steroids can help with coughs from conditions like asthma and COPD. They can also treat and prevent asthma and COPD flares. Inhaled and oral steroids are the most common forms of steroids used to treat these types of coughs.
Hay, A. D., et al. (2017). Effect of oral prednisolone on symptom duration and severity in nonasthmatic adults with acute lower respiratory tract infection: A randomized clinical trial. Journal of the American Medical Association.
Henning, M., et al. (2020). In adults with acute cough, do oral corticosteroids decrease or resolve cough faster than usual care? Evidence-Based Practice.
National Heart, Lung, and Blood Institute. (n.d.). Asthma care quick reference. U.S. Department of Health and Human Services.
Stevermer, J. J., et al. (2021). Pharmacologic management of COPD exacerbations: A clinical practice guideline from the AAFP. American Family Physician.