31 August 2017

Need to clear those cough symptoms quick? Ask your healthcare provider

Sponsored: The rise of self-medication, a growing global trend.


Increasing financial pressure and access to online health information has resulted in more South Africans turning to self-medication but to find the right cough treatment, you need to speak to your HCP.

According to an international market research company, the global over-the-counter (OTC) drug market will grow to about $162 billion by 2020.1pg1a More than 80% of people across the globe are using OTC medications as the first response to health issues,1pg1c with respiratory drugs – including cough medicines – making up more than one-third of this market.1pg1d

A global, growing trend

A recent South African cold and flu study found that the sale of OTC medicines, to treat colds and flu, increased the most last year, with the most popular medications aimed at pain- and fever relief, as well as OTC treatments for wet and dry coughs and colds.2pg1a Given the high cost of visits to the GP, as well as the availability of tons of information on the Internet, it’s not difficult to see why more people are self-medicating.

Choosing the right cough medication

Surveys suggest that at any one time, up to one in three children or adults are suffering from a cough.3pg1a It’s not surprising then that coughs are among the most common complaints for which people seek medical advice.3pg1a

Last year, South Africans spent around half a billion rand on cough syrup medicines alone. 3pg1b But there are risks in using consumer healthcare products, including the potential for misuse and abuse, and adverse effects when not used properly. The wrong choice or incorrect use of cough syrups can lead to potentially harmful medicine interactions and side-effects, and may end up costing you more in the long run.

In addition, the combination of ingredients found in some cough syrups may be counterproductive and addictive. A 2015 report by eNCA’s investigative current affairs show, Check Point found that cough syrups containing codeine were the most abused OTC drug in South Africa.4pg1a+b Abusing codeine, in whatever form, may be detrimental to your health and, like other opioid medications, abuse can result in vomiting and nausea, constipation, drowsiness, or even respiratory depression in severe cases.4pg2c

Treating the cause, not the symptom

A recent survey of OTC medications for acute cough found no good evidence for or against the effectiveness of these medicines.5pg3a An acute wet cough is caused by the build-up of mucus, so one way to treat it is by getting rid of the mucus causing the congestion. This is where OTC mucolytics have a key role to play.

Mucolytics are drugs that loosen or break down mucus in the nose and chest, making it easier to cough up, and helping to reduce coughing and congestion quickly.6pg1184a+1181b They contain N-acetylcysteine (NAC), are available from your pharmacy, and are suitable for adults and children. Some come in the form of an effervescent tablet, making the medicine a lot easier to administer.

They are alcohol-free, and because each tablet contains a fixed dose of NAC, it can be pre-mixed in a bottle of water, limiting the possibility of dosing errors.

Given the amount of money spent on cough medicines annually, it makes sense for you to speak to your health care practitioner about the best solution for your family’s needs. A visit to the pharmacy is a convenient time to ask your pharmacist key questions that could impact your health.

When buying OTCs, it’s important to ask what you can expect from the medication, how long you should use it before consulting your doctor, whether any new medication will affect other medicine you are already taking, and what to do about persistent, minor ailments.

1. Business Wire [Internet]. Rise in Self-medication to Create Opportunities for the Global Over-the-Counter Drug Market Through 2020, Reports Technavio. New York: Berkshire Hathaway; [updated 2016 August 25; cited 2017 March 10]. Available from:
2. Insight Survey [Internet]. SA Cold and Flu Industry: In Sickness and in Health… Cape Town: Insight Survey B2B Market Research; [cited 2017 March 18] Available from:
3. Frontshop Pharmacy Magazine [Internet]. Johannesburg: New Media Publishing; 2017 Feb 28. [cited 2017 Mar 08]; The high cost of coughs. Money well spent? Available from:
4. Health24 [Internet]. Why SA continues selling 'most abused over-the-counter drug'. [updated 2017 Jan 13; cited 2017 Apr 04]. Available from:
5. Smith SM, Schroeder K, Fahey T. Over-the-counter (OTC)medications for acute cough in children and adults in community settings. Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD001831. DOI: 10.1002/14651858.CD001831.pub5.
6. Rogers DF. Mucoactive agents for airway mucus hypersecretory diseases. Resp Care 2007;52(9):1176-1197.
7. Consumer Healthcare Products Association [Internet]. Statistics on OTC Use. Washington: Consumer Healthcare Products Association; [cited 2017 March 18] Available from:
8. Pew Research Centre [Internet]. Health Online 2013. Washington: Pew Research Centre; [cited 2017 March 18] Available from:
Information for editors:
The rise of self-medication – a growing global trend
? The OTC market is growing at a faster rate in emerging countries such as South Africa, India, and China – as compared to developed countries – fueled by favorable demographic trends, higher out-of-pocket expenditure, and the growing focus of multi-national companies that want to expand their business in these markets.1pg1b
? Insight Survey’s latest ‘SA Cold and Flu Industry Landscape Report 2017’ found that in South Africa, OTC medicines experienced the fastest unit sales growth at 5% in 2016.2pg1a Among the top-selling generic medicines in this category are those aimed at pain- and fever relief, as well as OTC cold preparations. The report forecasts that the cold and flu remedy industry is set to increase at a compound annual growth rate of 8%.2pg2b
? According to the Consumer Healthcare Products Association (CHPA) in the US physicians in the US say that 10% of visits to their offices each year – amounting to tens of millions of unnecessary appointments – could be avoided by treating common ailments with OTC medications.7pg2b
? OTC medicines provide affordable treatment options for consumers, says the CHPA.7pg2c Self-medication offers a cost-effective alternative for minor health problems, and there are benefits to the availability of OTC products, such as rapid access to effective medications and decreased reliance on the healthcare system.7pg1d
? The CHPA notes that 96% of US adults believe OTC medicines make it easy for them to care for minor medical ailments, 93% prefer to treat these ailments with OTC medicines before seeking professional care, 85% of parents prefer to treat their children's minor ailments with an OTC medicine before seeking professional care and significantly, 61 million US consumers have avoided missing work, school, or other appointments due to illness because they had access to OTC cough medicines to alleviate their symptoms. 7pg3e
? More tech-savvy consumers are arming themselves with online information. The number of people searching for medical information on the internet – called ‘online diagnosers’ – is large and continues to rise annually, according to the Pew Research Centre’s Internet & American Life Project.8pg1a


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Professor Keertan Dheda has received several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others. Read his full biography at the University of Cape Town Lung Institute.

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