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Cough suppressants

When our airways are inflamed from chemical, allergic, viral, fungal or bacterial causes, one of the most immediate responses is for the cells that line these airways to produce extra mucus. This mucus added to whatever other products of inflammation that may be present creates what we term phlegm.

As we recover from the inflammatory process, we have to rid ourselves of this phlegm; the only way to do so is to cough it up. Interventions that improve this process include:

    • Breathing well-humidified air (using a vaporizer or humidifier)
    • Drinking copious amounts of fluids
    • Breathing steam to which a drop of both eucalyptus and lavender oil has been added
    • Adding an expectorant. There is only one expectorant that is commonly found in the over the counter section of most pharmacies: guaifenesin.

There is a debate in the medical literature of the efficacy of guaifenesin; it may be helpful, in fact, most physicians think it is, but the studies done are not overwhelmingly conclusive. There is also a caution about its use in pregnant women; however, there is widespread guaifenesin use in both pediatric and adult patients so that its safety in non-pregnant patients can be assured. The dose for patients over 12 years is 200-400 mg every four hours; for patients between 6 and 11 years, 100-200 mg every four hours; and for patients between 2 and 5 years, 50-100 mg every four hours. Guaifenesin comes in liquid or pill form for older patients and in drop form for infants.

Robitussin plain is guaifenesin. The Robbins company has also formulated Robitussin with several different additives: pseudoephedrine (a decongestant) yielding Robitussin PE, and/or dextromethorphan (a cough suppressant) yielding either Robitussin DM or CF, or in an interesting twist remove the guaifenesin altogether leaving maximum strength dextromethorphan, Robitussin Max.

The only preparation for children under two recommended is the Robitussin DM Infant Drops or a similar generic product: They are safe to use in children six months and older for upper respiratory illness (such as colds and sinus infections). If your child has a lower respiratory tract illness (like pneumonia, bronchiolitis or asthma) you should ask your physician before using cold or cough remedies. Side effects of nausea, dizziness, and drowsiness infrequently occur with DM-containing cough syrups. The expectorant portion usually does not cause side effects.

DOSING CHART
Use supplied calibrated oral syringe.

<6 months (<14lbs) Not recommended
6-11 months (14-17lbs) 1.25 ml (¼ tsp) every 6-8 hours
12-23 months (18-23lbs) 2.5 ml (½ tsp) every 6-8 hours
2-6 years (24-47lbs) 2.5 ml (½ tsp) every 4 hours
>6 years Not recommended, use syrup

There are several other brands of guaifenesin. Guaifenesin is guaifenesin. The quality and effectiveness is the same. CVS has generic version for almost all the different forms.

November 2001