Cough

PharmDToYou is dedicated to patient care. This week, we will inform our patients about how to treat some ailments/illnesses without medications (non-pharmacological) and if needed, with medications (pharmacologic).

Today we will discuss cough. There are many reasons to have a cough (we know that this is one of many symptoms of COVID-19). There are also times when we would not treat this over the counter. In this post, we will break down who should not treat cough themselves (exclusions), what non-pharmacological treatment can be tried (ideas other than medications), and pharmacological choices that are available over-the-counter (medications you can buy without a prescription).

Exclusions – DO NOT TREAT YOURSELF AND SEEK HELP FROM YOUR PROVIDER IF:

• You have a fever over 103 degrees F
• You have a cough with significant weight loss that you did not intend, shortness of air, chest pain, chills, night sweats, rash and a throat that feels tight
• Your cough has thick sputum that is green or yellow
• You have significant history of asthma, Chronic Obstructive Pulmonary Disease (COPD), or chronic bronchitis
• Your cough has lasted more than 7 days

NON-PHARMACOLOGIC IDEAS:

• TRY THESE FIRST
• Lozenges made with Pectin (usually flavored)
• Humidification (puts moisture in the air)
• Hydration (helps hydrate your body to loosen congestion – makes you cough the stuff up)

PHARMACOLOGIC IDEAS AND KEY INFORMATION

• AVOID cold and cough medications over-the-counter for children under 4 years old unless under the direction of a healthcare provider
• Most medications are combinations of drugs including allergy medications, cough suppressants, and pain medications
• Make sure you read what the ingredients are and only treat what you need to (try not to get a combination pill if you only have a cough for instance)
• Dextromethorphan (Delsym, DM drugs) and Diphenhydramine (Benadryl)
  • Makes your body feel like it doesn’t need to cough
  • Helps with non-productive (dry) cough
  • Can cause drowsiness and dizziness
  • Dextromethorphan
    • Like Robitussin DM, usually in anything that says “DM”
    • Delsym brand is a liquid formulation
  • Diphenhydramine
    • Can dry you out – not  great for elderly or young children
• Guaifenesin (Mucinex)
  • Loosens and thins phlegm – makes you cough the stuff up
  • DRINK LOTS OF WATER – it will make sure you get up the congestion if you have a tight chest
  • DO NOT use if you often have a cough (chronic) due to COPD, asthma, or emphysema unless your provider suggests this
  • DO NOT use in pregnancy
  • Common in combination products
  • Mucinex DM is guaifenesin and dextromethorphan together

Other Important things to consider:

• Some common drugs can cause a cough that can occur at any time while you are taking it. These drugs include ACE Inhibitors like lisinopril, benazepril, captopril, enalapril, and ramipril (there are more. If you take any of these, talk to your pharmacist or provider to find out if your medication is the cause of your cough and what to do next.
• Some disease states like Congestive Heart Failure can cause cough. Talk to a healthcare provider like your physician or pharmacist if you are unsure if you need to treat your cough yourself.

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