Choosing the Best Cough Medicine for Adults (2024)

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.

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

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

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: