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Cough — what to take?

Cough is a reflex for clearing the airways, not a disease in itself. It is divided into dry (non-productive) and wet (productive, with expectoration) cough. Treatment differs radically between the two.

5 recommended OTC drugs
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OTC — no prescription

What you can take for cough

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Dry cough vs productive cough

Dry cough brings no secretions. It appears as irritation at the start of colds, on exposure to smoke, cold air, allergies, reflux or asthma. It can be distressing, especially at night, and responds to central antitussives.

Productive cough brings up sputum (mucus, phlegm) from the bronchi. It is useful - it clears the lungs. Do NOT suppress it with antitussives; help it with expectorants or mucolytics that thin the secretions.

OTC medicines for dry cough

Dextromethorphan (Tussin, Robitussin) is the central antitussive of choice, non-opioid, effective for irritative cough. Butamirate (Sinecod) is another option, well tolerated in adults and children over 3 years.

Plant-based syrups (plantain, thyme, linden) have emollient effect. Honey (for children over 1 year and adults) is as effective as dextromethorphan in comparative studies.

OTC medicines for productive cough

Acetylcysteine (ACC, Fluimucil), ambroxol (Mucosolvan) and carbocysteine are mucolytics that break the disulphide bridges in mucus, thinning it. Guaifenesin increases secretion and aids expectoration.

Important: do not combine antitussive with expectorant - you suppress the cough and are left with blocked mucus. Also avoid in children under 2 years without paediatric advice.

Rules for night-time cough

  • Raise the head of the bed by 15-20°.
  • Humidifier in the room.
  • Warm tea with honey before bed.
  • Avoid heavy evening meals (can worsen reflux, which triggers cough).

When cough is a warning sign

A cough that persists beyond 3 weeks (subacute cough) or 8 weeks (chronic) requires investigation - asthma, COPD, reflux, post-nasal drip, tuberculosis, heart failure, lung cancer in smokers. Chest X-ray and spirometry are first-line.

Medical disclaimer: the information in this guide is for informational purposes only and does not replace the advice of a physician or pharmacist. For diagnosis and treatment, consult a healthcare professional.

When to see a doctor

If any of these signs appear, consult a doctor — OTC treatment is not enough:

  • Cough with blood (haemoptysis)
  • Dyspnoea, wheezing when breathing
  • Severe chest pain
  • Fever above 38.5°C that persists
  • Cough lasting more than 3 weeks
  • Unexplained weight loss in a smoker

Frequently asked

Common questions

How do I know if it's dry or productive cough?
If you bring up secretions (phlegm, mucus) with your cough, it is productive. If you cough without bringing anything up, it is dry. Treatment differs - do not confuse them.
Can I take Sinecod and ACC together?
NO - they are logically incompatible. Sinecod suppresses the cough; ACC makes the mucus more fluid. If you take both, secretions will accumulate. Choose treatment based on the type of cough.
Does honey help with cough?
Yes, studies confirm the efficacy of honey for night-time cough, especially in children over 1 year. One teaspoon before bed. For infants under 1 year, honey is contraindicated (botulism risk).
When does a cough become chronic?
Over 8 weeks of continuous cough = chronic cough. It requires pulmonology evaluation - common causes: asthma, reflux, post-nasal drip, COPD, fibrosis.

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