What is the recommended treatment for a cough?

From the Guidelines

The recommended treatment for a cough is to use self-care measures, such as staying hydrated, using honey, and over-the-counter medications like dextromethorphan or guaifenesin, as these have been shown to provide symptomatic relief and improve quality of life. When considering the treatment of a cough, it is essential to determine its cause and severity. For most common coughs due to viral upper respiratory infections, self-care measures are appropriate, including:

• Staying hydrated
• Using honey (1-2 teaspoons for adults, not for children under 1 year) 1
• Over-the-counter medications like dextromethorphan (15-30 mg every 6-8 hours) for dry coughs or guaifenesin (200-400 mg every 4 hours) for productive coughs 1 Throat lozenges and humidifiers can also provide symptomatic relief. If the cough is due to allergies, antihistamines like cetirizine (10 mg daily) may help 1. For bacterial infections, antibiotics may be necessary but only when prescribed by a healthcare provider 1. Coughs lasting more than 3 weeks, those accompanied by fever over 100.4°F, shortness of breath, or bloody mucus require medical attention. These treatments work by either suppressing the cough reflex, thinning mucus to make it easier to clear, or addressing the underlying cause of the cough. Most acute coughs resolve within 1-2 weeks with appropriate treatment 1.

Some key points to consider when treating a cough include:

• Avoiding irritants, such as smoke and pollutants
• Using medications as directed and only when necessary
• Getting plenty of rest and staying hydrated
• Avoiding close contact with others to prevent the spread of infection
• Seeking medical attention if symptoms worsen or persist.

It is also important to note that some treatments, such as codeine and dextromethorphan, have limited efficacy for symptomatic relief in patients with cough due to URI and are not recommended for this use 1. In patients with chronic bronchitis, central cough suppressants, such as codeine and dextromethorphan, are recommended for the short-term symptomatic relief of coughing 1.

Overall, the most effective treatment for a cough will depend on its underlying cause and severity, and patients should work with their healthcare provider to determine the best course of treatment.

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 Purpose Cough suppressant USES Helps loosen phlegm (mucus) and thin bronchial secretions to make coughs more productive

The recommended treatments for a cough are:

• Cough suppression using medications like dextromethorphan (PO) 2
• Expectorants like guaifenesin (PO) to loosen phlegm and make coughs more productive 3
• Codeine (PO) to temporarily relieve cough due to minor throat and bronchial irritation 4

From the Research

Treatment Options for Cough

• The recommended treatment for a cough depends on the underlying cause and severity of the cough 5, 6, 7, 8, 9.
• For chronic cough, treatment with cough suppressants such as centrally acting opioids (e.g. morphine, codeine, dextromethorphan) and peripherally acting antitussives (e.g. moguisteine, levodropropizine) may be indicated 5.
• In advanced cancer, empiric treatment with antitussive agents such as benzonatate, codeine, hydrocodone, and dextromethorphan may be effective 6.
• For acute cough in children and adults, over-the-counter (OTC) medications such as antitussives, expectorants, mucolytics, and antihistamine-decongestant combinations may be used, but their effectiveness is not well established 7, 9.
• Antihistamines and centrally active antitussive agents should be used with caution in children due to the potential for serious harm 9.

Specific Medications

• Codeine and dextromethorphan are commonly used antitussives, but their effectiveness in reducing cough symptoms is variable 5, 7, 9.
• Guaifenesin, an expectorant, may be effective in reducing cough frequency and symptom scores 7, 9.
• Mucolytics, such as acetylcysteine, may be effective in reducing cough frequency and symptom scores 7, 9.
• Antihistamine-decongestant combinations may be effective in reducing cough symptoms, but their use should be cautious due to the potential for adverse effects 7, 9.

Considerations

• The selection of antitussives should take into account the patient's current medications, previous antitussive use, and other factors such as the presence of other symptoms and history of drug abuse 6.
• The efficacy of cough suppressants must be tested in double-blind randomized trials using validated measures of cough in patients with chronic cough not responding to specific treatments 5.
• The results of studies on OTC medications for acute cough should be interpreted with caution due to differences in study designs, populations, interventions, and outcomes between studies 7, 9.