Runny noses and wet coughs affect many of us during the winter and cold months. It’s a time when we spend more time indoors, in close contact with each other and our immune systems are often not at their best.
It’s therefore no wonder that winter is the season when we commonly visit our local pharmacy in an effort to relieve those troubling wet coughs, and to offer some much needed relief before an important presentation/ date you’ve been dying for.
However, once you get to the pharmacy you’re often faced with several options and the battle then becomes deciding which medication is going to be best for you .
Unless you’re a trained healthcare professional, the options can be quite overwhelming and choosing the right cough medicine can be like trying to find your way through a maze.
Targeting a wet cough – Mucolytics vs expectorants
The first consideration is the type of cough which needs to be targeted. If it’s a wet cough, caused by mucus congestion, then your options include expectorants or mucolytics, as these aid clearance of mucus from the airways and lungs.
Expectorants work by signalling the body to increase the amount or hydration of secretions, thus resulting in more yet clearer secretions and as a by-product lubricating the irritated respiratory tract.4P1b,d Active ingredients in expectorants may include guafenesin, ammonium chloride and sodium citrate.
While there are many expectorants on the market, there is little evidence to support their use.
On the other hand, mucolytics dissolve thick mucus by breaking the bonds which hold the mucus strands together, making it thinner and easier to remove from the airways or sinuses, an example of a mucolytic active ingredient would be N-acteylcysteine. Clinical studies support the use of mucolytics as being efficacious, with symptoms of cough and sputum production resolving faster when N-acetylcysteine was used as part of the therapy.
Type of formulation – liquids, granules, lozenges and effervescents
The next factor to consider is which preparation is most suitable for you and your family. Expectorants and mucolytics are available as liquids, granules, lozenges, solid tablets and effervescent tablets, so consider who needs to take the medication and which is going to be simplest to administer.
Important points regarding different preparations include;
· Liquids – Require the use of a measuring device, with risk of incorrect dosage and spillage.
· Granules – Come in a sachet and are dissolved in water. You need to ensure that the full or correct amount of contents in the sachet is completely dissolved to get the right dose.
· Lozenges – Easy to administer but may be a challenge if you have fussy children or adults who aren’t happy to let these dissolve in their mouths.
· Solid tablets – Convenient to use but may be problematic for children and elderly people due to possible swallowing difficulty.
· Effervescent tablets – These need to be dissolved in a glass of water. Some may even be scored which may make it easier to divide to ensure accurate dosing for adults and children.
Mucolytic cough medications are available in most of the above preparations. Solmucol and ACC 200 contain N-acetylcysteine as their active ingredient. Solmucol is available as a lozenge or as granules, while ACC 200 comes as a scored effervescent tablet.
Advantages in effervescents
A distinct advantage to using an effervescent mucolytic is in knowing that you and your family members are getting the right dose each time, without the complication of using a measuring device, or waiting for the medication to dissolve in your mouth.
They provide for simple dosing and can be dissolved in a glass of water, making them easy to administer and allowing them to be taken discreetly. Dr Marlin McKay, a General Practitioner at Goldman Medical Centre points out that effervescent medications carry a “lower risk of overdose and dose-related side-effects”.
In addition, effervescent formulations are generally alcohol and tartrazine free, which may be an important consideration when choosing medication for your whole family.
The maze simplified
When choosing a medication to alleviate those winter wet coughs, it’s important to consider which symptoms need to be targeted, as well as which formulation will work best for you and your family.
Mucolytics target wet coughs and are proven to be safe and effective, while effervescent preparations offer a simple means to get the right dose.
So, when next seeking reprieve from that winter wet cough, consider not only that N-acetylcysteine targets the symptoms, but also provides a simple and accurate means of administration in effervescent format, offering you and your family a good option for relief this winter.