Over The Counter drugs for Cough

The common over-the-counter (OTC) medications for cough have been grouped as:

Expectorants

Mucolytics

Antitussives

Decongestants

Antihistamines

These medications should not be given to children under 2 years of age and young children unless advised by a physician. 1, 3 

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Expectorants

These drugs help in increasing the volume of the sputum thereby facilitating the removal secretions from the respiratory tract. Guaifenesin (glyceryl guiaiacolate) is the only expectorant that has been approved for OTC use.

Indications: Productive cough.
Contraindications: Known allergy to the drug, Persistent cough due to asthma, Children below 2 years
Side-Effects: Gastric irritation, Dizziness, Headache, Rashes

Mucolytics

The thick sputum is broken down by these drugs, which help in easier removal of the sputum thereby clearing the airway.

Some of the commonly available OTC mucolytic agents include:

  • Acetylcysteine (fluimucil and ACC syrup)
  • Carbocisteine (rhinathiol 2% syrup)
  • Bromhexine hydrochloride (vasican, bisolvan)
  • Ambroxol hydrochloride (mucosolvan)
Indication: Productive cough with thick phlegm.
Contraindications: Known allergy to the drug, Individuals with peptic ulcers

Antitussives

The antitussives moderate the cough reflex either locally (in the throat or mouth) or centrally (act on the nerves that carry the cough sensation). Drugs that are categorized as centrally acting antitussives include:

  • Codeine phosphate (procodin, phensedyl, fedac compound, dhasedyl)
  • Pholcodine
  • Dextromethorphan
Further codeine and pholcodine are grouped as narcotic antitussives while dextromethorphan falls under non-narcotic antitussives.
Indication: Cough, which is associated with allergy or common cold.
Contraindications:
  • Known allergy to the drug
  • Individuals suffering from disorders such as asthma
  • Individuals who are receiving other similar drugs
  • Pregnant women and breast-feeding women
Side-Effects: Constipation, Dependency on the drug (especially codeine)

Decongestants

Decongestants are primarily used to relieve nasal congestion, but may be available as a combination with the other cough medications for nasal congestion associated with cough.

The main drugs under this category include:

  • Ephedrine
  • Pseudoephedrine
Indication: Nasal congestion associated with cough.
Side-Effects
  • Unwanted stimulation of the nerves of the heart and central nervous system (effect more prominent in elders and children)
  • Interact with other drugs such as furazolidine, tricyclic antidepressants, urinary acidifiers and urinary alkalinizers
  • Can exacerbate underlying conditions such as hypertension, diabetes, hyperthyroidism, heart disease

Antihistamines

Antihistamines are primarily advised to counter inflammatory or allergic conditions. These are sometimes included in cough medications for their antitussive action.

Some of the common antihistamines include:

  • Chlorpheniramine
  • Dexchlorpheniramine
  • Diphenhydramine
  • Cetirizine

Indication: Nasal congestion associated with cough.

Side-Effects: Dose dependent action on the central nervous system, Sensitivity to light
Written by: Healthplus24 team
Date last modified: March 21, 2012