Some Cough Medicines May Hurt, Not Help

Over-the-counter cough medicines do little good and may harm children, U.S. experts said in guidelines released Monday.

Adults are better off using older-type nonprescription antihistamines and decongestants to stop the flow of mucus that causes the cough, the American College of Chest Physicians said in its guidelines.

“There is no clinical evidence that over-the-counter cough expectorants or suppressants actually relieve cough,” said the chairman of the guidelines panel, Dr. Richard Irwin of the University of Massachusetts Medical School.

“There is considerable evidence that older-type antihistamines help to reduce cough, so unless there are contraindications to using these medicines, why not take something that has been proven to work?”

Dr. Peter Dicpinigaitis, a panel member who runs a cough clinic at the Montefiore Medical Center in New York, said cough medications might help some patients, but they carried the risk of oversedation, which was especially dangerous to children.

The older-generation antihistamines that work against cough include chlorpheniramine, Dicpinigaitis said.

Newer, brand-name antihistamines such as Claritin and Zyrtec do not help coughs, Dicpinigaitis said.

Under the new guidelines, adults with acute cough or upper airway cough syndrome, commonly known as postnasal drip, should use an older variety of antihistamine with a decongestant.

For children, Irwin said, “In most cases, a cough that is unrelated to chronic lung conditions, environmental influences or other specific factors will resolve on its own.”

The guidelines follow several studies that have suggested that nonprescription cough remedies do little more than offer comfort to patients.