Best OTC Cough Medicine: How Do I Choose the Right Option for Me?

A woman with a polka dot shirt and a thick white scarf around her neck pours some cough medicine into a spoon.
Summary
  • Over-the-counter (OTC) cough medicines are typically first-line treatment for coughs.
  • There are three different types of cough medicines: expectorants, suppressants, and combination medicines.
  • Before using OTC cough medicine, make sure your cough isn’t being caused by allergies, environmental irritants, or acid reflux — there are better solutions to these kinds of coughs.
  • If OTC cough medicines aren’t helping to relieve your cough, your doctor may recommend prescription cough medicines.
  • Cough medicines are typically safe, but the FDA does not recommend them for children under two years old.

Over-the-counter (OTC) cough medicines are popular in the U.S., with over 80% of adults using them as first-line treatment for illness.

Revenue from cold and cough remedies is expected to amount to $10.82 billion in 2023, and this figure is said to see an annual growth rate of 5.35%.

Dextromethorphan (Delsym) and guaifenesin (Robitussin) are among the most popular OTC cough medicines in the U.S., but there are many other options depending on the type of cough you have.

Whether you live with a chronic cough or you only deal with a cough once a year around flu season, this article will help you determine which OTC medicine is best for you.

Why Do We Cough?

A cough is a protective reflex that removes irritants — such as dust, smoke, or mucus — from your airways.

We also cough if small particles, like food and drink, “go down the wrong way” — this process is known as aspiration. If solid particles enter your airway, a strong cough is triggered to expel particles and prevent them from entering the lungs where they can do serious damage.

What Are Some Causes of a Cough?

It’s important to know what’s causing your cough before you start using OTC cough medicine. Not all coughs require cough medicine, and using it might not help — it could even worsen your cough.

Allergies

Allergic rhinitis, which is commonly called hay fever, can cause a chronic dry cough that’s often accompanied by symptoms like a runny nose, itchy eyes, and congestion.

People with a cough caused by allergies may notice that they cough more during some seasons than others, or that their coughing is triggered when they spend time in certain environments.

Some common triggers of coughs caused by allergies include dust, mold, pet dander, and cockroaches — especially roach droppings.

To treat a cough triggered by allergies, you’ll need to have a good allergy management plan. This may include using antihistamines and nasal sprays, removing your triggers, and practicing good sleep hygiene.

Irritants

Wood dust, fungi, chemicals in cleaning products, air pollution, and secondhand smoke are some examples of irritants that can cause coughs.

People who work in environments where they are exposed to irritants on a daily basis can develop occupational asthma. People with this condition typically develop shortness of breath, chest congestion, and a chronic cough.

Farmers, metal workers, millers, bakers, laboratory staff, and detergent manufacturers are among the workers in the U.S. who are most at risk of developing occupational asthma.

Fortunately, occupational asthma can be reversed by identifying and avoiding the triggers. Breathing aids — like dust masks and respirators — and medications can also be used as treatment.

Postnasal drip

Postnasal drip — which is also known as upper airway cough syndrome — occurs when mucus buildup drains down your throat, causing discomfort, coughing, or the sensation of something being stuck in your throat.

Treatment for this condition includes drinking more water, using a nasal rinse, and taking oral decongestants and antihistamines.

Depending on the cause, postnasal drip can also clear up without treatment.

Acid reflux

Acid reflux can trigger your cough reflex. If acid reflux is causing your chronic cough, a cough suppressant won’t help.

To treat a cough triggered by acid reflux, you’ll need to make diet and lifestyle changes — like maintaining a healthy weight, not eating before bedtime, and avoiding certain foods — to alleviate your cough.

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Other factors or conditions

A cough is a common symptom of many medical conditions. So if you can’t figure out what’s causing your cough and it doesn’t match anything we’ve listed above, see a primary care doctor for a formal diagnosis.

Here are some conditions that may be causing your cough:

  • Sinusitis
  • Pneumonia or bronchitis
  • Emphysema
  • Colds or flu
  • Sleep apnea

Could it be lung cancer?

A cough that won’t go away or worsens is sometimes a sign of a serious underlying condition.

The Moffitt Cancer Center lists a constant cough, chest pain, wheezing, hoarseness, and unexpected weight loss as some of the symptoms that would require urgent medical attention.

If you can’t stop coughing, get in touch with LifeMD. If lab tests or imaging are required, we can arrange for you to visit a local facility.

When is a Cough an Emergency?

Most times, a cough is not an indication of anything serious, but a cough could also be a medical emergency.

If you also experience any of the following symptoms, call 911 immediately:

  • Breathing difficulties
  • Vomiting or vomiting
  • High fever
  • Chest pain
  • Fatigue

How Do I Choose the Best Cough Medicine for Me?

If your cough isn’t caused by an environmental factor — like an allergy or irritant that you can remove or protect yourself against — cough medicine may be the best solution.

But with so many options on the market, how do you know which cough medicine is right for you?

Determine what kind of cough you have

Different types of coughs require different treatments. If you don’t know what kind of cough you’re treating, you may take the wrong medication and worsen your condition.

For example, if your cough is trying to clear particles from your airway and you use medication that blocks your cough reflex, these particles will reach your lungs and cause breathing difficulties.

It’s therefore important to identify your cough by its symptoms and treat it appropriately. Listed below are the main types of coughs:

Dry cough

Also known as an unproductive cough, a dry cough produces little or no mucus. People who are prone to dry coughs often feel a little “tickle” in their throat and they may experience frequent coughing fits.

Inflamed or irritated airways can cause a dry cough and they often occur in people who have conditions like sinusitis, allergies, asthma, or tonsillitis.

A dry cough can be serious if it is accompanied by symptoms like appetite loss, chest pain, high fever, and shortness of breath.

Wet cough

Also known as a productive cough, a wet cough produces mucus or phlegm. A wet cough helps expel excess mucus from the airways and lungs, preventing buildup that can affect your breathing.

A wet cough is typically accompanied by a rattling or wheezing sound.

Colds, flu, pneumonia, and bronchitis are some conditions that cause wet coughs.

Acute cough

A cough that lasts between two and three weeks is called an acute cough. Acute bronchitis — which is also called a chest cold — is a common cause of acute cough.

Chronic cough

If your cough lasts for eight weeks or more, it’s considered chronic. A persistent cough can affect your daily life and decrease your quality of sleep.

Around 90% of all chronic coughs are caused by asthma, postnasal drip, or acid reflux, while rarer causes include lung disease, infections, and the side effects of certain medications.

It can be tricky to treat a chronic cough as it’s frequently caused by an underlying condition or behavior.

For example, you may have a patch of mold in your home that’s worsening your asthma, so your cough won’t respond to treatment because you’re not addressing the cause—in other words, you need to remove the mold or move to a different location. In a case like this, OTC medicines will not work as well as removing the asthma trigger.

What if I Have a COVID-19 Cough?

A dry or wet cough can both be a symptom of COVID-19 and only a test can determine whether you have the virus or not.

If you’ve tested positive for COVID-19, there are four FDA-approved drugs to treat the virus. They are:

  • Paxlovid
  • Vaklury
  • Bebtelovimab
  • Molnupiravir

Many people can recover from COVID-19, without these treatments.

Most doctors suggest sticking to only the above treatments (if needed), but cough medicine can be used to help manage your symptoms — just make sure you speak to your doctor first.

Choose the best OTC medicine for your cough

There are so many OTC cough medicines on the market, so it’s advised that you ask your doctor or pharmacist to recommend the right one for your cough.

Listed below are the three categories of cough medicine available:

Expectorants

Expectorants are typically used when you have a wet or productive cough. Expectorants thin mucus and loosen phlegm, making it easier for your body to expel.

Expectorants may relieve symptoms of a wet cough and clear your airways, making it easier to breathe.

Guaifenesin is one of the most popular expectorants. It can be found in Mucinex and Robitussin.

Suppressants

Also called antitussives, cough suppressants do exactly what their name suggests: they suppress a cough.

Cough suppressants are commonly used for dry coughs, but people with a chronic wet cough may also use them — though this could lead to mucus buildup and breathing difficulties.

Dextromethorphan is a common OTC cough suppressant medicine that can be found in Robitussin Cough and Mucinex DM.

Combination medicines

Some cough medicines contain both expectorants and suppressants — these are known as combination medicines. These treatments target multiple symptoms. For example, if you’re treating allergies but also fighting cough and cold symptoms, you’d use combination medicine.

Some other active ingredients found in combination cough medicines include painkillers, antihistamines, and decongestants.

Robitussin Cold and Cough is a good example of a combination medicine that’s used to treat coughs, sinus and chest congestion, and a stuffy nose caused by allergies or colds and flu.

What Side Effects Can Cough Medicines Cause?

Cough medicines, much like any other treatment, can have side effects.

It’s important to disclose all other medications that you’re using to your pharmacist or doctor before you start taking cough medicine. Mixing medications can worsen their side effects and even cause you to overdose on certain active ingredients.

Some common side effects of cough medicines include:

  • Drowsiness or dizziness
  • Blurred vision
  • Nausea and vomiting
  • Sleep disturbances
  • Headaches
  • Confusion
  • Excessive sweating
  • Constipation
  • Stomach pain
A young, dark-haired woman in a blue shirt with white polka dots sits in front of a laptop as she stifles a yawn and appears tired.

Can Anyone Take Cough Medicines?

Cough medicines are typically safe for most adults, but the U.S. Food and Drug Administration (FDA) has not approved OTC cough medicines for anyone under the age of two as their side effects may be life-threatening to babies.

Most pregnant women can also safely use cough medicines, but it’s best to check with your doctor to be safe.

It’s good practice to always check out the drug facts labels on medication to check the warnings and ingredients.

What Are Some Home Remedies for Coughs?

Parents of children under two or those in search of more natural cough remedies may want to explore the following home remedies for coughs:

  • Honey
  • Ginger, thyme, peppermint, or marshmallow root tea
  • Saltwater gargle
  • Golden milk or turmeric tea

How Do I Know If I Need Prescription Medicine for My Cough?

OTC cough medicines are typically the first go-to if you have a pesky dry or wet cough you’re trying to treat. However, if you see no improvement in your symptoms, you may need a prescription cough medicine.

Codeine and hydrocodone are two of the most popular active ingredients in prescription cough medicine in the U.S.

Both of these opioids are highly addictive. Statistics from Addiction Center show that around 500,000 Americans suffered fatal overdoses from opioids between 1999 and 2019.

If your doctor can prescribe other options, it’s best to avoid prescription cough medicines with opioids like codeine.

When Should I Talk to a Doctor About My Cough?

If your cough persists for weeks or months and it’s starting to affect your quality of life, it’s a good idea to seek professional medical advice. With LifeMD, you can speak to a board-certified doctor or nurse practitioner right from home. Head over to LifeMD to make a video appointment.

LifeMD makes it easy to stay on top of your health because talking to a doctor, filling your prescriptions, getting your labs done—and more—are all easy and cost-effective.
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This article is intended for informational purposes only and should not be considered medical advice. Consult a healthcare professional or call a doctor in the case of a medical emergency.

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