There are many over-the-counter (OTC) medicines adults can use to treat a cough, including syrups, lozenges, sprays, and capsules. With a wet, productive cough, you want to be able to clear some of the fluid and mucus from your airways rather than trying to suppress a cough.
An expectorant is helpful if you're treating a productive cough, but a suppressant is the better option for a dry cough. Each has a different mechanism of action. The "best" cough medicine is ultimately based on the type of cough you have, as well as evaluation of possible side effects.
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Types of Over-the-Counter Cough Medicines
Over-the-counter cough medicines can help to relieve symptoms in different ways. They include:
- Cough suppressants that temper the cough reflex
- Expectorants that break up mucus so you can cough it up
- Multi-symptom formulas that may include these and other OTC drugs
Cough Suppressants
Cough suppressants, also known as antitussives, are a class of drugs that act on the brain to suppress the cough reflex.
There is one OTC antitussive approved for use in the United States called dextromethorphan. It is most commonly sold as a syrup but can be found as capsules and lozenges.
Dextromethorphan is the active ingredient in single-symptom medications such as:
- Delsym (syrup)
- Buckley's Mixture Cough Suppressant (syrup)
- Vicks44 Custom Care Dry Cough (syrup)
- RobitussinLong-Acting CoughGels (capsules)
- SucretsDM Cough Formula (lozenges)
- Dextromethorphan (generic)
Despite their popularity, a growing body of research suggests that cough suppressants aren't particularly effective, especially in children's medications. Dextromethorphan can also cause significant and sometimes intolerable side effects, including:
- Drowsiness or dizziness
- Blurred vision
- Shakiness
- Restlessness and irritability
- Nausea and vomiting
- Confusion
- Slowed breathing
- Difficulty urinating
Do You Need a Cough Suppressant?
If you have a productive ('wet") cough, it is usually more beneficial to cough mucus out of your lungs rather than trying to suppress a cough. Speak to your healthcare provider if you have a "chesty" or "rattling" cough to ensure you are getting the right treatment.
Robitussin vs. Mucinex: How Do They Compare?
Expectorants
An expectorant is a type of drug that breaks up and thins respiratory mucus so that it is easier to cough up. An expectorant is used when you have a productive ("wet") cough with stubborn or heavy mucus, rather than a non-productive ("dry") cough.
Guaifenesin is the only expectorant approved for use in the United States. As a single-symptom remedy, it can be found over the counter as:
- Mucinex
- Guaifenesin (generic)
These medicines are sold as either immediate-release tablets taken every four hours or sustained-release tablets taken every 12 hours. Side effects are relatively mild and may include:
- Dizziness
- Headache
- Nausea
- Vomiting
- Rash
2:29
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Combination Medicines
Dextromethorphan and guaifenesin are often combined into multi-symptom cough formulas, most often as syrups or capsules.
Additional drugs may be added to the formula to help ease accompanying symptoms, including:
- Antihistamines like Benedryl (diphenhydramine) and chlorpheniramine to ease postnasal drip that contributes to coughing
- Decongestants like Sudafed (pseudoephedrine) and Sudafed PE (phenylephrine) to ease the swelling of blood vessels in the nose that cause nasal stuffiness. However, while phenylephrine is a common ingredient in oral decongestants, it is not considered effective at clearing up congestion
- Pain relievers like Tylenol (acetaminophen) to reduce body aches and fever
There are many multi-symptom cold & cough formulas found on pharmacy and grocery store shelves:
| DXM | GUA | CLM/DPH | PSE/PE | ACT | |
|---|---|---|---|---|---|
| Alka-Seltzer Plus Flu/Body | X | X | X | ||
| Alka-Seltzer Plus Severe Cold & Flu | X | X | X | X | |
| Coricidin HBP Chest Congestion & Cough | X | X | |||
| Coricidin HBP Cold Cough and Flu Maximum Strength | X | X | X | ||
| Coricidin HBP Day & Night Multi-Symptom Cold | X | X | X | X | |
| Mucinex DM | X | X | |||
| Mucinex Fast-Max Maximum Strength | X | X | X | X | X |
| Mucinex Fast-Max Severe Cold | X | X | X | X | |
| Robitussin Cough & Allergy | X | X | X | ||
| Robitussin Cough + Chest Congestion DM | X | X | |||
| Robitussin Cough & Cold | X | X | X | X | |
| Theraflu Flu Cold & Cough | X | X | X | ||
| Theraflu Max-D | X | X | X | X | |
| Triaminic Cold & Couch | X | X | |||
| Triaminic Day Time Cold & Cough | X | X | |||
| Triaminic Multi-Symptom Fever | X | X | X | ||
| Tylenol Cold Multi-Symptom Nighttime | X | X | X | X | |
| Tylenol Cold + Flu Multi-Action | X | X | X | ||
| Tylenol Cold | X | X | X | X | |
| Tylenol Cold and Flu Severe Day & Night | X | X | X | X | X |
| Vicks DayQuil | X | X | X | ||
| Vicks NyQuil | X | X | X |
As a general rule, find the formula that treats your symptoms. Taking unnecessary drugs increases your risk of side effects. Examples include:
- Antihistamines: Drowsiness, dizziness, dry mouth, nausea, constipation, headache, nervousness, loss of appetite, and vomiting
- Decongestants: Headache, dry mouth, restlessness, insomnia, shakiness, dizziness, and rapid pounding heartbeat
- Acetaminophen: Nausea, stomach pain, headache, hoarseness, loss of appetite, and itching
Avoid Overdosing
When taking a multi-symptom cough formula, check the product label for all the ingredients it contains. This will help you avoid overdosing if you take another OTC medicine with the same ingredient.
Risks and Considerations
Cough medicines are generally safe but aren't appropriate for everyone. There are certain people for whom the drugs may pose certain health risks.
Dextromethorphanshould generally be avoided in people with severe asthma, chronic obstructive pulmonary disease (COPD), or pneumonia. Doing so can lead to a worsening of symptoms by allowing mucus to pool in the lungs rather than being coughed up.
Guaifenesin should also be used with caution in people with severe asthma or COPD unless under the supervision of a healthcare provider.
The American Academy of Family Physicians advises against OTC cough medicines for children under 6 due to the risk of accidental poisoning. These drugs have not been proven to be particularly effective in young children.
Dangers of Cough Medicines in Kids
When to Call a Healthcare Provider
While most coughs associated with colds and flu can be treated at home, some can get unexpectedly worse or be caused by something far more serious than a cold or flu.
Seek immediate medical care if you have a cough and develop these signs and symptoms:
- High fever with chills
- Shortness of breath (dyspnea)
- Coughing up greenish mucus
- Coughing up blood (hemoptysis)
- Bluish fingers, skin, or lips (cyanosis)
- Coughs with a whooping, barking, or wheezing sound
Home Remedies for Cough
Whether you're avoiding cough medicines or need more relief than they offer, these tips may help alleviate your cough:
- Drink a lot of fluids to thin and loosen mucus and soothe your throat. For a hacking cough, try hot water, tea, or lemon juice with honey. Research suggests honey may be more effective than cough syrups.
- Lozenges or cough drops can help to relieve a dry cough.
- Try a salt water gargle. Saline (salt water) has been shown to have antibacterial properties. Bacteria prefer an acidic environment and salt water makes your mouth and throat more alkaline.
- Don't smoke. Smoking dries out the airways and introduces irritants to the throat and lungs.
- Avoid airborne irritants such as smoke, pollution, or dust. If you can't avoid irritants, wear a mask.
- Use a humidifier to help keep your airways from drying out. You also can breathe in warm mist from a bathroom shower.
- Use extra pillows to elevate your head when you sleep.
6 Ways to Stop a Cough
Summary
Cough medicines for adults include cough suppressants, expectorants, and multi-symptom cough formula.
Dextromethorphan is the suppressant used in OTC remedies that acts on the brain to suppress the cough reflex. Guaifenesin is the OTC expectorant that thins mucus so you can cough it up. These drugs can be co-formulated in multi-symptom remedies along with antihistamines, decongestants, and pain relievers.
Cough medicines should not be used in children under 6 years.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus. Dextromethorphan.
Wark P. Bronchitis (acute).BMJ Clin Evid. 2015;2015:1508.
MedlinePlus. Guaifenesin.
National Capital Poison Center: Poison Control. Cough and cold medicine safety.
American Academy of Family Physicians. OTC cough and cold medicines and my child.
American Lung Association. Learn about cough.
Kaiser Permanente. Relieving a cough.
Seattle Children's Hospital. Coughs: Meds or home remedies?
Penn Medicine.Cough.
Williams, Daily & Frazier Dental. The Science Behind Salt Water Rinses for Your Mouth.
:max_bytes(150000):strip_icc()/DUDANEW-59495ac65f9b58d58a86b566.jpg "Choosing the Best Cough Medicine for Adults (2)")
By Kristina Herndon, RN
Kristina Herndon, BSN, RN, CPN, has been working in healthcare since 2002. She specializes in pediatrics and disease and infection prevention.
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