Products
Cough syrups are commercially available from numerous suppliers. Typical categories include herbal, “chemical” (containing synthetic active ingredients), cough-irritant, and expectorant. They are sold in pharmacies and drugstores, among other places. Cough syrup can also be prepared by the patient. For example, vegetable extracts (see below), honey, sugar and drinking water can be used. Homemade cough syrup should be stored in the refrigerator. For more information, see the article DIY medicines.
Ingredients
Cough syrups are liquid preparations with a sweet taste and a thick consistency, intended for the treatment of a cough. On the one hand, they contain the active ingredients. A distinction is made between the so-called antitussives, i.e. active ingredients against cough irritation, and the expectorants, also known as mucolytics or expectorants. Active ingredients (selection):
- Antitussives: codeine, dextromethorphan, noscapine, butamirate, morclofon, antihistamines.
- Expectorants: ambroxol, bromhexine, carbocisteine, guaifenesin, N-acetylcysteine.
- Herbal extracts that can be both soothing and expectorant: Thyme, thyme, ivy, licorice, eucalyptus, fennel, ribwort, primrose, ipecacuanha, sundew, marshmallow.
- Essential oils and their components such as menthol.
In addition to the active ingredients, the syrups contain, on the other hand, various excipients (examples):
- Sugar: sucrose, glucose, honey.
- Sweeteners: sorbitol, cyclamate, saccharin, sucralose.
- Preservatives: ethanol, parabens, benzoic acid.
- Extraction and solvent: ethanol, water.
- Flavoring: vanillin
- Colorants: caramel
- Sugar alcohols: glycerol
- Thickening agent: celluloses
- Acidifier: citric acid
Effects
Depending on the ingredients, cough syrups have soothing, expectorant, expectorant, calming and soothing properties.
Indications
For the treatment of a cough, usually due to a cold or flu.
Dosage
According to the prescribing information. Many syrups must be shaken before use and have a limited shelf life after opening. Expectorants are usually taken in the morning or during the day; antitussives are also taken during the day or before bedtime.
Abuse
Cough syrups containing psychoactive, euphoric, and depressant agents such as codeine, dextromethorphan, and first-generation antihistamines are abused as intoxicants. Because of the health risks and potential for dependence, this is strongly discouraged. Because of abuse, the critical syrups became prescription-only (dispensing category B) in many countries in 2019. However, they can still be sold in pharmacies after a consultation and dispensing documentation. For more information, see the article Misuse of Cough Syrups.
Contraindications
Contraindications depend on the drug. They do not apply to all products (selection):
- Hypersensitivity
- Use in infants, young children or children.
- Pregnancy, lactation
- Renal insufficiency
- Gastric and intestinal ulcers
- Bronchial asthma
Full precautions can be found in the drug label.
Adverse effects
Adverse effects depend on the active ingredients and excipients used. They include, for example, allergic reactions, skin reactions, gastrointestinal disturbances such as nausea, diarrhea, constipation, and abdominal pain, and central side effects such as fatigue and dizziness. Some cough syrups, for example those containing codeine and first-generation antihistamines, can cause drowsiness and drowsiness and are therefore not suitable when driving or operating heavy machinery.
