Most OTC Cough Medicines Don't Work

One pill makes you larger
And one pill makes you small
And the ones that mother gives you
Don't do anything at all
Go ask Alice
When she's ten feet tall

- Jefferson Airplane, "White Rabbit".

Alice could have told you this a long time ago, but now medical researcher's agree.

New guidelines issued by the American College of Chest Physicians (ACCP) "strongly recommend against the use of OTC cough and cold medications in children 14 years-old and younger." These medicines have real risks of causing harm to children and provide little or no benefit. Specifically not found to be useful are product "containing the expectorant guaifenesin or the cough suppressant dextromethorphan."

There are a handful of exceptions to the general rule that over the counter (OTC) cough medicines should be avoided:

[A]dults with acute cough or upper airway cough syndrome (also known as postnasal drip syndrome) should be treated with a decongestant and/or a first-generation antihistamine such as Benadryl (diphenhydramine). . . .

[A]dults up to 65 years old [should] receive the new adult pertussis vaccine; about 28% of pertussis cases annually in the U.S. occur in adults . . . . the older vaccine only gives protection for less than 10 years," Dr. Irwin said. "Because the older vaccine caused serious side effects when given to older children and adults, it was only given to [young] children . . . now a new safe and effective whooping cough vaccine that can prevent adults from contracting this disease."

Special considerations also apply to individuals with chronic coughs with causes such as "upper airway cough syndrome, asthma, gastroesophageal reflux disease (GERD), smoking, and side effects from medications (e.g., ACE inhibitors for high blood pressure)."