Breath of Fresh Air: Feature Articles

Chapter 41: When should I take a cough syrup and what kind of cough syrup should I use?

Over-the-counter cough remedies are most appropriate for symptomatic relief during upper respiratory tract infections ("the common cold"). They can provide relief from troublesome cough during self-limited, non-serious illnesses. A cough suppressant can be particularly helpful at bedtime to minimize sleep disturbance due to cough. Cough remedies are not appropriate for suppression of coughs that are of long duration (more than 2 weeks) or uncertain cause or that complicate serious underlying lung diseases, unless a medical evaluation is performed (because of the risk of suppressing the symptom of a serious disease without treating the underlying problem).

Cough may also be a manifestation of asthma. If you are coughing because asthma has caused narrowing of your bronchial tubes (a low reading on your peak flow meter will tell you if this is the case), then the best treatments are medications that help your asthma, not over-the-counter cough remedies.

Most over-the-counter cough remedies contain guaifenesin (used to loosen thick airway secretions) and/or dextromethorphan (5-30 mg/dose) to suppress cough. Different preparations add an antihistamine (such as chlorpheniramine), a decongestant (such as phenylpropanolamine or pseudophedrine), and/or acetaminophen for control of other symptoms of a cold. Cough lozenges usually contain menthol to soothe the throat and perhaps decrease the cough reflex. Some cough syrups contain as much as 10% alcohol. Persons with asthma and aspirin sensitivity should carefully read the labels of cold remedies to ensure that no aspirin is contained in the product.