The most common cough medicine is DXM, but everything I’ve read suggests that it’s no more effective than a placebo at actually suppressing coughs. Even codeine is considered ineffective these days. So, are there any drugs that can actually suppress coughs?
BenzonatateRx only in the US is effective for some people.
Chloraseptic is OTC and has numbing properties that help with upper airway discomfort.
If you have a deep productive cough, such as seen with pneumonia, you should stop running around outside with your shoes off. An action which my grandmother guaranteed would give me pneumonia.
Liquid codeine worked fairly well for me, but I needed a prescription to get it (but man, I was so happy to finally be able to sleep, after three nights of just constant hacking cough).
I swore by Buckley’s Mixture, which tastes horrible but WORKS, until it basically became unavailable south of the border. :mad:
I think most cough suppressants are only helpful for milder coughs. IME, the direction of cough-severity and the direction of medicine-effectiveness are inversely proportional to each other.
The only intervention that I know has actual evidence as having any efficacy for cough is honey, both in comparison to dextromethorphan, and to a similarly tasting sweet/thick/colored date extract in a double blind RCT.
Kessler 20mL every 15 minutes until you no longer care.
The only thing that has ever worked for me is some prescription medicine I don’t recall the name of. It wasn’t codeine, but it was some sort of opioid. I only had it once, didn’t experience any weird drug effects that would make me want to use it recreationally, but it did seem to stop my cough. Nothing over the counter has worked, so I don’t bother with cough syrup for coughs. I do use the honey trick, and that seems to minimally help for a few minutes when it coats my throat, but the effect is usually quite temporary.
Unfortunately the only med class for cough suppression that is truly effective for the vast majority of the population are the opioids, which unfortunately carry with them a lot of other baggage, so good luck getting a prescription these days.
While dextromethorphan is marketed over the counter as a cough suppressant (it is the dextro-isomer of a potent opioid), it does not seem to be terribly effective, except in such high doses as to cause dysphoria, dissociation, and hallucinations. If you use it that way, at least your transcendental experience won’t be interrupted so much by coughing fits.
Benzonatate is somewhat effective for a small number of folks, but doesn’t do much to tame a severe cough.
A cough is generally there for a reason, to keep the lungs clear. So I am loathe to suppress it, unless the cough is so severe as to cause significant misery. In that case I will cough up (see what I did there??) a script for a few codeine pills. I never saw the need for a cough syrup when it’s the opioid that is the effective ingredient, not the liquid.
My advice, for a moderately annoying cough is to drink plenty of fluids to keep the secretions moist, use tylenol or ibuprofen as needed for pain and fever, cough into your elbow when amongst others, and have a pillow you can clutch to your abdomen when the cough becomes so severe that it hurts your abdominal muscles. And go suck on some honeycomb. And consult your doc if your cough becomes bloody, if you have shortness of breath or other difficulty breathing, or persistent fevers over 101.
Dextromethorphan helped me a little in the past, but I guess that was just the placebo effect (and now that I know it’s ineffective, it won’t anymore).
I was prescribed codeine for a cough once before and it worked like magic, but obviously that’s not something one wants to use often, especially these days.
The other thing opiates work amazing well for is diarrhea, I took an opiate-based medication once (in Africa, I doubt it’s legal here) and it worked like magic.
Imodium is a common OTC opioid in the US
But I know a woman who was given codeine or something in the UK.
Loperamide abuse is now a thing in the US, complete with fatalities.
It seems that any molecule with any sort of agonist activity at any type of opioid receptor is going to be abused. Even those that cause wicked dysphorias. Because, to an active opioid addict (like me in my bad old days) a dysphoria is better than no phoria at all. 
Really. I thought the point with loperamide was that it acted only on the opioid receptors in the colon, not passing the blood brain barrier, so it didn’t get you high, and didn’t have a potential for abuse. Certainly, a few years back when I had some problems with chronic diarrhea, I was taking the stuff daily for a few months, until a gastroenterologist muttered something about “bile salt diarrhea” and proscribed me cholestyramine, which fixed things up pretty well. Other than the loperamide being hard to control (a little too much and I’d wind up bound up before resuming having diarrhea), I never noticed any other effects. On examination, I see the “abusers” are taking ridiculous quantities of the stuff or taking with other stuff which supposedly facilitates it crossing the barrier. I hope they don’t start regulating it.
I know someone who was talking about stockpiling just in case. She’s the sort who plans trips based on where toilets are.
I have chronic bronchitis, even diagnosed as asthma, and various inhalers. But even the inhalers (various bronchodilators and corticosteroids) don’t always work all that well. I’ve even spent occasional lovely vacations in the Emergency Room with coughing and breathing trouble. I think now that this is what’s most likely to kill me eventually.
In the meanwhile, for some of my worst coughing days, I have a bottle of Guaifenesin/codeine cough syrup (Rx only) that I use. It seems to be fairly helpful.
This appears to be not as strictly regulated as I would expect for an opioid. The pharmacy will send it by mail-order, and the prescription is written for three refills. Who’da imagined that?
This works really, really well for me. My insurance doesn’t like to pay for it though, because codeine is so much cheaper. Codeine works too, but after a few days, it starts to give me headaches.
Thanks for the tip on Imodium. Will start stockpiling, as I have mild IBS. Maybe it will just get moved behind the counter, like Sudafed.
I use codeine, when I really need to suppress a cough (like when I was afraid I would crack my ribs, or when it’s a dry irritated cough) but in general, I feel like clearing crap from my lungs is probably helpful. So I take guafenesin (sp?) or maybe a licorice tea, either with lots of fluids.
That’s interesting. I took dextromethorphan once, with a prescription. It worked really well as a cough suppressant – much better than codeine – but that came along with disphoria, agitation, and insomnia. I felt like my brain was bouncing in my skull, I couldn’t work, I couldn’t sleep, and I felt like crap. I decided I’d rather cough. I also talked my doctor into giving me codeine, and have talked every subsequent pcp into giving me codeine based on that experience.
I’m in my fifties. I’ve used codeine since I was a child, and have had my own bottle sitting in the cupboard since I was 15 or so, and haven’t run into trouble yet. So I’m inclined to keep using it. But I’m worried it will become hard to obtain.
Qadgop, while I’m sure the syrup doesn’t work any better than tablets on the cough, the pain-numbing sensation in the throat as it goes down is magical, if short-lived. I drink my teaspoon ever-so-slowly to maximize that effect. Coughs that need to be suppressed are almost always accompanied by a sore throat. You might want to reconsider your pill-only rule.
Dosing tends to be imprecise with syrup/liquids. I’d recommend one take the pill and suck on some honey or other soothing syrup. Win-win.
But there’s still plenty of codeine cough syrup being made so you won’t lose it.
Codeine when in a syrup and when mixed with tylenol is schedule III so doesn’t need as much oversight for prescribing, and can have refills on it.
Guaifenesin does work to thin secretions, and that can provide a lot of relief for some folks. But to have this effect, most adults do need to take 1200 mg of it a day, which is far below what you get in most combination products.
Sounds like DXM is not the drug for you, though!
I have an occasional dry hacking cough at night, which my doctor regards as a side effect of lisoprinil. A few squirts of chorospeptic helps, but only so much. An opioid would be entirely too much fun, so I haven’t sought that.