Are you coughing and would you like to use cough syrup? You can save this money…

There are plenty of cough suppressants, but their effectiveness leaves much to be desired, according to a 2018 study by researchers from the University of Basel and the University Hospital of Basel. After systematically analyzing six studies on the effects of cough medicines, they concluded that None of the treatments showed any clear benefit in curing so-called subacute cough. Subacute cough usually lasts three to eight weeks and goes away on its own.

As part of the study, seven different active ingredients were examined. According to the results, the healing of the cough was not significantly improved by any of the treatments. In all patients, cough symptoms resolved with and without treatment.

Study leader Lars G. Hemkens states:

Despite the seemingly unprovable effectiveness of cough medicines, the choice is enormous. The entire drug jungle can be easily divided into five areas of application. These in turn usually contain the same few active ingredients in different combinations and strengths. When choosing the cough medicine, the type of cough is central: there are coughs with mucus (productive) and there are dry, irritating coughs (unproductive).

These are the five impact areas:

These cough medicines are used in productive coughs and affect the production, consistency and removal of mucus. One of the most common expectorant medications available without a prescription is guaifenesin. It is said to thin the mucus and thus promote phlegm. The drug is classified as effective by the US Food and Drug Administration (FDA), which is responsible for the approval and market surveillance of foods, drugs, cosmetics and medical devices. However, the evidence for this is limited and controversial, writes the pharmacy journal DrugTopics. However, because the drug is considered low risk, its use in patients with severe coughing may be considered on a case-by-case basis.

Unlike expectorants, suppressants, also called antitussives, are only used for dry, irritating coughs. These cough medicines suppress the cough reflex in the brain. Over-the-counter ingredients such as dextromethorphan and butamirate are often used for this. Cough medications containing opioids, such as codeine, are available by prescription in Switzerland. They may only be given to customers after a documented consultation – even without a doctor’s prescription. By recording the personal data of customers, the aim is to prevent misuse of cough medicines. The reason for this is the sedative effect of the opioids it contains, which at higher doses leads to states of intoxication and dependence.

If you not only have a cough but also a stuffy nose, you should use decongestants. Active ingredients such as xylometazoline, okymetazoline and pseudophedrine constrict the blood vessels in the nose, causing the mucous membrane to swell. The accumulated discharge can drain and the nose is clear again.

Decongestants, also called decongestants, are usually administered as nasal drops or nasal sprays. But be careful: prolonged use can lead to chronic swelling of the mucous membrane and thus to dependence on the active ingredient. For this reason, such nasal drops and sprays should never be used for more than seven days.

The effectiveness of antihistamines depends on the cause of the problem. If allergies like hay fever are responsible for coughing and nasal congestion, antihistamines work exactly as their name suggests: they block histamine. It’s the chemical that causes runny noses and watery eyes in allergy sufferers.

But if you suffer from a stuffy nose and cough from a cold, histamine has nothing to do with it. Still, some antihistamines can help reduce nasal discharge and suppress coughing, according to a release from Harvard Health Publishing, the media and publishing arm of Harvard Medical School. It is still unclear exactly how this works.

However, in the 2015 Cochrane Review, in which research results were systematically analyzed and summarized, the effectiveness of antihistamines against symptoms in cold patients could hardly be proven.

Over-the-counter cold medications such as acetaminophen, ibuprofen, and acetylsalicylic acid (ASA – found in aspirin) can help with cold-related sore throats, headaches, body aches, and earaches. Although all three remedies have an analgesic and fever-reducing effect, only ibuprofen and ASA are anti-inflammatory.

Please note: Many cold and cough preparations already contain paracetamol. Additional intake of this active ingredient can lead to liver damage.

If you want to bring out the big guns, you can buy combination preparations at the pharmacy without a prescription that contain a whole cocktail of different active ingredients. Headache, fever, nasal congestion and productive cough. The solution seems within reach: a decongestant, a painkiller and an expectorant in one!

It’s not that simple. When you have a cold, the symptoms often appear one after the other and with different intensities. That is why a combination preparation often goes too far and puts unnecessary strain on the body. You are also at increased risk for side effects and interactions. Stiftung Warentest therefore advises against such preparations and instead recommends treating the symptoms individually.

Coughing yourself is bad, having a coughing child is even worse. Because: You can’t really do much to help the child. No, even worse: you don’t have to do anything either. Of course, this does not mean that you should ignore the child, but in any case you should stay away from cough medicines.

Pediatrician Corinne Wyder from Burgdorf no longer prescribes cough medicine to children. She explains to SRF:

The new recommendations from Pediatrics Switzerland, which Corinne Wyder also co-authored, advise against cough medicine for children. Because these are not only ineffective, but can even be dangerous. Children often have to be treated in emergencies because they drank too much cough medicine without supervision, Alexander Möller, a pulmonologist at the Children’s Hospital of Zurich, told SRF.

The U.S. Food and Drug Administration (FDA) also does not recommend over-the-counter medications to treat cough and cold symptoms in children under 2 years of age, “as they may cause serious and potentially life-threatening side effects.” The American Academy of Pediatrics, the equivalent of Pediatrics Switzerland, even recommends against giving cough medicine to children under the age of six.

With patience.

So far, cough medications have not been proven to speed the healing process or even be effective. Although the latest studies show that honey relieves coughs better than cough medicine, the evidence is still very poor. However unsatisfactory it may be, in most cases it is simply a matter of biting the bullet or coughing it up. If you have an acute cold, the cough should disappear completely after two to three weeks. For the subacute cough mentioned at the beginning, you must be patient for a maximum of eight weeks.