No
evidence cough syrups work: panel
By Maggie Fox, Health and Science Correspondent
Mon Jan 9, 7:37 PM ET
WASHINGTON (Reuters) - Over-the-counter cough medicines do little
good and may harm children, U.S. experts said in new guidelines
released on Monday.
Adults are better off using older nonprescription antihistamines
and decongestants to stop the flow of mucus that causes the cough,
the American College of Chest Physicians said in its
guidelines.
"Cough is the number one reason why patients seek medical
attention," Dr. Richard Irwin of the University of Massachusetts
Medical School, who chaired the guidelines panel, said in a
statement.
"There is no clinical evidence that over-the-counter cough
expectorants or suppressants actually relieve cough," Irwin
added.
"There is considerable evidence that older type antihistamines help
to reduce cough, so, unless there are contraindications to using
these medicines, 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
might help some patients. But they carry the risk of oversedation
-- especially dangerous to children, he said in a telephone
interview.
The older-generation antihistamines that work against cough include
chlorpheniramine, he said. Newer, brand-name antihistamines such as
Claritin and Zyrtec do not help coughs, Dicpinigaitis said.
RESOLVING ON ITS OWN
Under new guidelines, adults with acute cough or upper airway cough
syndrome, commonly known as postnasal drip, should use an older
variety of antihistamine with a decongestant.
And while coughs in children are worrisome and annoying, cough
syrup is not the answer, Irwin said.
"Cough is very common in children. However, cough and cold
medicines are not useful in children and can actually be harmful,"
he said. "In most cases, a cough that is unrelated to chronic lung
conditions, environmental influences, or other specific factors,
will resolve on its own."
The guidelines follow several studies that have suggested that
nonprescription cough remedies do little more than offer comfort to
desperate patients.
Researchers reported in July of 2004 that neither dextromethorphan,
often listed on labels as DM, or diphenhydramine, an antihistamine,
offered any more relief to children suffering from cough than sugar
water.
The study, published in the journal Pediatrics, showed that
children usually recovered quickly whatever the treatment.
Francis Sullivan, a spokesman for Wyeth Consumer Healthcare, which
makes the popular cough treatment Robitussin, said he did not
expect the guidelines to affect sales.
"The FDA (U.S. Food and Drug Administration) has concluded that
these drugs are safe and they work," Sullivan said in a telephone
interview.
In general, analysts say, drug makers make more profit off their
prescription products than on over-the-counter medications.
In 2000 the FDA warned against the use of common over-the- counter
cold remedies and diet pills containing phenylpropanolamine or PPA
after researchers found it raised the risk of stroke in
women.
