What is the treatment for cough?

From the Guidelines

Cough treatment should be guided by the underlying cause, with the most recent and highest quality study suggesting that inhaled corticosteroids should be considered as first-line treatment for chronic cough due to asthma (1). For mild coughs, staying hydrated and using over-the-counter medications like dextromethorphan or guaifenesin can provide relief. Some key points to consider in cough treatment include:

• For dry coughs, cough suppressants containing dextromethorphan are most effective
• Expectorants like guaifenesin work better for productive coughs by thinning mucus
• Using a humidifier, sucking on lozenges, and avoiding irritants like smoke can also help
• If the cough is due to allergies, antihistamines may be beneficial
• For coughs lasting more than 2-3 weeks, accompanying high fever, producing discolored phlegm, or causing breathing difficulties, medical attention should be sought as these may indicate a more serious condition requiring prescription medications or other interventions. The approach to chronic cough should be sequential and empiric, starting with the most common causes such as upper airway secretions, asthma, and gastroesophageal reflux disease (1). It is also essential to consider the possibility of multiple causes of cough and to maintain all partially effective treatments (1). In patients with chronic bronchitis, avoidance of respiratory irritants and therapy with short-acting inhaled β-agonists, inhaled ipratropium bromide, and oral theophylline may improve cough (1). Central cough suppressants such as codeine and dextromethorphan are recommended for short-term symptomatic relief of coughing (1). Overall, the goal of cough treatment is to either suppress the cough reflex in the brain or reduce irritation and inflammation in the airways, and the approach should be individualized based on the underlying cause and severity of the cough.

From the FDA Drug Label

Uses temporarily relieves: cough due to minor throat and bronchial irritation as may occur with a cold or inhaled irritants your cough to help you sleep helps loosen phlegm (mucus) and thin bronchial secretions to rid the bronchial passageways of bothersome mucus and makes cough more productive USES Helps loosen phlegm (mucus) and thin bronchial secretions to make coughs more productive. Uses temporarily relieves • cough due to minor throat and bronchial irritation as may occur with the common cold or inhaled irritants • the impulse to cough to help you get to sleep

Cough Treatment Options:

• Codeine (PO) can be used to temporarily relieve cough due to minor throat and bronchial irritation, and helps loosen phlegm (mucus) and thin bronchial secretions 2.
• Guaifenesin (PO) helps loosen phlegm (mucus) and thin bronchial secretions to make coughs more productive 3.
• Dextromethorphan (PO) temporarily relieves cough due to minor throat and bronchial irritation, and helps with the impulse to cough to help you get to sleep 4.

From the Research

Cough Treatment Overview

• Cough is a common symptom of respiratory tract infections and can be caused by a wide range of disease processes 5, 6, 7, 8.
• Definitive treatment of cough depends on identifying the cause and diagnosis, and specific treatment of the cause should control the cough 5, 8.

Symptomatic Relief

• Symptomatic relief must be considered when the cough interferes with the patient's daily activities 5.
• Antitussive preparations, such as codeine or dextromethorphan with antihistamines, decongestants, and expectorants, can provide effective symptomatic relief of dry or non-productive cough 5, 9.
• First-generation antihistamines like chlorpheniramine and centrally acting opioid derivatives like codeine are often used alone or in combination in the management of nonspecific cough 5.

Chronic Cough

• Chronic cough in adults can be caused by many etiologies, but four conditions account for most cases: upper airway cough syndrome, gastroesophageal reflux disease/laryngopharyngeal reflux disease, asthma, and nonasthmatic eosinophilic bronchitis 6.
• Patients with refractory chronic cough may warrant referral to a pulmonologist or otolaryngologist and may benefit from a trial of gabapentin, pregabalin, and/or speech therapy 6.

Treatment Approaches

• A practical approach to treatment and management of cough emphasizes causes and potentiators, and considers the multifactorial nature of cough 7.
• Combination cough preparations should not be prescribed unless necessary, as they may not be effective in all cases 8.
• Clinical trials have shown that codeine, dextromethorphan, and guaifenesin are equally effective in relieving cough symptoms 9.