Cough Syrup

General

A cough syrup (antitussive) is a medicine that suppresses or dampens the urge to cough. Most often, the basis for a cough syrup is a simple syrup (syrupus simplex, purified water and table sugar) or an alcoholic solution.
A wide variety of cough syrups containing many different active ingredients are available. The cough suppressant mechanism of action of some active ingredients is very well known, but the mechanism of action of some is also largely unknown.
There are different types of coughs, so choosing the right cough syrup with an appropriate ingredient is important. Antitussive agents are used against dry, irritating coughs, expectorants help the body to get rid of the mucus that has developed in the course of the body's own defense reaction.

Most of the cough-relieving drugs contain derivatives of the opiatethat from the Opium poppy be won. Opiates not only have a pain reliever (analgesic) Effect, but also have an antitussive effect (antitussive).
These are opiate derivatives prescription only and are mainly used for dry, irritating coughs without the formation of mucus. For example Codeine, Dihydrocodeine and Noscapine fall under this group of cough syrups. The effect of these substances takes place on Central nervous system instead, there they have a dampening effect on the cough center in the brain stem and a slight soothing (sedating) Effect.
Opiate descendants should only a few days be applied as there is a risk of Dependency development consists.
Cough syrup with newer active ingredients contains substances that do not have this addictive potential and the depressant (sedative) side effect. Clobutinol, Levodropizine and Pentoxyverine are examples of this group of antitussive cough syrups.
Over-the-counter (non-herbal) cough syrup often contains the active ingredient Dextrometorphan. Dextrometorphan inhibits the urge to cough, but, in contrast to the opiate derivatives, still lets in cleansing cough to. The risk of becoming dependent is also significantly lower.

Used to treat cough with Slime formation other ingredients are used to make coughing easier. Cough suppressants should be used in this case Not be used because by suppressing the coughing stimulus the mucus in the Airways is no longer coughed up, which can hinder breathing and the settlement of bacteria favored in the stuck mucus.
Cough syrup to dissolve mucus (contains Expectorants) contains for example Acetylcysteine (a mucolytic that reduces the viscosity of the mucus) or Bromhexine and Ambroxol (Secretolytics, stimulate the secretion of the thin fluid bronchial secretion).
Cough syrup containing these ingredients does not require a prescription. For this group of expectorant cough syrups, the mechanisms of action have not all been clarified, the focus is on Normalization of viscosity of the mucus (slime viscosity).

Cough syrup with herbal ingredients can also calm the urge to cough (e.g. ribwort, coltsfoot, Icelandic moss and marshmallow root) and have an expectorant effect such as thyme, ivy, spruce, fennel, eucalyptus and aniseed.

Cough syrup in babies and children

Coughing is an unpleasant symptom of a cold, but coughing also has an important cleaning function for the lungs, as phlegm has to be coughed up.
Coughing in infants and babies is very distressing for the child, especially at night. Cough suppressants should only be used when the baby is one year old, and a pediatrician should be consulted beforehand if there is a cough.
A child from one year of age (some recommendations are even from two years of age) can be treated with cough syrup and home remedies, but the baby's cough should last longer than one week stop, a doctor's visit must take place. Likewise if the child coughs up blood, develops a fever or vomits when coughing.

The common cold usually has two phases, initially with a dry, unproductive cough, then with a moist, mucus-producing cough. By the way, this applies not only to children, but also to adults.
In the first stage, cough suppressants are the medication of choice, in the second stage an expectorant cough syrup is indicated.
In children and babies, simple home remedies such as hot milk with honey or cough syrup such as Tuscalman® can often help against dry coughs.
Remedies that are more effective against coughing and contain codeine, for example, require a prescription and should be used especially if the cough prevents you from sleeping through the night.
Thyme can also have an anti-spasmodic effect on the bronchi, promote expectoration and kill bacteria, thanks to the essential oils it contains. Thyme relieves spasmodic and irritable coughs as well as hoarseness in colds of the upper respiratory tract and can be used for baby coughs from one year.
Against the moist, productive baby cough, which usually occurs in the second phase, expectorant cough syrups can help expectorate the mucus. Cough syrup with the active ingredient Clenbuterol (such as Mucospas®) has a mucus-mobilizing effect and can also be used on babies. In general, it should be noted that too much alcohol (over five percent) in the cough syrup is not suitable for babies and children. Cough syrups have no effect against the symptoms of whooping cough.

Cough syrup for dry coughs

Dry cough is a non-slimy (unproductive), dry cough that is often accompanied by hoarseness.
Especially at the start If you have a cold, dry cough occurs, but even after all other cold symptoms have subsided, a permanent dry cough may occur.
Also, dry cough can be an indication of bronchial asthma without having to have a classic asthma attack.
No prescription dextromethorphan-containing Cough syrup (e.g. Silomat®) can be used to dampen dry coughs. But ingredients such as Icelandic moss (e.g. Aspecton®), pentoxyverine (e.g. Sedotussin®) and marshmallow (e.g. Imupret®) can be found in the pharmacy without recipe can be purchased to combat dry cough.
Prescription Only Cough syrup, which works well against dry coughs, contains ingredients such as codeine, dihydrocodeine (e.g. Paracodin®), noscapine (e.g. Capval®) or levodropropizine (e.g. Quimbo®).

Cough syrup for acute cough

u Acute cough lasts less than three to four weeks and is most often through bacteria or Viruses triggered. Upper and lower respiratory tract infection or colds with inflammation of the airways (acute bronchitis) are the most common causes of acute coughs.
If the cough is productive, i.e. promotes phlegm, then cough syrup with ingredients such as Ambroxol (e.g. Ambril®), Bromhexine (e.g. Bisolvon®), Acetylcysteine (e.g. ACC effervescent tablets) or Marshmallow (eg Imupret ®) help to make coughing easier and counteract the mucus in the airways.
Symptoms of inflammation of the airways in the event of an acute cough are caused by Cowslips and Thyme herb (e.g. Bronchicum®), Cineole (e.g. Soledum®) and Eucalyptus oil (e.g. Aspecton Eukaps®) alleviated.
In general, the acute cough does not require medical treatment, but in the case of severe, long-lasting illness, Shortness of breath or fever a doctor should be consulted in any case. The doctor will usually prescribe expectorants (as described above).

Cough syrup for chronic cough

A chronic cough is by definition chronic bronchitis referred to when coughing and sputum on most days during at least three months in two consecutive years occurs.
Over-the-counter medications that can initially be used for chronic coughs are, for example, cough syrups with active ingredients such as Ambroxol (e.g. Ambril®) or Bromhexine (e.g. Bisolvon®). This can loosen mucus, make coughing easier and relieve sore throats.
Cough syrup with ivy can also reduce spasms in the airways muscles and the Bronchi expand. Also thyme, Acetylcysteine (e.g. ACC effervescent tablets), Marshmallow (e.g. Imupret ®) and Myrtol (e.g. GeloMyrtol®) can be used to treat the symptoms of chronic coughs.
Against chronic bronchitis (but also against bronchial asthma and chronic obstructive pulmonary disease, COPD) Ingredients can be applied that the smooth musculature relax in the lungs and dilate the bronchi. These include active ingredients such as Theophylline (e.g. Afonilum®), Clenbuterol (e.g. Spiropent®) and Salbutamol (e.g. Apsomol®). Also Noscapine (e.g. Capval®) can be used to suppress the urge to cough in chronic coughs.

Cough syrup in pregnancy

Especially more centrally acting Cough syrup must not be used during pregnancy and breastfeeding, so are Opiate derivatives how Codeine, Dihydrocodeine, Noscapine and the non-opioid cough suppressant Dextromethorphan taboo!
But also more peripheral Cough syrup should be used with caution and only with strict indication be applied. For example Dropropizine, Pentoxyverine and Pipaceta should not be used during pregnancy and breastfeeding.
The expectorant drug Bromhexine is absolute contraindicated during pregnancy and breastfeeding, during Acetylcysteine and Ambroxol should only be used if there are strict indications.

Side effects of cough syrup

Especially non-herbal ingredients in cough syrup can cause undesirable effects. At Codeine and Containing hydrocodone There is a risk of cough syrups Dependency development. These drugs should therefore only be used against coughs low dosages and only for short time be taken.
Due to the calming (sedative) effect, it often occurs when taking these active ingredients fatigue, thereby reducing the ability to react, drive and use machines safely. Even under the over-the-counter cough suppressant Dextrometorphan can to Drowsiness, fatigue and Dizziness lead, which is why it is better not to drive for the duration of the action. In addition, dextrometorphan can cause undesirable effects in the stomach and intestines and skin problems.

Expectorant cough syrup can also have various side effects. For example, by approaching Acetylcysteine or Bromhexine-containing cough syrup a headache, Noises in the ears such as Stomach and intestinal discomfort to be triggered.
Side effects of Ambroxol are for example dry mouth, shortness of breath, fever, runny nose, swelling of the face or skin rashes. Other side effects of cough syrups can be caused by, for example too high dosage to cardiac arrhythmias and Hallucinations lead, which is why the specified or prescribed dosage should be strictly observed.

In addition, it should always be remembered that with all ingredients of cough syrups too Drug interactions may occur. For this purpose, the package insert should be read carefully or the pharmacist or doctor treating you should be asked.

Is a cough syrup always necessary?

In the case of a cold, cough is used to prevent the Clear the lungs of phlegm, or the urge to cough is caused by a Inflammatory response of the body triggered. However, regular and persistent coughing can be very nerve-wracking and disrupt everyday life and sleep. For these reasons, it can make sense to use cough syrup.
The choice of cough syrup should always be based on the symptoms, so should Cough suppressants at dry, unproductive cough and Expectorant at moist, productive cough be applied. However, drugs should not be used to suppress cough until the underlying disease is identified. Proper treatment of the Underlying disease The cough usually also subsides. Proven home remedies like adequate Hydration, fair Indoor climate, inhalation or Steam baths can alleviate the symptoms in many cases.
Cough syrup can be useful for very excruciating coughs. Basically, it is advisable if you have a cough that lasts longer than two weeks continues to see a doctor, even after in babies and children a week. Even if the cough symptoms do not improve despite the cough syrup or if the mucus turns yellow or green, a visit to the doctor is advisable.