How to Treat a Cough

Should you take an over-the-counter cough medicine, or are there better options? Here's how to treat a cough with both OTC and home remedies.

When a cold or other respiratory infection leaves you with a hacking cough that disrupts your work and interrupts your sleep, you could reach for an over-the-counter (OTC) cough suppressant. Yet chances are, it won’t do you any good.

How to treat a cough

Over-the-counter cough remedies to treat cold or flu-related coughs include antitussives, expectorants, antihistamines, and decongestants. Antitussives are cough suppressants that work by blocking the cough reflex. Expectorants loosen mucus, making it easier to bring it up and out of the airways. Antihistamines and antihistamine/decongestants clear up nasal congestion, and may help coughs caused by postnasal drip.

Do these drugs actually work? A 2014 Cochrane review evaluated 29 studies on over-the-counter medicines, and found no real evidence antihistamines, decongestants, or antitussives ease coughs. (The review didn’t look at expectorants.) The authors cautioned they had few studies of each drug type to review, so it was hard for them to draw any real conclusions. But many of the studies that did yield positive results were sponsored by drug companies.

Despite finding little evidence OTC cough medicines work. The analysis noted some mild but unpleasant side effects, such as nausea, vomiting, headache, and fatigue. So by taking these drugs you could get the downsides, with little to no benefit.

Prescription cough medicines

Drugs your doctor prescribes are typically more effective at easing coughs than OTC medicines, but they’re usually considered a last resort when nothing else has helped. Many prescription cough medicines contain powerful narcotics, which can cause serious side effects — even death.

In 2008, the Food and Drug Administration (FDA) issued an alert on the narcotic cough medicine Tussionex (hydrocodone and chlorpheniramine), after receiving numerous reports of life-threatening side effects from the drug. “There is a real and serious risk for overdosing if this medication is not used according to the labeling,” said Curtis Rosebraugh, MD, MPH, acting director of the FDA’s Office of Drug Evaluation II.

Coughs and kids

For adults, taking an OTC cough medicine might not help, but it probably won’t cause much harm. The same is not true for young children, in whom cough medicines can cause serious side effects, such as rapid heart rate, convulsions, or death. For this reason, cough and cold medicines are not recommended for children younger than four years old. Kids ages 5 to 11 can take OTC cough medicines, but the FDA warns parents to follow the dosing directions carefully and not give children more than is appropriate for their age and weight.

A cough will usually clear up in a week or two once the infection that caused it runs its course. If your child needs relief in the meantime, ask your pediatrician for advice on the best way to treat the cough.

Non-drug cough remedies

You may be just as likely to find an effective cough remedy in your pantry as you are in your medicine cabinet. One study by researchers at Penn State College of Medicine found that a spoonful of buckwheat honey relieved children’s coughs and helped them sleep better than dextromethorphan, an ingredient in cough suppressants. The only side effects honey caused were mild, such as hyperactivity. Other natural remedies have also been touted for cough relief — including licorice and ginger — although there isn’t any real evidence to show they work.

One easy way to soothe a cough without medicine is to drink more water and other fluids, which helps loosen trapped mucus. Or, turn on a cool-mist humidifier or steam vaporizer.

If you or your child has a cough that lingers for more than a week or two or is severe, call your doctor. It could be caused by a bacterial infection, which will need to be treated with antibiotics. It may also be caused by allergies or asthma, or even acid reflux; your child’s doctor will need to treat the underlying problem for the cough to go away.