When a cold or flu comes on, its partner may be a cough, usually a dry hacking cough that’s a social liability by day and then keeps you awake at night. The chemist’s shelves are packed with cough medicines, syrups, lozenges, tablets and drops. Some contain combinations of ingredients and promise to solve all your problems at once. Which of these products should you try? Some time back the medical journal published a review of studies of over the counter cough remedies and found no good evidence that any of them work. Even that old standby codeine is not an effective cough suppressant. Cough remedies, they conclude, are probably a waste of money.
Nevertheless, very few good studies have ever been done, and the researchers advised caution in interpreting these negative findings. Critics of the study say that cough remedies must work because so many people use them, there’s a hole in the logic there. Coughing can be so tiring, especially when it keeps you from sleeping or otherwise proves exhausting, that it’s natural to want to do something. And anything that gives you at least a sense of control may help.
Cough it out: First consider whether the cough is productive or not, that is, is it bringing up phlegm? If so, it serves a purpose, and it’s best not to suppress this kind of cough, unless it keeps you from functioning. In contrast, dry cough that usually accompanies the first stages of a cold is nonproductive.
The old ways: If you want to treat your cough, first give home remedies a try:
• Increase your fluid intake, like water, juices, tea. Keeping your throat moist helps make your cough productive.
• Hot chicken soup is soothing. So is hot tea with plenty of lemon juice and honey.
• Breathe steam and keep the air humidified, if possible.
• Suck on a lemon drop or other hard candy to promote saliva flow. Sugarless gum may also help. Cough drops and lozenges with combinations of ingredients are generally harmless, but there is no evidence they are any better than hard candy.
• Gargle with a mild salt solution every hour or so.
• Rub a camphor ointment on your chest if you’re at home where the smell won’t bother anyone. It’s the only topical treatment for coughs approved by the FDA.
Drugstore options: If home remedies fail, try one of the following over the counter products. Cough products come in three types: suppressants, expectorants and combination products.
Suppressants, the most common kind act on the cough center in the brain. Some contain the narcotic codeine, which in studies has been found ineffective. It also has side effects such as constipation, nausea. But if you take it at bed time, it is most appropriate.
Expectorants claim to loosen the mucus and turn a dry cough into a productive cough. The active ingredient is guaiphenesin, which was shown effective in at least one clinical trial. It has few side effects.
Combination products may combine a suppressant or expectorant with an antihistamine or decongestant or both, and sometimes a pain reliever.