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10 February 2010
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Cough medicines

The choice of cough medicines is mind-boggling. Do any work better than others?

William

Dr Trisha Macnair responds

Dr Trisha MacnairPharmacists are a mine of information about the different products and it's always worth asking them for their opinion. They'll be able to ask you questions about the sort of cough you want to treat, so they can suggest the most appropriate medicine.

It's worth remembering that coughing is usually a helpful protective mechanism by which the body expels harmful substances or excessive phlegm. Suppressing a cough may not always be the best move and could delay recovery.

Sometimes, however, the cough is dry and a reaction to irritation, which can be distressing.

Types of cough remedy

Cough remedies can be divided into two types.

The first are those that alter the consistency or production of phlegm. These are useful if you're coughing up something. Remedies include:

  • Mucolytics (such as acetylcysteine) - break down phlegm, making it less sticky and easier to cough up. Often inhaled into the lungs rather than swallowed as syrup. They seem to help when used appropriately.
  • Expectorants - are supposed to help bring phlegm up so coughing is easier. I'm not convinced these treatments, which include ammonium chloride, have much useful effect.

The second group are those that suppress the cough reflex by affecting nerve centres in the brain. These are recommended for dry coughs where no phlegm is being produced, but do have a sedating effect. They include:

  • Antihistamines - usually recommended for children
  • Mild narcotic drugs - such as codeine

Other possible ingredients in cough remedies include flavourings, colourings and sometimes mild analgesics such as paracetamol.

Making a choice

It's best to choose a cough medicine based on a single active ingredient. Diabetics should look for sugar-free varieties.

If you have complicated respiratory problems, it may be worth discussing cough medicines with your doctor.

If symptoms persist, seek medical advice rather than taking bottle after bottle of medicine.

This article was last medically reviewed by Dr Trisha Macnair in December 2007

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