Cough Medicine: Understanding Your OTC Options

Over-the-counter (OTC) drugs are medicines you can buy without a doctor’s prescription. OTC cough medicines are grouped into two types: antitussives and expectorants.

Antitussives are cough suppressants. They relieve your cough by blocking the cough reflex. Dextromethorphan (some brand names: Triaminic Cold & Cough, Robitussin Maximum Strength, Vicks 44 Cough Relief) is a commonly used antitussive.

Expectorants thin mucus. This may make coughing work better to clear the mucus from the airway. The only expectorant available in OTC products is guaifenesin (two brand names: Mucinex, Robitussin).

Dextromethorphan and guaifenesin are sometimes combined with each other (one brand name: Robitussin DM). They are also available in combination with other drugs, such as pain relievers, decongestants or antihistamines. These combination products, such as multisymptom cold medicines, are meant to treat many symptoms at once. However, if your main symptom is cough, be careful of the drying effect of antihistamines and decongestants in combination medicines. This effect can make mucus thicker and harder to clear from the airways, which can make a cough worse.

Most of the time, a cough doesn’t require treatment. It will go away on its own. Cough medicines may be helpful if your cough is caused by a cold or the flu (influenza). Some types of cough should not be treated with cough medicines because the cough is helping to keep the lungs clear so you can breathe. Examples include cough from smoking, emphysema, asthma or chronic bronchitis.

Side effects from OTC cough medicines aren’t common for healthy adults. Side effects may be a concern for people who have health problems, are elderly or use cough medicines for long periods of time.

If certain drugs are used at the same time, the way your body processes them can change. When this happens, your risk of side effects increases.

Talk to your doctor or pharmacist before taking dextromethorphan if you take a monoamine oxidase inhibitor (MAOI). This is a type of prescription drug used to treat depression and other conditions. MAOIs include isocarboxazid (brand name: Marplan), phenelzine (brand name: Nardil), selegiline (brand names: Eldepryl, Carbex) and tranylcypromine (brand name: Parnate). Dextromethorphan interferes with the way MAOIs work. Dextromethorphan may cause problems while you are taking an MAOI or within two weeks of taking one.

Cough medicine is often combined with decongestants, antihistamines and/or pain relievers. If you take one of these combination medicines, it’s important to understand each of the active ingredients and the interactions they may have with other drugs you’re taking.

Be sure not to “double up” on cough medicine. Many OTC cold and allergy products contain cough medicine, as do some prescription drugs. If you take more than one of these products, you can take more cough medicine than you intend.

Talk to your doctor before taking cough medicine if you have any of the following symptoms:

Stop taking cough medicine and call your doctor if your cough lasts for more than 1 week, if it keeps coming back, or if you also have a fever, rash or ongoing headache. These could be signs of a more serious problem.

When choosing an OTC cough medicine, check the drug label for possible side effects or interactions with other drugs you’re taking. This information will appear in the “Warnings” section of the label.

Be sure to check that you’re not taking two medicines that contain the same active ingredient. You will find this information in the “Active Ingredient” section.

Always read and follow the directions on the label. Be sure you understand what the label says before taking the medicine. If you have any questions, ask your family doctor or pharmacist.