OTC cough medicine: Not worthwhile for children or adults?

January 23, 2008

Alert parents know that small children should not take over-the-counter cough medications. Now researchers say the stuff might not help adults much, either.

Over-the-counter medicine is commonly and casually used by millions of cold sufferers every year, but there is no good evidence for or against the effectiveness of OTC cough medicines, concludes a new systematic review of studies.

“I do not give my kids over-the-counter cough medicine,” said Thomas Fahey, professor of general practice at the Royal College of Surgeons in Ireland Medical School and review co-author. “I do not advise my patients to do so.”

In their review, Fahey and colleagues looked at both children- and adult-focused studies. Some reported that OTC cough medicines helped patients; others said they did not. With conflicting evidence, the various studies presented a non-cohesive picture.

Another issue concerned the researchers, who wrote, “six out of the nine studies that were supported by the pharmaceutical industry showed positive results compared to three positive studies out of 16 trials that did not report any conflict of interest.”

On the other hand, “Most preparations appear to be safe based on those studies reporting side effects, which only described a low incidence of mainly minor adverse effects,” the researchers found.

The review of the studies appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews like this one draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

The Cochrane review encompassed 25 studies, 17 of which involved 2,876 adults and eight of which involved 616 children.

In the adult studies, six compared antitussives medicines used to relieve coughs, such as Robitussin, with placebo and had variable results. Two studies compared an expectorant such as Mucinex, which promotes the discharge of mucus from the respiratory tract, with placebo; one found benefits. Another two studies focusing on combinations of antihistamine and decongestants, produced conflicting results, while three studies found antihistamines were no more effective than placebo in relieving cough.

Three other adult studies compared combinations of drugs with placebo and showed some benefit in reducing cough; one study found that mucolytics, which break down mucus, reduced cough frequency.

In studies involving children, seven — two with antitussives, two with antihistamines, two with antihistamine decongestants and one with antitussive-bronchodilator combinations — showed the drugs were no more effective than placebo. (Bronchodilators work to ease coughs by widening air passages.)

In another study of two pediatric cough syrups, Triaminicol and Dacol, both showed “satisfactory” response compared to placebo medicines.

The duration of drug therapy varied from “a single dose treatment to an 18-day course,” the authors wrote. “For example, five studies testing antitussives used short-term cough relief after a single dose as an outcome…whereas more relevant outcomes for patients would be the effect after one day, three days or a week.”

Because of the variations, there were no broad statistical conclusions. “It wasn’t appropriate to pool the data,” Fahey said.

During the past decade, physicians have increasingly voiced concerns about these medicines and the potential for overdosing young children. In August, the U.S. Food and Drug Administration warned parents not to give over-the-counter cough and cold remedies to children under 2 years old without a doctor’s approval. During a hearing before an FDA panel in October, federal health advisers said that children younger than six years should not take the medicines.

But is it even necessary to cure a cough?

People often worry about a cough if it has not gone away after a week, Fahey said. Actually, the duration of a cough is commonly two weeks in children and three weeks in adults.

“I think there’s the laymen’s perception,” Fahey said. The common conclusion is that “something should be done about it. It [coughing] is troublesome at night. But it is not a bad thing to be coughing. It could be helpful. It is a mechanism for shedding viruses.”

Source: Center for the Advancement of Health

Explore further: Peppa Pig may encourage inappropriate use of primary care services

Related Stories

Peppa Pig may encourage inappropriate use of primary care services

December 11, 2017
Exposure to the children's television series Peppa Pig may be contributing to unrealistic expectations of primary care and encouraging inappropriate use of services, suggests a doctor in the Christmas issue of The BMJ.

UN: About 11 percent of drugs in poor countries are fake

November 28, 2017
About 11 percent of medicines in developing countries are counterfeit and likely responsible for the deaths of tens of thousands of children from diseases like malaria and pneumonia every year, the World Health Organization ...

Meningococcal vaccine could protect against 91 percent of targeted bacterial strains

November 22, 2017
Up to 91 percent of bacterial strains causing a common type of invasive serogroup B meningococcal disease in children and young adults are likely to be covered by a four-component vaccine called MenB-4C (Bexsero), according ...

US scientists try first gene editing in the body

November 15, 2017
Scientists for the first time have tried editing a gene inside the body in a bold attempt to permanently change a person's DNA to try to cure a disease.

Children without allergies can still be afflicted with asthma-like coughing and wheezing

October 2, 2017
Doctors have long wondered why children without allergies can still be afflicted with asthma-like coughing and wheezing. In a new study, Cleveland Clinic researchers have identified a protein that may be responsible.

What really works to fight a stubborn cough?

November 8, 2017
(HealthDay)—If you're looking for a cough remedy this cold season, you might be out of luck.

Recommended for you

Drug for spinal muscular atrophy prompts ethical dilemmas, bioethicists say

December 11, 2017
When the Food and Drug Administration approved the first drug for people with spinal muscular atrophy a year ago, clinicians finally had hope for improving the lives of patients with the rare debilitating muscular disease. ...

FDA's program to speed up drug approval shaved nearly a year off the process

December 7, 2017
Speeding the pace at which potentially lifesaving drugs are brought to market was a rallying cry for Donald Trump as a candidate, and is a stated priority of his Food and Drug Administration commissioner, Dr. Scott Gottlieb. ...

Dangers of commonly prescribed painkillers highlighted in study

December 6, 2017
Commonly prescribed painkillers need to be given for shorter periods of time to reduce the risk of obesity and sleep deprivation, a new study has revealed.

Viagra goes generic: Pfizer to launch own little white pill

December 6, 2017
The little blue pill that's helped millions of men in the bedroom is turning white. Drugmaker Pfizer is launching its own cheaper generic version of Viagra rather than lose most sales when the impotence pill gets its first ...

Surgery-related opioid doses can drop dramatically without affecting patients' pain

December 6, 2017
Some surgeons might be able to prescribe a third of opioid painkiller pills that they currently give patients, and not affect their level of post-surgery pain control, a new study suggests.

Four-fold jump in deaths in opioid-driven hospitalizations

December 4, 2017
People who end up in the hospital due to an opioid-related condition are four times more likely to die now than they were in 2000, according to research led by Harvard Medical School and published in the December issue of ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.