What's the Best Cough Medicine? OTC vs. Prescription Cough Suppressants

Non-prescription and over-the-counter cough suppressants

Acute cough due to a viral upper respiratory tract infection (URI) is the most common form of cough—and a ton of money is spent on making and marketing drugs to manage it.

You may be surprised to hear that studies show that over-the-counter cough suppressants like Robitussin aren’t any more effective than a placebo. A review of studies on OTC medications for acute cough also found fairly disappointing results for the effectiveness of Mucinex and antihistamine decongestants like Dimetapp and Delsym. The review concluded that there is no evidence for or against the effectiveness of these medicines for an acute cough.

What works then? Here’s a cool fact: honey (specifically buckwheat honey) can suppress a cough better than over-the-counter medications for children—and possibly those for adults—by forming a soothing film over irritated mucous membranes.

Prescription cough suppressants

Still coughing? Consider benzonatate (Tessalon) capsules. Benzonatate is a prescription, non-narcotic cough medication that numbs the airways, air sacs (alveoli) in the lungs and the lining of the lungs (pleura). You can take a recommended dose every eight hours. Additionally, studies show that benzonatate combined with 600 mg of Mucinex works even better than benzonatate alone.

What about adding inhalers when you have a cough? If your doctor hears wheezing with your cough, they may prescribe an albuterol inhaler like Proventil or Proair. Routine use of inhalers like Proventil and Proair, however, has not been shown to improve the severity of a cough or shorten its duration.

Codeine cough suppressants like promethazine/codeine should only be an option for short-term use in desperate times. If your cough is keeping you up at night, these can help. Just know that their daytime use is limited because they can make you feel dopey during the day, and codeine may make some folks nauseated. Oh, and they’re habit-forming.

Hope this helps.

Dr O.

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