From the Guidelines
An irritative cough can be distinguished from other types of cough by its persistent, dry, non-productive nature that is triggered by irritation rather than by infection or fluid buildup, as suggested by expert opinion in the management of cough 1. Irritative coughs are typically caused by environmental irritants (like smoke, pollution, or strong odors), post-nasal drip, gastroesophageal reflux disease (GERD), or medication side effects (particularly ACE inhibitors) 1. Unlike productive coughs that produce phlegm or mucus, irritative coughs feel like a constant tickle or scratch in the throat. They often worsen at night or when talking and may be accompanied by a sensation of throat clearing. Some key points to consider in distinguishing an irritative cough include:
- The medical history and physical examination are crucial in determining the cause of the cough, although the timing and characteristics of the cough are of little diagnostic value 1
- Identifying and avoiding triggers, staying hydrated, using a humidifier, trying honey (1-2 teaspoons as needed), or using over-the-counter cough suppressants containing dextromethorphan may help manage an irritative cough
- For persistent irritative coughs, prescription medications like benzonatate (Tessalon Perles) 100-200mg three times daily or low-dose gabapentin may help by suppressing the cough reflex
- If an irritative cough persists beyond 3-4 weeks, worsens, or is accompanied by concerning symptoms like fever, chest pain, or shortness of breath, medical evaluation is necessary to rule out more serious conditions, such as bronchiectasis, which can cause persistent cough even in the absence of sputum production 1. The most effective approach to managing an irritative cough involves a systematic and stepwise evaluation of potential causes, as outlined in the ACCP evidence-based clinical practice guidelines 1.
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 The FDA drug label does not answer the question.
From the Research
Distinguishing Irritative Cough from Other Types of Cough
To distinguish an irritative cough from other types of cough, it is essential to understand the characteristics of each type.
- An irritative cough is typically a dry, non-productive cough that occurs due to irritation of the throat or airways.
- Other types of cough, such as productive coughs, may be associated with the presence of mucus or other secretions.
Causes and Treatment of Cough
The treatment of cough depends on the underlying cause, as stated in the study 2.
- If the cause of the cough is known, treatment should focus on addressing the underlying condition.
- If no cause can be found, symptomatic relief of cough may be necessary, as discussed in the study 3.
- Various medications, such as codeine, dextromethorphan, and guaifenesin, may be used to treat cough, depending on the type and severity of the cough, as mentioned in the studies 2, 4, 5, and 6.
Characteristics of Irritative Cough
Irritative cough is often characterized by a dry, hacking sound, and may be accompanied by a sensation of irritation or tickling in the throat.
- The study 4 found that dextromethorphan had little effect on cough sound pressure level (CSPL) and cough frequency (CF) in patients with acute upper respiratory tract infection.
- In contrast, the study 5 found that dextromethorphan was effective in reducing cough intensity in patients with chronic cough.
- Guaifenesin, an expectorant, may be used to treat coughs associated with mucus production, as discussed in the study 6.
Diagnosis and Management of Cough
A practical approach to the diagnosis and management of cough is essential, as emphasized in the study 3.