Doctors warn against using cough syrups
Updated Tue. Jan. 10 2006 10:04 AM ET
http://tinyurl.com/8rcbp
CTV.ca News Staff

Doctors are warning that a commonly-used remedy --cough syrups -- may not work.

The American College of Chest Physicians has reviewed dozens of studies of cough
syrups and concluded "(there's) little efficacy in patients with coughs due to
upper respiratory infections. Their long-term effectiveness has not been
established."

The dose of drugs in over-the-counter cough syrups are generally too low to be
effective or contain combinations of drugs that have never been proven to treat
coughs, said Dr. Richard Irwin, chairman of a cough guidelines committee for the
American College of Chest Physicians.

"Some of the products contain medications that have no chance of working at
all," Irwin said.

About 40 per cent of adult Canadians use cough medicine annually, Gerry
Harrington of the Non Prescription Drug Manufacturers of Canada told CTV.ca.
Canadians spend about $100 million annually on these medicines.

Coughs are classified as either acute (lasting less than three weeks) or chronic
(lasting three to eight weeks or longer). Acute coughs are usually caused by the
common cold while chronic coughs are caused by post-nasal drip syndrome, asthma
or gastroesophageal reflux disease.

Dr. Louis-Philippe Boulet, a respiratory specialist with the Canadian Thoracic
Society, told Canada AM on Tuesday that acute coughs usually resolve themselves,
while patients with longer-term coughs should be examined by a doctor.

"In most instances, people take those cough syrups for a long period of time and
. this is hiding another problem that should be treated with other treatments,"
he said.

"And a cough is actually good. It helps relieve some of the symptoms."

The ACCP has issued guidelines on managing coughs, in the January issue of their
journal Chest.

These guidelines discourage use of newer, non-sedating antihistamines.

The drug manufacturer's association stands behind cough syrups though.

"These agents are safe and effective at providing relief in the short term from
coughs due to upper respiratory infections such as colds and flu," Harrington
said.

The ACCP also found that the doses of two drugs --codeine and dextromethorphan--
contained in some over-the-counter cough syrups are too small to be effective.

What does work are older antihistamines combined with a decongestant or
anti-inflammatory drugs such as Advil.

Some of the cough syrups contain narcotics, alcohol or drugs that affect the
brain. Many of them contain a combination of these drugs. Doctors are concerned
these combinations can leave children disoriented and agitated.

Harrington also disagreed with this assessment.

"Codeine shouldn't be given to children and the amount of alcohol (in cough
syrups) is getting lower and lower. The safety standards for over-the-counter
medications are very high."

Some doctors are concerned that the use of cough syrups means people will put
off getting treatment for chronic coughs.

"If they are not diagnosed you are postponing good treatment for a disease that
remains untreated and can get worse with time," Dr. Louis-Philippe Boulet of the
Canadian Thoracic Society said.

However, cough syrup labels tell people to see their doctor if the cough
persists for more than three days, said Harrington.

The ACCP guidelines recommend an old-fashioned treatment for coughs --drinking
lots of fluids and visiting a doctor if the cough persists.

With files from CTV's Avis Favaro and the Associated Press