Is this you? Standing in front of what seems like a 100-foot wall of endless choices of cough syrups totally confused. Each one calling out to you with bright labels and hopeful promises — many of them familiar to you from TV ads. You can even hear the silly jingles used to promote them as you look through the shelf!

Americans tend to think that if something is good, more is better. Therefore when choosing an over-the-counter (OTC) cough medicine, we tend to go for the ones labeled “Max” or “Extra Strength” and ones that promise to help with more than one thing like in “the nighttime, sniffling, sneezing, aching, coughing, stuffy head, fever so you can rest medicine”. But that could be a fatal mistake!

Combination cough medicines often contain Tylenol (Acetaminophen). Too much Tylenol can damage your liver; and even send you to the emergency room with a potentially fatal overdose. Many people take multiple combination medications for different symptoms all of which may contain Tylenol or Ibuprofen, so it can easily add up to too much.

Cough syrups like Robitussin contain codeine or codeine like drugs, and too much can create dependence or respiratory failure by suppressing the breathing center. Drugs like Afrin to dry up congestion can cause a rebound effect, meaning that it wears off more quickly each time you use it, you need more and more, eventually damaging the lining of the nose. Both of these drugs are fine for short-term use but dangerous in the long run. With Afrin, it’s better not to even get started.

How to choose among the hundreds of over-the-counter options?
I’ll give you a few simple guidelines:

  • Go for the generic, the drugstore brand. You may have to hunt for it: it will have a simple packaging compared to the blaring bright packaging of the commercial brands. You can tell it’s exactly the same product as the commercial brand by comparing the “Active Ingredient” on the back of the box. Don’t worry about not being able to pronounce this long chemical name! Just look to see if they are the same.
  • Go for the simplest product. Don’t buy a combination product that promises to do things you don’t need. Again, look for the “Active Ingredient” on the back of the box.
  • Consider an antihistamine. In most cases, that’s all my patients need to stop an acute cough. It will dry up your nasal secretions that are causing post-nasal drip, which is dripping down the back of your throat and triggering your cough. A word of caution with antihistamine: The most effective one have more side effects such as dry mouth, urinary retention and drowsiness. Just take them “as needed”. I usually recommend them at bedtime.
  • Finally, consider Grandma’s remedies.

Using these simple guidelines will save you money, time and ultimately promote a healthier lifestyle by avoiding dangerous combination drugs you don’t really need.

For more helpful tips, check out Cough Cures: The Complete Guide to the Best Natural Remedies and Over-the-Counter Drugs for Acute and Chronic Coughs

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