Does Cough Syrup Actually Help?

Does Cough Syrup Actually Help?
By Kurtis Bright

The Formula for Cough Syrup Essentially Hasn't Changed in 50 Years. Does It Do You Any Good?

It's winter in the northern hemisphere, and that means cold season. We've all heard or felt that rasping, dry cough that just won’t go away. The tickle in the throat that threatens at any moment to burst out of your lungs and throat like a creature from the “Alien” movies in paroxysms of uncontrollable coughing, those horrid coughs that seem to hang on, and on, and never quite go away.

 What can you do when you feel so helpless?

More people go to the doctor for coughs than any other single symptom. We spend billions of dollars a year on various cough suppressants, expectorants, and other supposedly “soothing, throat-coating” medications. 

The thing is, though, there's not a whole lot they can actually do about a cough--the syrups or the doctors.

Cough medicine is largely made up of the same ingredients as it was 50 years ago. Little has changed in the “science” of cough syrup--so should we keep using them? Do they have any effectiveness at all?

Not so much, according to some experts.

“We've never had good evidence that cough suppressants and expectorants help with a cough,” said Norman Edelman, MD, senior scientific advisor at the American Lung Association in a WebMD interview. “But people are desperate to get some relief. They're so convinced that they should work that they buy them anyway.”

That’s a pretty harsh, blanket judgment, which, no doubt many in the cough syrup industry would refute. So let’s take a look at the evidence.

One metastudy looked at over a dozen studies across many years that evaluated the efficacy of over-the-counter drugs and found no proof that they are in any way effective at helping ease your cough. This evaluation includes dextromethorphan, the well-known cough suppressant, and guaifenesin, which purports to loosen up mucus in the airways.

That’s not to say that those drugs aren't completely useless; ample evidence exists that they suppress coughs and bring up mucus, respectively. But do they help make your cough go away? Eh, not really. Another survey of cough medicine studies found no evidence that they help with coughs caused by viruses.

Indeed, this clear lack of effectiveness combined with the risk of serious side effects in children prompted the Food and Drug Administration in 2008 to recommend that toddlers and infants not be given cough syrup, even formulae designed for them. Now they only recommend cough syrup for children four and older. And the American Academy of Pediatrics says to hold off administering cough syrup until a child is at least six years old.

That said, for adults and children over the age of six there is little chance of serious side effects, as long as you are aware of potential drug interactions and take appropriate precautions. Indeed, with a cough that is persistent or becoming painful, experts say a cough suppressant may be appropriate.

“I consider a cough suppressant in some patients who have a chronic cough that hasn't responded to other treatments,” said John E. Heffner, MD, past president of the American Thoracic Society.

Just don’t fool yourself: none of these medicines can make a cough go away.

Time is the only cure.

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