How To Choose The Best Cough Medicine - Forbes

In the same way that there are different types of coughs, there are two different types of over-the-counter cough medicines to help ease acute coughing caused by a cold or flu.

  • Antitussives: Otherwise known as cough suppressants, antitussives block the cough reflex by decreasing activity in the part of the brain that causes coughing. Some brand names include Triaminic Cold and Cough and Robitussin Cough.
  • Expectorants: This type of cough medicine works to thin mucus, which can in turn help your cough move mucus out, clearing your airway. Two expectorant brand names include Mucinex and Robitussin Chest Congestion.

The type of cough medicine that will work best for you will depend on the issue you're dealing with. "An expectorant is typically used for a wet cough (caused by the common cold, bronchitis, etc.) to help clear congestion from the respiratory tract, whereas an antitussive is used for a dry cough to control the cough reflex," explains Niraj Patel, D.O., an Atlanta-based, board-certified family medicine physician, medical director of GoodRx Care and a Forbes Health Advisory Board member. "It is especially useful for those that have a dry cough that is preventing them from sleeping at night."

Prescription Cough Medicine

For most individuals, over-the-counter cough medicine is helpful in relieving symptoms, but occasionally, your doctor may decide a prescription cough medicine is necessary. Two of the most common prescription cough ingredients are hydrocodone and codeine.

  • Hydrocodone: An opioid cough suppressant, hydrocodone is used to treat a persistent dry cough. It affects the part of the brain responsible for the cough reflex. Hydrocodone is not to be given to children younger than 18, and because it is considered an opioid, has a high risk of misuse and dependence. It can also make you feel drowsy, and may cause nausea and constipation.
  • Codeine: An opioid pain reliever, codeine is often used in combination with other medications to ease coughing. Like hydrocodone, codeine accesses the part of the brain responsible for the coughing reflex, and works to decrease activity. Also like hydrocodone, codeine can be extremely habit forming, should not be used in children under 18 and can come with serious side effects, such as stomach pain and difficulty with urination.

People who should be extra aware of using cough medications that include codeine or hydrocodone are those with former drug misuse issues, as well as those with an underlying lung disease like emphysema, since they can suppress the ability to breathe, explains Elliot Dinetz, M.D., a double board-certified family medicine and functional medicine physician based in Miami, Florida and a Forbes Health Advisory Board member. "There are also issues surrounding overdosing," Dr. Dinetz continues, "which is why [prescription cough medicines] are not typically recommended."

"Hydrocodone and codeine are not routinely used in the treatment of cough due to their addiction potential and possible sedation," agrees Dr. Patel.

Best Cough Medicine for COVID-19

While there are currently a few treatments available for COVID-19, including monoclonal antibody therapy and antiviral pills such as Paxlovid, if you and your doctor have decided you have a mild case that can be treated at home, you can ease your COVID-19-induced cough the same way you would ease a cough caused by the cold or the flu—using home remedies and OTC cough medicines, if you choose.

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