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Cough

Updated 26 February 2018

Treating a cough

To effectively treat a cough, the cause must first be identified and the expected duration estimated.

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When to call your doctor

Call your doctor if:
 You notice blood in the sputum. 
 Coughing is accompanied by difficulty breathing or chest pains (particularly sharp, stabbing pains or pain when you take a deep breath).
• You produce lots of yellow-green sputum when coughing.
• Your cough doesn’t clear up by itself after 2-3 weeks.
 The cough is accompanied by fever and/or malaise (fatigue and severe body aches).
• You recently starting using an ACE inhibitor for hypertension and seem to be coughing as a result.

Giving a cough mixture for a few days might help if a viral cold is the cause, but giving a cough mixture isn’t going to help in the case of lung cancer.

Fortunately, the vast majority of acute coughs that occur as a result of a common cold resolve by themselves in a few days. Rarely, they may last a few weeks. 

These coughs are transient, but can be frustrating. If they don’t settle within a week after your cold or flu has cleared, it’s worth seeing a doctor as complications can occur, even with a common cold.

Complications are rare but may result in a prolonged cough, especially if you’re bedridden for a few days or have other medical conditions such as heart failure or a pulmonary embolism (a blood clot in the lung). If these are all excluded, the post-viral cough just needs time to improve on its own. 

Most people with colds or the flu head to the nearest chemist for an over-the-counter cough mixture that may provide some symptomatic relief, help you to cough up some mucus, and relieve a dry, scratchy throat.

But these medicines aren’t effective in shortening the duration of the cough. It provides symptomatic relief, but often won’t treat the cause of the cough. 

The best you can do is to give your body a chance to fight off the virus that’s causing the cough. This would include bed rest, not exercising strenuously, drinking plenty of fluids, avoiding exposure to irritants such as smoke or dust, or using a humidifier to add moisture to the air.

Many people take cough drops, while some swear by honey, ginger or turmeric. There’s no real proof that any of these are truly effective. But if they make you feel better, these remedies can do little harm.

Remember that antibiotics and cold medicines can’t cure colds. In the case of a serious acute cough, which is life-disrupting, your doctor can prescribe cough suppressants and medicines that would loosen mucus. These would be more effective than over-the-counter cough mixtures.

Treatment for chronic cough
Accurately diagnosing the cause of a cough is essential – just treating the symptom (cough), and not the underlying disease, is a recipe for disaster. Treatment varies widely and there’s no one-size-fits-all approach to treating this symptom.

It can be a frustrating process for both patient and doctor to find a treatment that alleviates chronic coughing.

The table below outlines some of the most common recommendations and treatments for the various causes of a chronic cough, according to the US National Institutes of Health.

Side effects of cough medication
Certain cough medications have ingredients (e.g. codeine) that help to suppress cough. Common side effects from this type of medication include dizziness, drowsiness, nausea and constipation.  Many of the cough mixtures also contain stimulants that are banned substances for use by competitive athletes.

So, be very careful before you use anything if you’re a professional athlete or sportsperson. 

Expectorants are medications that work to break up mucus and loosen congestion. Side effects from this type of medication can include nausea, diarrhoea, dizziness, headaches and drowsiness.

If you’re pregnant, have heart disease, asthma, glaucoma or an enlarged prostate, check with your doctor – cough medications can complicate these conditions. 

Medications also have ingredients to which some people are allergic. Make sure you read labels carefully and ask your pharmacist or doctor to assist in finding an alternative.

Note that some cough medications may contain ingredients that are habit-forming and that you shouldn’t give cough medicine to a young child under the age of two.

Accidental overdoses of cough medicine, or reactions to other medications, can sometimes be fatal.

Reviewed by Professor Richard van Zyl-Smit, Head of the Lung Clinical Research Unit at the University of Cape Town. MBChB, MRCP(UK), Dip HIV(Man), MMED, FCP(SA), Cert Pulm(SA), PhD.

 

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Ask the Expert

Cough Expert

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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