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Expectorants are medications or natural ingredients that help clear mucus from the airways. People may take them to help alleviate congestion due to the common cold or flu.

Expectorants are available as a standalone drug or as an ingredient in all-in-one cold and flu medications.

In this article, we discuss the definition and uses of expectorants. We also explore the possible side effects of medicinal expectorants and the effectiveness of natural expectorants.

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Guaifenesin is an expectorant available in many OTC medications.

An expectorant is a medication that people can use when they have a cough that produces mucus. Doctors and pharmacists refer to these types of cough as “productive” or “wet.”

Expectorants reduce the thickness of mucus and make secretions in the airways thinner. By loosening up the mucus in these ways, expectorants make it easier for a person to cough up phlegm and clear out their throat.

Medicinal expectorants contain an active ingredient that will thin the mucus, making the cough more productive. Common medicinal expectorants include:

Guaifenesin

The most commonly available expectorant in over-the-counter (OTC) medications is guaifenesin. People can find guaifenesin in the following OTC products:

  • cough, cold, and flu remedies
  • decongestants
  • cough suppressants
  • pain and fever medications

Guaifenesin is currently the only expectorant on the market in the United States that the Food and Drug Administration (FDA) have approved.

Experts do not yet know how guaifenesin prevents coughing. However, some researchers have suggested that guaifenesin reduces the stickiness of mucus by hydrating it, which makes it easier for people to cough up.

According to the authors of a 2017 study, researchers consider guaifenesin a safe and effective expectorant for treating mucus-related symptoms in upper respiratory tract infections and stable chronic bronchitis.

However, in a 2019 review article, researchers suggest that the current research is weak and state the need for further studies of guaifenesin as an expectorant.

Potassium iodide

Potassium iodide is an expectorant that is only available via prescription.

Doctors prescribe potassium iodide oral solution to people with chronic lung diseases. This drug helps loosen mucus and make it easier to cough up. It does this by increasing respiratory secretions, which are more fluid than phlegm.

As OTC expectorants may not always be effective, some people try natural treatments instead. These may include:

Menthol

Menthol is a natural chemical that derives from plants belonging to the mint family. It is a common ingredient in throat lozenges and cough syrups.

Menthol provides a cooling sensation that can soothe a sore throat. A 2014 animal study suggests that menthol may relax the airway muscles, allowing more air to enter the respiratory system and helping improve cough and cold symptoms.

Further studies in humans are necessary to confirm the action of menthol on cough symptoms.

Ivy leaf extract

Ivy leaf extract is a popular natural remedy for cough and cold symptoms because of its supposed effects on mucus production, cough, and airway dilation.

A 2017 Polish study suggested that a medicine containing dry ivy extract may be effective in treating productive coughs, such as those that occur in respiratory tract infections.

However, more studies are still necessary to determine the effectiveness of ivy leaf extract for relieving cold and cough symptoms.

Hydration and steam inhalation

Other techniques to help release mucus from the airways are oral hydration therapy and steam inhalation. The mechanism of action behind each of these techniques is unknown, and doctors have questioned their effectiveness.

Different cold and flu symptoms require treatment with different types of drugs. A person with a productive cough can take an expectorant, but a dry or tickly cough usually requires a cough suppressant. Many OTC products contain a decongestant, but these are only effective for treating nasal congestion.

All-in-one cough, cold, and flu products may contain a combination of these ingredients. People who take all-in-one products are at risk of taking medicines that they do not need, and this can increase the likelihood of side effects.

Manufacturers sometimes add acetaminophen or ibuprofen to products to help treat pain or fever. Some products also contain an antihistamine, which can help control coughing. However, antihistamines can cause drowsiness.

Before choosing a product, people should decide which symptoms they want to treat. Anyone who is unsure whether a product is right for them should speak to a pharmacist.

Decongestants

Decongestants help alleviate a blocked nose. Phenylephrine and pseudoephedrine are two decongestants that people may find in OTC cold and cough medications.

These drugs work by constricting blood vessels in the nasal passages. This constriction increases the size of the airway, allowing people to breathe more easily through their nose.

Cough suppressants

Low dose codeine and dextromethorphan are two cough suppressants that people can find in OTC medicines.

These medications act on the centers in the brain that tell a person to cough.

One of the risks of taking an expectorant is that people sometimes use them for persistent or chronic coughs.

People should not use expectorants to mask the symptoms of a chronic cough that is due to smoking, asthma, chronic bronchitis, or emphysema.

People with excessive mucus should consult a doctor before taking OTC remedies.

Guaifenesin

Large doses of guaifenesin can irritate the digestive tract and may cause nausea and vomiting.

Potassium iodide

The most common side effects of potassium iodide are:

Menthol

Although rare, one side effect of menthol is an allergic reaction, which may include hives or difficulty breathing.

Ivy leaf extract

Potential side effects of ivy leaf extract are:

  • nausea
  • vomiting and diarrhea
  • allergic reactions, such as hives and skin rash

Expectorants are drugs or natural chemicals that may help loosen and dislodge mucus from the airways. Further studies are still necessary to prove their effectiveness.

According to the FDA, guaifenesin is the only safe and effective expectorant on the market. However, some people may prefer to try using natural expectorants, such as menthol and ivy leaf extract. Products containing guaifenesin are available to purchase in stores and online.

People should not use expectorants to mask the symptoms of a chronic cough or a cough with excessive mucus. These conditions require medical attention.