Coughs send more people to the doctor's office than any other specific symptom, according to experts. And Americans spend billions of dollars every year on over-the-counter medications to fight coughs, such as cough suppressants and expectorants.
Clearly we're concerned about our coughs. Clearly we rely on cough medication. What's unclear is the answer to this core question: Do cough medicines work?
"We've never had good evidence that cough suppressants and expectorants help with cough," says Norman Edelman, MD, chief medical officer at the American Lung Association. "But people are desperate to get some relief. They're so convinced that they should work that they buy them anyway."
Should you take cough medicine? Here's what you need to know about the pros and cons of common cough medicines.
Cough Medicine: The Evidence
Coughs cause a lot of misery. According to research:
- Coughs are the reason for more than 30 million doctor visits every year.
- By some estimates, coughs are the most common medical symptom.
- Studies show that acute and chronic coughs reduce a person's quality of life.
We're desperate for an effective cough treatment. However, we don't seem to have one. No new licensed cough treatment has appeared in more than 50 years -- and the evidence for older drugs is not strong.
- A 2010 review of studies found that there is no evidence to support using common over-the-counter drugs for cough. This includes cough suppressants, such as dextromethorphan, or expectorants such as guaifenesin, which are supposed to loosen up mucus in the airways.
- In 2006, the American College of Chest Physicians surveyed a number of cough medicine studies from the last few decades. It found no evidence that these medicines help people with common coughs caused by viruses.
It's important to understand that these studies have not proven that cough medicines don’t work. Rather, they’ve just found no proof that they do. It’s always possible that further studies could show that they help.
Cough Medicine and Children
Because of a lack of good evidence that cold and cough medicines help -- and a very small risk of serious side effects -- the FDA stated in 2008 that toddlers and babies should not use cold and cough medicines. Drug makers voluntarily changed the labeling of OTC cough and cold products, recommending them only for children aged 4 and older.
The American Academy of Pediatrics went further, saying that there's no reason that parents should use them in children under age 6.
Unfortunately, a recent survey suggests that parents aren't listening to the warnings. In a nationwide poll, more than 60% of parents with children under age 2 said they have given their kids cold or cough medicine.
Why Do We Use Cough Medicine?
Why would these medicines be so popular if they don't work very well? People find them reassuring, says John E. Heffner, MD, a pulmonologist at the Providence Portland Medical Center in Oregon and past president of the American Thoracic Society.