Cough medications are available in over-the-counter (OTC) and prescription formulas. They may help suppress the urge to cough or break up mucus in the case of productive coughing. However, evidence to support their efficacy is limited.

Cough medication is a commonly available item at pharmacies. The active ingredients in cough medications may be included in multi-drug formulas, such as cold and flu medications, or as independent cough medications. Formulas are available for both children and adults.

It is important to note that different types of cough medication may interact with other medications and may not be safe for everyone, such as people who are pregnant. Some people may also misuse cough medication and take it for recreational purposes or in ways that differ from the product instructions.

This article reviews the different types of OTC and prescription cough medications available in the United States, the possible side effects of taking cough medications, and when to see a doctor.

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There are two main types of OTC cough medications available from the pharmacy. They include antitussives and expectorants.

Other medication types, such as antihistamines and vapor rubs, may also help relieve a cough.

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Antitussives

Antitussives are a common cough medication that may be available for adults and children. They come in a variety of doses and oral formulas.

One of the most common compounds in brand and store own-brand antitussive medications is dextromethorphan. Experts speculate it works by suppressing the central nervous system’s cough receptors, which interferes with the cough reflex to prevent a person from coughing.

Dextromethorphan may interact with other medications, and it can cause a range of effects at high doses, such as euphoria, which means it has the potential for misuse.

It is also important to note that researchers indicate that there is little evidence to support the efficacy of most antitussive medications.

Learn more about drug interactions.

Expectorants

People may use OTC expectorants to help relieve a wet cough, or a cough that produces mucus. Expectorant medications help to break up and clear mucus from the airways.

Currently, the Food and Drug Administration (FDA) has only approved an expectorant medication called guaifenesin for OTC use. Researchers suggest it may work by helping to hydrate and thin the mucus, making it less sticky and easier to cough up.

Some studies involving guaifenesin in acute upper respiratory infections or stable chronic bronchitis suggest it has a favorable safety profile and can be effective. However, more research is necessary to prove its efficacy.

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Other medications

Researchers suggest that antihistamines may have antitussive effects, particularly if the cough is due to an itching throat from allergies. However, limited evidence supports their use as a cough treatment.

Vapor rubs are another type of medication that people may use to help relieve a cough. These topical medications may contain a variety of ingredients, such as:

However, there is limited evidence to support the efficacy of vapor rubs.

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Similar to OTC medications, prescription cough medications come in two main forms, including antitussives and expectorants.

Antitussives

Prescription antitussives may include certain opiates. These medications work similarly to dextromethorphan by suppressing the cough reflex. Some examples include:

These medications may be effective at preventing coughing at lower doses than a person would need for pain relief. However, the FDA does not recommend them for teens and children. Opiates also have a high potential for misuse.

Another type of prescription antitussive medication is promethazine. It works by suppressing histamine receptors in the nervous system. Research to support its efficacy is limited, and it has a high potential for misuse, particularly among young adults and adolescents.

Finally, benzonatate is another form of prescription antitussive. Researchers suggest that this medication may work to suppress coughing by inhibiting pulmonary stretch receptors, which help to detect and respond to excessive stretching of the lungs during large inspirations (when the lungs take in air).

It is important to note that there is limited evidence to support the efficacy of benzonatate. In 2010, the FDA released a safety announcement that warned about the risk of death from accidental ingestion of benzonatate in children under 10 years old. The warning still applies.

Expectorants

Prescription expectorants may include medications that contain higher doses of guaifenesin than in OTC formulas. They work in the same way as OTC expectorants.

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Cough medications can cause side effects. They may not be appropriate for some groups of people, including younger children and people who are pregnant.

According to a 2021 study, some possible side effects of dextromethorphan in children include:

A person should speak with a healthcare professional about potential side effects and drug interactions of any medications before taking them.

Learn more about using cough medications safely.

Potential for misuse

Some OTC and prescription cough medications have the potential for misuse, as they contain higher dosages of active ingredients than healthcare professionals recommend.

For example, people may misuse dextromethorphan because it can cause hallucinations at high doses, similar to ketamine and PCP. Misusing dextromethorphan may lead to a range of adverse health effects, including the risk of overdose and addiction.

A person should only take cough medications as instructed by a healthcare professional. People who misuse cough medications like dextromethorphan should contact a doctor who can offer advice and support to help prevent overdose and addiction.

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A person may not need to see a doctor or take any medication if their cough is due to a cold and goes away within a few days.

However, according to a 2021 study investigating the use of antitussive medications in children, due to the possibility of potentially serious side effects, a person should talk with a doctor before taking any cough medications. Particularly if they:

  • do not know the underlying cause of the cough
  • might be pregnant
  • take other medications
  • have other health conditions

A person should consider speaking with a doctor if their cough does not go away within a few weeks.

Learn when to see a doctor about a cough.

There are two main types of OTC and prescription cough medications. One suppresses the cough (antitussives), while the other (expectorants) helps break up mucus, making it easier to cough up.

Research suggests that there is little evidence to support the efficacy of cough medications. They may also cause side effects, and some cough medications have the potential for misuse. People should speak with a healthcare professional before they take any cough medications.

A person should also speak with a doctor if they have a cough that does not go away within a few weeks.