Most common questions about coughs Part II

Creator of Zarbee’s, Dr. Zak Zarbock, clears up more questions dealing with cough confusion on some of the most common questions about coughs. If you missed the first part of this series, check it out here: Clearing Up Cough Confusion, Part 1.

What are the dangers surrounding the popular ingredient Dextromethorphan found in lots of drug-based cough medicines?

Dextromethorphan (DM) is a controversial ingredient used frequently in adult and pediatric cough medications. Even when used according to package instructions, DM may not always be safe for cough. Between 5 and 10% of Americans are poor metabolizers of the drug, which may result in very high levels in the body with repeat use. Very high levels may result in hallucinations, breathing difficulty, coma or even death. The drug is also increasing in popularity among teens and adults as a recreational drug of abuse for its psychedelic effects. This practice has led to many retailers and some states requiring proof of age before purchase.

The use of DM in children is also no longer supported by the American Academy of Pediatrics. It has been shown to be ineffective in children, and given their small size, it may be even more deadly when excessive amounts are ingested.

Are there any other cough suppressants available OTC?

Currently there are no other medicated cough suppressants available over-the-counter.

Why did the FDA ban the use of DXM in children?

In 2008, the US Food & Drug Administration (FDA) issued a Public Health Advisory formally recommending that drug-based OTC cough and cold products not be used in infants and children under the age of two “because serious and potentially life-threatening side effects can occur.”

As a result of the warnings, the Consumer Healthcare Products Association (CHPA), an association that represents most of the makers of children’s OTC cough and cold medicines, announced that its members were voluntarily changing their product labels to say “do not use” in children under 4 years of age and introducing child-resistant packaging and new measuring devices. In Canada and the UK, Dextromethorphan has been banned in products for children under 6.

Are there any concerns with adults?

For many adults, the use of cough and cold products containing ingredients like dextromethorphan (DM) may be problematic and potentially dangerous. While for most, if taken as directed, there is little risk, the benefits may be only marginal. DM is not recommended during pregnancy or breast feeding and may interact with many common medications. The most notable interactions include many regularly prescribed anti-depressants, including the SSRI medications. In fact, 1 in 10 individuals in this country over the age of 12 is taking an anti-depressant, posing a major safety risk. There is also a significant portion of adults in the US (roughly 7%) who are poor metabolizers of DM. While unknown to that individual, poor metabolism could result in dangerously high levels of the drug with repeated use.

What are some ways to avoid getting a cough?

– Be sure to wash your hands regularly, for at least 15 seconds if using soap and water
– Help your immune system by eating a healthy diet, drinking plenty of fluids, exercising, and getting adequate rest
– If your home is dry, a humidifier or the regular use of nasal saline sprays may be helpful
– Try to avoid touching your own face—the gateway for viruses and bacteria—whenever possible
-Allergy sufferers may benefit from avoiding allergy triggers, non-sedating antihistamines during peak seasons, as well as personal hygiene, i.e. washing hair before bed, regularly changing clothing and bed linens
– For chronic congestion or sinusitis, saline sprays or a neti bottle may be helpful to reduce congestion and postnasal drainage
– A cough drop or hard candy may also soothe an irritated throat, further preventing cough

Can cough syrup “cure” a cough or does it just soothe it?

Cough syrups are generally divided into two categories, anti-tussives, which are cough suppressants, and expectorants, which are designed to thin mucus. Neither are cures for a cough, but a suppressant may be helpful in adults to limit the cough reflex. They are generally regarded as ineffective in children. Expectorants may help improve a wet cough by thinning mucus that can be difficult to cough up.

Can cough syrup help throat pain sometimes caused by a cough?

A cough syrup with demulcent or coating properties may be very helpful to soothe throat pain caused by coughing. Zarbee’s dark honey cough syrup has excellent demulcent properties that not only help calm the cough, but also improve sore, irritated throats.

Can cough syrup be taken in addition to an antibiotic?

Cough medicines can be used in conjunction with antibiotics. However, if a person is being treated with an antibiotic for a lung infection, a cough can be the body’s way of clearing irritants from the airways. In this instance, it would be more appropriate to use a natural remedy like honey to soothe throat irritation, without impeding the body’s innate reflex.

Zak Zarbock, M.D. is one of the country’s top practicing pediatricians and the Founder of Zarbee’s Effective & Natural remedies, the fastest-growing cough remedy brand in the country. Dr. Zak (as he is known) is a member of the American Academy of Pediatrics, and also practices medicine at Families First Pediatrics in South Jordan, Utah. Dr. Zak is married to his wife of thirteen years and is the proud father of four boys between the ages of three and eleven. In his spare time, Dr. Zak enjoys skiing, hiking, camping and spending time with his family.


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