The Never Ending Cough: Is Cough Medication the Answer?

James Thompson, MD Health Pro
  • We have almost made it through the last of outdoor allergy season. Ragweed has run its course in most of the U.S. while mold spores try to survive the declining temperatures of the Midwest and Northeast. Currently outdoor mold, weather changes and shared germs are leading factors in the escalation of cough, wheezing, runny nose and sinus congestion plaguing many of us. Although many areas of the country will soon see a dramatic decline in outdoor mold counts as the first hard frost approaches, the common cold virus is here to wreak havoc for several more months.

     

    As a parent, I know there is nothing more frustrating than hearing your child cough all night. During the fall and winter months, the common cold virus is often the culprit responsible for upper respiratory tract infections and asthma attacks in adults and children. Stopping the cough becomes a main goal for surviving work, school and sleep time.

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    The Chicago Tribune published an article about the shortcomings of cough medicine last week. The article summarized the conclusions of many studies that show a lack of effectiveness of over the counter (OTC) cough medicines. In most cases the severity and frequency of cough was not changed by taking OTC cough medication.

     

    A 2004 Penn State University Study found that cough formulas containing dextromethorphan (DM) and diphenhydramine (main ingredient of Benadryl) were no more effective than sugar water at reducing cough.

     

    The article pointed out that studies which showed improvement in cough suppression after taking cough medication were funded by the drug companies which make the product (making them less believable).

     

    A major point of clarification is what's in cough medication. Some OTC brands contain DM (a cough suppressant) along with antihistamine and expectorant (a mucus thinning agent such as guaifenesin). Others may have only DM or DM plus expectorant. Other formulas have all of the above drugs plus additional medications (for example acetaminophen and/or a decongestant).

     

    Is there a role for cough medication in the setting of the common cold or asthma?

    The answer often differs depending on who you ask (doctors, including specialists, have differing opinions). I believe certain cough medications may benefit those suffering from the common cold and asthma or allergic sinus problems, when used in conjunction with other appropriate medications. There is less of a proven role for these agents in treating the isolated common cold (e.g. person with no history of allergy problems or asthma).  Rest and drinking plenty of fluids as the cold virus runs its course is probably sufficient for most children and adults. Antihistamine to dry up post-nasal drip (and perhaps reduce cough) and analgesics such as acetaminophen have been reported to aid in reducing some of the symptoms of the common cold but do not make it go away any faster.

     

    The role of cough medication for you or your child should depend on advice from your doctor.

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    Be aware of recent FDA recommendations:

     

    •  Cough preparations labeled for adults should not be given to children.
    • Carefully review the active ingredients section of any cough or cold medication in order to understand what symptoms the medication is intended to treat (an avoid giving multiple meds that are similar and may increase side effects)
    • Follow the directions on how to use the medication with respect to dose and age adjustments in order to avoid over dosing which may cause severe side effects.
    • Avoid using common silverware as measuring utensils. Household spoons differ in how much they hold. Use measuring cups or spoons that come with the medication or spoons that are made for measuring accurate amounts.

    The best way to manage cough is to understand what is behind it before treating it. There are many causes of cough that depend on several different variables. Here is a link to more information about causes of cough.

     

    Bottom Line:

    Consult your doctor or pharmacist before starting cough medication especially if you are already on other medications. Cough associated with fever, shortness of breath, chest pain, distress or that is prolonged (more than a week) should be fully evaluated by a physician.

     

    Have you found cough medication helpful for you or your child?

Published On: October 27, 2008