Coughing is your body’s way of getting rid of harmful irritants and germs. The cough reflex pushes air out of your lungs to drive out whatever is bothering you.
But while coughing is an important function, frequent or painful coughing can seriously affect your daily activities. This is when most people turn to cough medicine to stop their symptoms.
In this article, we will detail some of the best over-the-counter (OTC) and prescription cough medicine options available.
Common causes of coughing
The cause of your cough depends on what type of cough you have. There are two primary types of cough: acute and chronic.
An acute cough lasts for three weeks or less, and is caused by a temporary illness, like the common cold.
Potential causes of acute coughs include:
- The common cold
- Influenza (the flu)
- Pneumonia
- Whooping cough
- Allergies
A chronic cough lasts longer than eight weeks in adults and four weeks in young children. It’s usually caused by longer-term health issues like allergies or asthma.
Potential causes of chronic coughs include:
- Allergies
- Asthma
- Chronic obstructive pulmonary disease (COPD)
- Bronchitis
- Acid reflux (GERD)
- Medication reaction
- Congestive heart failure (CHF)
The best OTC cough medicines for adults
The best cough medicine for adults will depend on the type of cough you have and what's causing your symptoms.
Based on your symptoms, try these OTC cough medicines:
- Best cough suppressant for a dry cough: Antitussives like Robitussin
- Best cough medicine for a wet cough: Expectorants like Mucinex
- Best cough medicine for cough caused by allergies or post-nasal drip: Antihistamines like Benadryl
- Best cough medicine for a cough that occurs with other symptoms (like fever or chills): Combination medicine like Tylenol Cold + Flu
- Best medicine for a sore throat from coughing: Pain relievers like Tylenol or Advil -Best for cough caused by GERD (acid reflux): Antacids (Tums) or acid reducers like omeprazole (Prilosec OTC) and famotidine (Pepcid)
While OTC cough medicines don't always treat the root cause of a cough, many healthcare providers still recommend them for symptom relief.
If you have questions or concerns regarding the best treatment for coughing or if you have a chronic medical condition, talk to a healthcare provider before taking OTC cough medications.
The best prescription cough medicines for adults
Prescription cough medicine is often recommended when OTC options aren't effective. Your provider may also prescribe them if your cough is severe, persistent, or caused by an underlying condition that requires stronger treatment.
Based on your symptoms, here’s what a provider may recommend:
- Best prescription cough suppressant for a dry cough: Antitussives like benzonatate, codeine or hydrocodone (often combined with guaifenesin or acetaminophen)
- Best prescription medicine for a wet cough: Prescription-strength expectorants like guaifenesin (high dose)
- Best prescription for cough caused by allergies or post-nasal drip: Antihistamines like hydroxyzine or azelastine, or inhaled corticosteroids
- Best treatment for cough with underlying infection: Antibiotics like azithromycin (only if a bacterial infection is present)
- Best for cough related to asthma or COPD: Inhaled corticosteroids or combination inhalers (like fluticasone/salmeterol)
- Best for cough caused by GERD (acid reflux): Acid-reducing medications like proton pump inhibitors (PPIs), such as omeprazole or pantoprazole
Some prescription medications, especially ACE inhibitors used for high blood pressure, can cause a persistent dry cough. If you think your medication is causing your cough, don’t stop it on your own. Talk to your healthcare provider about switching to a different treatment.
Prescription cough medications can be more effective for certain conditions, but they may come with stronger side effects or the potential for dependence. Always consult your healthcare provider to determine the safest and most appropriate treatment based on your specific symptoms and health history.
Types of cough medicine
There are five primary types of cough medicine, each targeting a different cause or symptom. These medications come in both over-the-counter (OTC) and prescription forms, depending on the severity and underlying condition. Here’s a breakdown, along with examples of both OTC and prescription options for each.
1. Antitussives
Antitussives, also known as cough suppressants, are a family of drugs designed to suppress coughing. They do this by acting on the brain's cough reflex.
OTC antitussive options include:
- Dextromethorphan (found in Delsym, Tussin, Robitussin Cough Gels & Cough Syrup, and Vicks 44 Dry Cough Relief)
Prescription antitussive options include:
It’s important to note that other prescription antitussives contain codeine or hydrocodone, controlled substances that may cause addiction or dependency. Benzonatate is the only prescription antitussive that does not carry this risk.
2. Expectorants
Expectorant medications work by thinning mucus and phlegm from the respiratory system. The body can then expel the thinned mucus, which can relieve chest congestion.
OTC expectorant options include:
- Guaifenesin (found in Mucinex, Robitussin Chest Congestion)
Prescription expectorant options include:
- Prescription-strength guaifenesin (higher-dose formulations are sometimes prescribed for chronic bronchitis or more severe congestion)
- Potassium iodide (SSKI)
Common side effects of expectorants include nausea, dizziness, and headaches.
3. Antihistamines
Antihistamines can help ease coughs caused by an allergic reaction. They work by blocking the action of histamine. This helps reduce coughing from allergic reactions and postnasal drip.
OTC antihistamine options include:
- Cetirizine (Zyrtec)
- Loratadine (Claritin)
- Diphenhydramine (Benadryl)
- Fexofenadine
- Brompheniramine (Dimetane)
- Chlorpheniramine (Chlor-Trimeton)
- Clemastine (generic for Dayhist)
- Doxylamine (generic for Vicks NyQuil)
Prescription antihistamine options include:
Antihistamines are generally well tolerated, but they can cause side effects, including dizziness, dry mouth, nausea and vomiting, difficulty with urinating, blurred vision, and skin irritation (more common in topical antihistamine use)
If these side effects persist over a few days, or you begin to notice more severe symptoms such as shortness of breath, skin rash, or chest tightness, seek medical attention immediately.
4. Decongestants
Decongestants work by narrowing the blood vessels in the nasal passages and respiratory tract. This eases swelling and congestion, making it easier to breathe and lessening the urge to cough.
OTC decongestant options include:
- Pseudoephedrine (Sudafed)
Oral phenylephrine (Sudafed PE) is another common OTC option that is marketed as a decongestant. However, an FDA review found phenylephrine to be ineffective as a nasal decongestant and recommended taking it off store shelves in 2024.
Prescription decongestant options include:
- Prescription-strength pseudoephedrine (higher-dose formulations may be prescribed when OTC versions are not sufficient)
It is crucial to use decongestants as directed and for a limited time. Long-term use can make congestion worse. Decongestants may not be effective for coughs caused by allergies or irritants.
5. Combination medicines
Many cough and cold medicines contain two or more of the ingredients listed above. These are called combination medicines because they help ease coughing while treating flu and cold symptoms like a runny or stuffy nose and sore throat.
OTC combination medicine options include:
- Mucinex Fast-Max (Acetaminophen, dextromethorphan, guaifenesin)
- Dayquil Severe Cold + Flu (Acetaminophen, dextromethorphan, guaifenesin, phenylephrine HCl)
- Tylenol Cold + Flu (Acetaminophen, dextromethorphan, guaifenesin, and phenylephrine HCl)
Prescription combination medicine options include :
- Delsym CF (guaifenesin, dextromethorphan, pseudoephedrine)
There are also prescription combination cough medicines that contain controlled substances like codeine or hydrocodone. While effective, these medications also carry the potential for drowsiness, dependence, or misuse. Providers typically reserve them for more severe or persistent symptoms when non-controlled options aren’t sufficient.
Is cough medicine safe for kids?
The U.S. Food and Drug Administration (FDA) does not recommend giving OTC cough and cold medicines to children under 2 years old. These products can cause serious and potentially life-threatening side effects in infants and toddlers.
Here are general guidelines by age:
For children under 2 years old:
- Never give OTC cough or cold medicine due to safety concerns
For children ages 2 to 4:
- Most manufacturers recommend not using these medicines in children under 4.
- Always talk to your child’s doctor before giving any medication.
For children 4 and older:
- OTC medicine may be safe, but only if used properly
- Read the label carefully and follow dosing instructions exactly.
- Use the dosing tool (dropper or cup) that comes with the medicine—never guess the amount.
- Monitor for any side effects like drowsiness, irritability, or allergic reactions. If anything seems off, call your doctor right away.
When treating cough symptoms in young children, caution is key. If you're unsure whether a product is safe, check with your pediatrician first. Often, simple remedies like fluids, rest, and a humidifier can be the best medicine.
At-home cough remedies
If you're dealing with a mild cough and prefer to avoid medications, home remedies may help soothe your symptoms and support recovery. At-home options include:
- Honey: Honey is a natural remedy for easing sore throats and mild irritation. Mix honey with warm water or herbal tea for a soothing drink. Honey should not be given to children under 12 months due to the risk of botulism.
- Lozenges: Lozenges (cough drops) are a popular over-the-counter remedy for a cough. These tablets dissolve slowly in the mouth, relieving dry and productive coughs. The active ingredients in cough lozenges typically include menthol, honey, or herbal extracts. Sucking on a lozenge may be a choking hazard for young children. Do not give children under five years of age lozenges for their cough.
- Hydration: Staying well-hydrated helps soothe the throat and thin mucus, making it easier to get rid of. Warm liquids, such as herbal teas, broths, or warm water with honey and lemon can help soothe the throat.
- Gargling with salt water: This simple yet effective technique involves dissolving salt in warm water and using the solution to rinse the throat. The saltwater solution reduces swelling and irritation. It can also help to loosen mucus and remove irritants, relieving dry and productive coughs.
- Humidifying the air: Humidifiers work by increasing the moisture content in the air, which can help soothe an irritated throat and respiratory passages. Keep your humidifier clean to prevent the growth of mold or bacteria. Be sure to follow the manufacturer's guidelines for proper use.
Home remedies like the ones listed above can be a great option for kids dealing with an acute cough, since the FDA does not recommend giving young children cough or cold medicine.
How Sesame can help
If you’re dealing with an ongoing or painful cough, a healthcare provider on Sesame can offer same-day guidance and prescribe medication if appropriate.
Just book an online doctor appointment at a time that works for you – no long waits, no insurance needed. During your video call, your provider can assess your symptoms and create a treatment plan. If medication is prescribed, your prescription will be sent to your preferred pharmacy for pickup.
