Tincture of time

Flu season hit hard this year, and the normal, if unwelcome, after effect of many viral upper respiratory infections is a lingering cough.

A recent review of the medical literature found that, on average, a cough will last 17.8 days! Fortunately, most coughs are self limiting; that is, they will get better without special treatment, such as antibiotics.

If you have a question about when to seek medical attention for a cough, visit FamilyDoctor.org ‘Check Your Symptoms’. 

For home treatment, however, the drugstore shelves are filled with a dizzying array of cough products. Which one, if any, is best?

Before spending money, try a simple and inexpensive treatment: a mug of warm water (or tea) with an added tablespoon of honey (or sugar). The sugar coats your throat and the warm vapor from the water helps soothe your airway.

FYI, most “soothing” lozenges are just sugar. Sucking on any hard candy will increase salivation and ease the dryness in your throat.

To me, cough medications are a good example of the mass marketing of over-the-counter drugs that offer minimal relief and might actually make you feel worse. Cochrane Reviews suggest there is little evidence to recommend any OTC cough/cold product.

But if you must buy something, ignore the sales pitch on the front of the package and read the ingredients.

Avoid mentholated cough drops. Menthol is a common ingredient in cough suppressant drops because it temporarily numbs the tissue in your throat. But it is also very irritating, and after the very temporary analgesic effect wears off, your cough or sore throat might get worse.

Cough syrups often contain several ingredients. Consider what you need and read the labels to know what you are buying.

Dextromethorphan is a cough suppressant. It works by decreasing the feeling that you need to cough. A side effect of dextromethorphan is slight drowsiness, which is most appropriate for nighttime use.

Guaifenesin is an expectorant. It works by thinning and loosening the mucus in your airway, making it easier to cough up and clear your airway. Guaifenesin is also available in tablet form.

I have never understood why manufacturers combine dextromethorphan and guaifenesin, since they actually work against each other.

Other common ingredients in these cough/cold cocktails are:

  • Antihistaminesdiphenhydramine (Benadryl) or doxylamine—usually found in “night” formulations as they cause drowsiness.
  • Decongestants—phenylephrine—can further dry out your airway and make your cough worse. Also, a common side effect is jitteriness or rapid heart rate.
  • Pain relievers—acetaminophen—I recently posted about the danger of acetaminophen overdose. Please be careful and read the labels!

If your main complaint is a cough, avoid these multi-symptom drugs. Always try the simplest (and usually the cheapest) treatment first.

Remember, a cough can take as long as 3 weeks to go away. Patience (with a touch of honey) is key.

Sláinte,

Frugal Nurse

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