Coughing is your body’s natural response when something is irritating your airways or your throat. And a cough from a cold or the flu will often go away on its own without any treatment. But in the meantime, a cough can be bothersome -- for example, if you’re coughing at night, it might keep you awake. You might want to try cough medicine to get some relief.
Many types of over-the-counter (OTC) cough medicine are available. But don't just grab any box of cough medicine off the pharmacy shelf. These medicines contain different active ingredients, and some are more likely to help than others, depending on the type of cough you have.
Types of OTC Cough Medicines
If your cough is bothering you and interrupting your daily activities, cough medicine might help. Although cough medicine doesn’t cure your cold -- or whatever is causing your cough -- it can ease your symptoms while your body heals.
As a glance at the drugstore shelves will show you, there are many, many brands of OTC cough medicines. But there are only three basic types.
Expectorants
Expectorants thin mucus. When you have a cough that produces mucus, or phlegm, expectorants help loosen it up, making it easier to cough up and clear out of your airway. This can help relieve congestion in your chest.
The ingredient guaifenesin is the most commonly used expectorant. Guaifenesin comes in a tablet, capsule, or syrup.
These are some of the over-the-counter expectorant medications on the market that contain guaifenesin:
- Bidex 400
- Mucinex
- Organidin NR
- Robitussin
- Tussin Expectorant
- Xpect
Natural expectorants that may help include menthol, which is an ingredient in some cough drops, and honey.
Suppressants
Cough suppressants, also called antitussives, suppress or reduce your cough by blocking your brain’s cough reflex. One of the most common active ingredients in suppressants is dextromethorphan (DM). Here are some cough suppressants that contain dextromethorphan:
- Delsym 12-hour Cough
- Robitussin Cough Long-Acting
- Triaminic Long-Acting Cough
- Vicks DayQuil Cough
Other types of cough suppressants include camphor, eucalyptus oil, and menthol. Some ointments or rubs, like Vicks VapoRub, contain these ingredients. Sometimes cough drops contain menthol, and they may help relieve a cough.
Combination medicines
Some cough medicines combine both guaifenesin and dextromethorphan. Some OTC cough medicines that contain both include:
- Delsym Cough + Chest Congestion DM
- Mucinex Fast-Max DM Max
- Robitussin Adult Cough + Chest Congestion DM
- Robitussin Adult Peak Cold
- Triaminic Cough & Congestion
- Tussi-Organidin DM NR
- Vicks DayQuil Mucus Control DM
Combination products also may include other medicines to ease other symptoms at the same time. These other ingredients may include decongestants for stuffy nose, antihistamines for allergies or a runny nose, and painkillers. Cough medicines sometimes contain ingredients to help coat and soothe your throat as well.
Which is the strongest over-the-counter cough medicine?
Because OTC cough medicines have different active ingredients, it’s hard to compare them. And studies haven’t shown much reliable evidence of how effective these medicines are. Some studies have shown that these medicines aren’t any better than a placebo.
But different types of cough medicines might work better for certain symptoms than others. For example, if your cough is preventing you from sleeping and you are more concerned about suppressing your cough, you might choose a suppressant over an expectorant. Your doctor can recommend which type of OTC cough medicine is best for your symptoms.
Best Over-the-Counter Cough Medicines for Dry and Wet Coughs
With a dry cough, no mucus comes out when you cough. You might feel like you have a tickle in your throat or a sore throat.
With a wet cough, you do cough up mucus. This is called a productive cough. A wet cough is common when you have a cold or the flu.
If you have a dry cough, a suppressant can help control your symptoms. If your cough isn’t productive, an expectorant isn’t likely to help.
For a wet cough, an expectorant can help you clear the mucus out of your airways.
Which is the best cough suppressant medicine over the counter?
Dextromethorphan is one of the most common active ingredients in OTC cough suppressants. Although a cough medicine may or may not work for you, a cough suppressant that contains dextromethorphan may be a good option to try.
OTC Cough Medicines for Infants and Children
OTC cough medicines are not recommended for children under 4, according to the American Academy of Pediatrics. The FDA points out that for children under 2, OTC cough medicines can cause serious and potentially life-threatening side effects.
For children between the ages of 4 and 6, OTC cough and cold medicines should be given only if the child’s doctor recommends them. For children older than 6, OTC cough medicines are safe to use, but it’s important to follow the dosage instructions carefully.
To make sure you’re giving the correct dose to your child, use the syringe or cup that comes with the medicine, not a measuring spoon or other tool from your kitchen. OTC cough and cold medicines can be harmful if children take more than the recommended dose.
An overdose can also happen if a child takes two OTC medicines, such as one for pain relief and one for cough, that contain the same active ingredients. Children should not take medicines made for adults because these medicines can cause an overdose.
Other options that may help with your child’s cough symptoms include honey for children age 1 or older and mentholated rub for children age 2 or older.
Side Effects of OTC Cough Medicines
OTC cough medicines don’t usually cause side effects in healthy adults. But here are some possible side effects. For the expectorant guaifenesin, side effects include:
- Headache
- Nausea
- Vomiting
For the suppressant dextromethorphan, side effects include:
- Dizziness
- Drowsiness
- Nervousness
- Nausea
- Vomiting
- Rash
If you have these symptoms and they are severe or they don’t go away, see your doctor.
Effects of cough medicines in those who are pregnant or breastfeeding
If you’re pregnant or breastfeeding, check with your doctor before taking any medicine. Generally, both guaifenesin and dextromethorphan are considered safe to take if you’re pregnant or breastfeeding.
If you do want to take an OTC cough medicine while you’re pregnant or breastfeeding, it’s a good idea to avoid combination products. For example, you can take an OTC cough medicine that contains either guaifenesin or dextromethorphan as a single active ingredient rather than a cough and cold medicine that contains multiple active ingredients.
OTC Cough Medicine Interactions With Other Drugs
If you’re taking other medications, check with your doctor before taking an OTC cough medicine because some cough medicines can interact with other OTC medicines, prescription drugs, or vitamins or supplements. The cough medicine may alter the effects of other drugs or increase your risk of serious side effects.
For example, dextromethorphan may interact with certain antidepressants, medicines to treat high blood pressure, and celecoxib (Celebrex).
Guaifenesin may cause problems if you take it along with other drugs that can cause drowsiness or slow your breathing, such as some opioid medicines or medicines for anxiety or seizures.
Homeopathic Cough Suppressant Medicines
Another option to treat cough symptoms is a homeopathic cough remedy, which may be labeled as a natural alternative. But it’s important to understand that no homeopathic products are approved by the FDA.
Homeopathic remedies typically contain small amounts of highly diluted substances such as plants, animal or human sources, bacteria, minerals, and chemicals. Homeopathy is an alternative medical practice based on the principle that “like cures like.” It takes a substance that causes symptoms in healthy people and uses it in a very diluted form to treat those symptoms.
Check with your doctor before taking homeopathic cough suppressants or expectorants. According to the FDA, children under 4 should not take homeopathic cough or cold medicines.
Can You Overdose on OTC Cough Medicines?
If you take too much of an OTC cough medicine, it’s possible to overdose. This can happen either accidentally or on purpose. For example, you might accidentally overdose if you combine an OTC cough medicine with other medicines that contain the same active ingredients.
For children, accidental overdoses can happen if you combine medicines, if more than the recommended dose is given, or if the doses are given too often.
Dextromethorphan is an opioid substance. People sometimes abuse it, taking more than the recommended dose on purpose to get high. This can cause serious side effects.
Although guaifenesin is generally safe, it’s still possible to overdose. And taking too much cough medicine that contains guaifenesin and other active ingredients, such as acetaminophen, can be harmful.
Signs of over-the-counter cough medicine overdose
Symptoms of a dextromethorphan overdose include:
- Breathing problems
- Coma
- Seizures
- Bluish fingernails and lips
- Blurred vision
- Drowsiness
- Hallucinations
- Rapid heartbeat
- Nausea and vomiting
Seeking help for OTC cough medicine overdose
If you think that you or someone else has overdosed on OTC cough medicine, call the poison control helpline at 800-222-1222 or see www.poisonhelp.org.
If the person has collapsed, has had a seizure, is having trouble breathing, or can't be awakened, immediately call 911 for emergency medical help.
How to Use Cough Medicine Safely
Before buying an OTC cough medicine, look closely at the label. Don't just buy anything that says "cough" on it. Is it a suppressant or an expectorant? Is it both? What are the active ingredients? Make sure you're getting the right medicine for your symptoms.
Always measure the correct dose. Some people drink OTC cough syrup right out of the bottle without measuring it, but that’s risky because even safe medicines can be dangerous if you take them in high doses. High doses of dextromethorphan can cause serious problems, including brain damage, seizure, and death.
Be careful with combination medicines. Many OTC cough medicines have multiple ingredients -- expectorants and suppressants along with decongestants, antihistamines, or painkillers. Select products with only the medicines that treat your symptoms. If your symptom is only a cough, for instance, you don't need a decongestant or painkiller. If you need to treat multiple symptoms, check other medicines you take to see if they contain the same ingredients. Don't take two medicines that have the same ingredients. If you have any questions, ask your pharmacist or doctor.
Be sure to keep any medicines, including cough medicines for children, out of children’s reach to avoid overdose.
Don't use medicine for more than 7 days. If you do, you could be covering up a more serious problem. See your doctor if your cough is severe or if it doesn't get better.
Consider not taking any cough medicine. Remember that most coughs don't need treatment. You may want to wait for your cough to go away on its own or to try home remedies like taking a spoonful of honey or drinking warm beverages.
When to Contact Your Doctor
If your cough doesn’t go away in 2 weeks, or if it keeps coming back, call your doctor. A cough from a cold, the flu, or allergies that lasts for a few days usually isn’t anything to worry about. But if it lingers, it could be a sign of another condition, like asthma, gastroesophageal reflux disease (GERD), or chronic bronchitis, that you should get medical attention for.
Also contact your doctor if you have these symptoms along with your cough:
- Wheezing
- Fever over 101.5 F
- Fever that lasts more than 2 days
- Chills
- Phlegm that is yellow, green, or bloody
If you see a lot of blood when you cough, you can’t breathe well, or you have severe chest pain, these are signs that you need emergency medical care. You should call 911 or go to an emergency room.
Takeaways
A cough from a cold or the flu usually will go away on its own. But if your cough is getting in the way of your usual daily activities, you might try OTC cough medicine to help ease your symptoms. OTC cough medicines contain different ingredients, and you should choose one based on what type of cough you have.
Although OTC cough medicines are generally safe, it’s important to avoid taking too much because high doses can cause serious medical problems.
OTC Cough Medicine FAQs
- What is the best OTC medicine to get rid of a cough fast?
Studies haven’t provided much reliable evidence on the effectiveness of OTC cough medicines, and one type may be better than another depending on your symptoms. Your doctor can help recommend which type to try.
- Does honey help a cough?
Honey may help relieve a cough. You can try a spoonful of honey on its own or add some to hot tea.
- How do I stop uncontrollable coughing with phlegm?
A cough that brings up phlegm or mucus is called a productive or wet cough. An OTC cough medicine that’s an expectorant can help thin the mucus and clear it out of your airway.
- How do I cure a cough fast at home?
OTC cough medicines don’t cure the underlying cause of your cough, but they can help relieve your cough symptoms.
- Why do I have cough that won’t go away but I am not sick?
It’s common to have a cough if you have a cold or the flu. But if you’re not sick and your cough doesn’t go away, call your doctor. Your cough could be a sign of another condition, like asthma, gastroesophageal reflux disease (GERD), or chronic bronchitis.
