Doctors critical of cough syrups

WASHINGTON — Over-the-counter cough medicines do little good and may harm children, U.S. experts said in new guidelines released Monday.

Adults are better off using older-generation nonprescription antihistamines and decongestants to stop the flow of mucus that causes coughs due to colds, the American College of Chest Physicians said.

Some over-the-counter cough syrups contain two drugs that have been shown to help relieve coughs caused by colds — codeine and dextromethorphan — but generally the doses are too small to be effective, said Dr. Richard Irwin of the University of Massachusetts Medical School, who chaired the guidelines panel.

The new guidelines say that adults with acute cough or upper airway cough syndrome, commonly known as postnasal drip, should use an older variety of antihistamine with a decongestant.

Antihistamines that work against cough include chlorpheniramine and diphenhydramine.

"There is no clinical evidence that over-the-counter cough expectorants or suppressants actually relieve cough," Irwin said. "There is considerable evidence that older type antihistamines help to reduce cough, so ... why not take something that has been proven to work?"

Dr. Peter Dicpinigaitis, a panel member who runs a cough clinic at the Montefiore Medical Center in New York, said cough medications carry the risk of oversedation, which is especially dangerous to children.

And while coughs in children are worrisome and annoying, cough syrup is not the answer, Irwin said.

"In most cases, a cough that is unrelated to chronic lung conditions, environmental influences or other specific factors, will resolve on its own," he said.