UMMS cough expert: Over-the-counter cough medicine offers no benefit in treating flu, cold symptoms

Richard Irwin, MD, studies pathogenesis, diagnosis and treatment of cough

By Bryan Goodchild and Megan Bard

UMass Medical School Communications

February 05, 2018

Of all the symptoms associated with the common cold, it is the cough that spurs most Americans to seek medicinal relief, according the American College of Chest Physicians.

Yet, coughs cannot be successfully treated with over-the-counter medication, said Richard S. Irwin, MD, professor of medicine and chairman of the cough guidelines committee for the American College of Chest Physicians. Dr. Irwin’s primary area of research is the pathogenesis, diagnosis and treatment of cough. He recommends treating other symptoms, such as nasal stuffiness, and simply waiting it out.

“There isn’t anything that is going to make that cough go away faster. Hopefully, you save your money and you’re not one of the people who collectively spend up to $10 billion on over-the-counter cough and cold medications that have never really been shown to work,” Irwin said.

Millions of Americans are dealing with coughs this season, as 2017-18 is becoming one of the worst flu seasons in nearly a decade, according to the Centers for Disease Control.

“If you have the common cold and you are someone who is otherwise completely healthy, you generally have a self-limited illness. In this instance, there isn’t anything that is going to make that cough go away,” said Irwin, editor-in-chief of the American College of Chest Physicians journal CHEST. “If you have trouble breathing through the nose, you can use an over-the-counter nasal decongestant, but, generally speaking, nothing has been shown to make the cough go away.”

Irwin said when an acute cough—one that comes on gradually and normally lasts for no more than three week—is joined by “red flags,” such as high fever, a shaking chill, spitting up blood or having terrible muscle aches and pains, it is time to see a doctor. While a mild case of influenza can cause nasal stuffiness, scratchy throat and postnasal drip, a severe case of influenza is another matter.

A severe Influenza infection that is associated with malaise, headache, fever, muscle aches and pains, and cough can be treated with Tamiflu, particularly if given within the first 48 hours of flu symptoms, Irwin said.

“However, because cough was not targeted as the sole symptom outcome of the original Tamiflu studies, I can’t tell you whether it is a good treatment for cough due to flu,” he said.