Cough Medicine: When to Use It, Which to Choose, and When to Get Checked

A cough is your body's way of clearing your airways, so it isn't always something to stop. But a dry, hacking cough that keeps you up at night is another story. Here's a pharmacist's guide to when a cough medicine makes sense, which kind to choose, and when to get checked instead.

First: what kind of cough is it?

• Dry cough. Tickly, with nothing coming up. This is the kind a cough suppressant is meant for, especially when it's stopping you from sleeping.
• Wet (productive) cough. You're bringing up mucus. That mucus needs to come out, so suppressing the cough isn't usually a good idea. An expectorant, plenty of fluids and steam may help more.

Your options

Honey. A teaspoon of honey, alone or in warm water, is a good first choice for a cough from a cold, for adults and children over one year old. Never give honey to a baby under one.

Dextromethorphan (the "DM" on many labels) is the most common non-prescription cough suppressant. It's mainly for dry coughs. It can interact with some antidepressants and other medications, so check with us if you take anything regularly.

Guaifenesin is an expectorant. It's meant to loosen mucus in a wet cough rather than stop the cough.

Codeine cough products are more restricted. Codeine should not be given to children under 12, and it isn't recommended while breastfeeding. It can also cause drowsiness and constipation. Ask a pharmacist before using it.

Combination "cold and cough" products often contain several medicines at once, such as a decongestant, an antihistamine and a pain reliever. Check the label so you don't double up on something you're already taking.

Children

In Canada, over-the-counter cough and cold medicines are not recommended for children under six. For young children, rest, fluids, saline for a stuffy nose and, for kids over one, honey are the safer options. Ask us before giving anything.

Is a medication causing your cough?

Some blood pressure medications, called ACE inhibitors (their names usually end in "-pril", like ramipril or lisinopril), cause a dry, persistent cough in some people. It can start weeks or even months after beginning the medication. If that sounds familiar, don't stop your medication. Talk to your pharmacist or doctor, since there are alternatives.

Acid reflux can also cause a lingering cough. Here's more on heartburn and reflux.

When to see a doctor

• A cough lasting more than three weeks
• Coughing up blood
• Shortness of breath, wheezing or chest pain
• A high fever, or a fever that lasts more than three days
• Night sweats or weight loss you can't explain
• A cough in a baby under three months

If you have asthma or COPD and your cough is getting worse, contact your doctor rather than reaching for a cough medicine.

For more on getting through cold season, see what actually helps with colds. Not sure which product fits your cough? Stop by 430 The Boardwalk or call (519) 578-3000. We'll help you choose, free.