date: 12/20/2006
How to treat a cough
Do you wonder why your cough medicine never seems to work? ConsumerReportsHealth.org provides nondrug alternatives and helps you sort through the many drug options for treating a cough, so you can talk to your doctor about the best treatment for you.
Subscribe to ConsumerReportsHealth.org today and learn about differences among older antihistamines, decongestants, and prescription nasal sprays.
Traditional over-the-counter cough drugs, such as Mucinex DM, Robitussin Maximum Strength, and Vicks 44 Cough Relief, are largely ineffective against the most common coughs, experts say. The same goes for prescription codeine, studies suggest. But there are effective remedies--including OTC drugs that attack the underlying cause.
WHAT CAN HELP

Most coughs are caused by postnasal drip from a cold or allergy that irritates the throat. You can usually treat such coughs on your own. In addition to postnasal drip, cold symptoms include a stuffy or runny nose, a scratchy or mildly painful throat, coughing that starts a day or two after the nasal symptoms, and possibly a mild fever. Allergies feature similar symptoms but without fever and often with watery, itchy eyes, sneezing, and some identifiable trigger.

The following steps, starting with nondrug measures, can help relieve these coughs:
  • Use humidity. Drape a towel over your head and inhale from a bowl of steaming hot water three or four times a day. Or use a humidifier, provided you clean it first and dry it after each use to discourage bacterial and fungal growth.
  • Drink hot liquids. Hot drinks, soups, and syrupy substances soothe the throat. Chicken soup not only soothes but may also have some antiviral activity.
  • Suck lozenges. Choose nonmedicated lozenges containing glycerin or honey (which coat the throat). Even sugar-free hard candy can help by stimulating saliva flow. Don't bother with medicated cough drops, which work no better than other drops.
  • Know the limits of herbal remedies. Slippery elm (Ulmus rubra), plantain (Plantago lanceolata), and marshmallow (Althaea officinalis) contain slippery substances that may soothe throat irritation, although their effectiveness has not been proved. Avoid herbal cough remedies if you're pregnant or breast-feeding, and talk to your physician before taking them if you're on other drugs.
  • Take medication if needed. You may get relief from an older antihistamine such as chlorpheniramine (generic, Chlor-Trimeton) or diphenhydramine (generic, Benadryl Allergy); the decongestant pseudoephedrine (generic, Sudafed); or both drugs combined in products such as Benadryl D or Chlor-Trimeton Allergy-D. But the older antihistamines can cause sleepiness, and the newer, nondrowsy versions don't ease cold-related coughs. And you now have to sign a register and show identification to buy products containing pseudoephedrine, since it can be converted to the illicit drug methamphetamine.
As an alternative, ask your physician about the prescription nasal spray ipratropium (generic, Atrovent) to dry the drip. Note that it may be inappropriate to use either the nasal spray or an antihistamine if you have glaucoma or prostate enlargement. And the decongestant may be inadvisable if you have anxiety, diabetes, coronary heart disease, hyperthyroidism, or high blood pressure.


This article first appeared in the December 2006 issue of Consumer Reports on Health.


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