What medications are used to treat cough?

From the Guidelines

For treating a cough, the most effective medication is dextromethorphan, which can be taken at a dose of 10-20 mg every 4-6 hours as needed, not exceeding 120 mg in 24 hours for adults, as recommended by the most recent and highest quality study 1. When considering treatment options for cough, it's essential to prioritize medications that have been shown to be effective in reducing cough severity and improving quality of life.

• For patients with chronic bronchitis, peripheral cough suppressants such as levodropropizine and moguisteine are recommended for short-term symptomatic relief of coughing, as stated in the guidelines 1.
• In patients with cough due to URI or chronic bronchitis, the only inhaled anticholinergic agent recommended for cough suppression is ipratropium bromide, with a substantial benefit and grade of recommendation A 1.
• For patients with lung cancer experiencing cough, a trial with demulcents such as butamirate linctus or simple linctus may be suggested, followed by pharmacological management using an opiate-derivative titrated to an acceptable side-effect profile if necessary, as recommended by the expert panel report 1. It's crucial to note that the choice of treatment may be dictated by availability rather than pharmacologic parameters, and local anesthetics such as nebulized lidocaine may be tried when other pharmacologic approaches have failed to manage cough, as suggested by the systematic review of cough management approaches 1. Always stay hydrated and consider using a humidifier, and if symptoms persist beyond 2 weeks or are accompanied by fever, chest pain, or difficulty breathing, consult a healthcare provider.

From the FDA Drug Label

Helps loosen phlegm (mucus) and thin bronchial secretions to make coughs more productive. Contains sodium metabisulfite, a sulfite that may cause allergic-type reactions 12 Hour Cough Relief Day or Night Alcohol-free Cough Suppressant The medications used to treat cough are:

• Guaifenesin (PO): helps loosen phlegm and thin bronchial secretions to make coughs more productive 2
• Dextromethorphan (PO): a cough suppressant that provides 12 hour cough relief 3 3

From the Research

Medications Used to Treat Cough

The following medications are used to treat cough:

• Dextromethorphan: an antitussive that has been shown to be effective in reducing cough frequency and intensity in some studies 4, 5, 6
• Codeine: an antitussive that has been compared to dextromethorphan in several studies, with mixed results 5, 7, 8
• Guaifenesin: an expectorant that has been shown to be effective in relieving cough symptoms in some studies 7, 8, 6
• Moguisteine: an antitussive that has been shown to be no more effective than placebo in reducing cough symptoms in one study 8
• Antihistamine-decongestant combinations: have been shown to be effective in relieving cough symptoms in some studies, but not others 8
• Mucolytics: have been shown to be effective in reducing cough frequency and symptom scores in some studies 8, 6
• Antihistamines: have been shown to be no more effective than placebo in relieving cough symptoms in several studies 8

Comparison of Medications

Some studies have compared the effectiveness of different medications in treating cough, including:

• Dextromethorphan vs. codeine: dextromethorphan was found to be more effective in reducing cough intensity in one study 5, but not in another 4
• Dextromethorphan vs. guaifenesin: no significant difference was found in one study 7
• Codeine vs. guaifenesin: no significant difference was found in one study 7
• Antihistamine-decongestant combinations vs. placebo: significant differences were found in some studies, but not others 8

Study Limitations

Many of the studies had limitations, including small sample sizes, differences in study designs and populations, and conflicting results 8. Therefore, the results of these studies should be interpreted with caution.