ABCs of Cough Remedies

What’s in that cough syrup? The lowdownon active ingredients.

Carol Deasy Brown

PARENTING magazine

When a child’s doctor recommends an over-the-counter cough remedy, parents can get a headache just trying to figure out what’s in the bottle. Here’s a guide to common types of active ingredients in nonprescription syrups for school-age kids.

Decongestants and Antihistamines

“Of all over-the-counter cough medicines, decongestants (such as phenylpropanolamine and pseudoephedrine) offer the most hope for symptomatic relief,” according to Dr. Richard Lampe, chairman of pediatrics at the Texas Tech University School of Medicine in Lubbock. They shrink mucous membranes and dry up the discharge and congestion that feeds a cough. In syrup form, decongestants are often paired with antihistamines (such as chlorpheniramine, doxylamine, diphenhydramine, and brompheniramine), which relieve stuffiness caused by allergies. The combination counterbalances certain side effects, including nervousness and irritability (from the decongestant), and drowsiness (from the antihistamine).

Expectorants

These remedies, which includeguaifenesin, thin the mucus, making it easier to expel, and clear phlegm from the chest or throat. Humidifying a child’s room and giving him lots of fluids to drink are also effective, says Dr. Robert Fink, a spokesman for the American Academy of Pediatrics.

Suppressants
Suppressants, including dextromethorphan, are designed to inhibit the impulse to cough — but most pediatricians generally don’t recommend them. “Coughing is a protective reflex that clears breathing passages,” says Lampe. Some medical experts warn that a suppressant can actually worsen a child’s condition, since it allows mucus to build up in the chest; other researchers say such ingredients don’t really stop the coughing. Most doctors recommend them only in rare cases — for example, when a cough is so severe that a child is vomiting or can’t sleep — and they’re usually not advisable for babies under age one, whose small breathing passages are easily plugged.

Some cough remedies also contain alcohol, usually in a concentration similar to that of table wine, about 10 percent. Although alcohol can be toxic in larger quantities, in advised doses it shouldn’t harm a child.Many doctors suggest discontinuing the use of nonprescription medications if a child’s discomfort persists. If a cough hangs on for more than two weeks, becomes severe, or is accompanied by fever or difficulty breathing, a child should see a physician. He may have a more serious condition that requires treatment with antibiotics or a stronger remedy.