What to Expect When You Need an Expectorant (2024)

An expectorant is a type of cough medicine that thins and loosens mucus. These medications are typically used for managing chest congestion, especially when symptoms are caused by a lot of mucus.

Expectorants are a mucoactive class of drugs—those that clear mucus from the airways. Guaifenesin is the most common expectorant and is found inMucinex 404and Robitussin.

In addition to over-the-counter (OTC) liquids, pills, and tablets, there are natural remedies that some people use to thin mucus and relieve congestion.

Benefits of Expectorant

Expectorants are commonly used for symptoms of short-term (acute) respiratory tract infections, like the common cold, pneumonia, or bronchitis.

These infections can cause a buildup of phlegm in your throat or lungs. Expectorants thin this phlegm. Once it's loosened, you can cough up the excess mucus, making it easier to breathe.

Types of Medicinal Expectorants

There are many brand-name over-the-counter (OTC) products and prescriptions that use different types of medication.

• Guaifenesin: Guaifenesin is considered the most effective expectorant and is the only medication legally approved as an expectorant. It's available as a brand-name medication (Mucinex, Tussin, etc.) and in generic form.
• Combination medicines: Some medications combine an expectorant with another type of medication to relieve symptoms. For example, Robitussin DMand Mucinex DM are a combination of guaifenesin and dextromethorphan (cough suppressant). Mucaphed is a combination of guaifenesin and phenylephrine (a decongestant).
• Potassium iodide: Potassium iodide is often used to treat respiratory issues in people with asthma, chronic bronchitis, or emphysema because it is thought to act as an expectorant, decreasing the thickness of mucus.
  

Natural Expectorants

Some home remedies can act like an expectorant to thin secretions. However, there is limited evidence supporting their effectiveness in treating cough and congestion.

Studies of natural remedies may include only animal tests and others consist of small human trials. Do not discontinue prescription medications, and talk to your healthcare provider before using alternative treatment.

Examples of natural expectorants include:

• Honey: Honey is a popular sore throat remedy and may also help with a cough. It can be taken by spoonful or added to tea. Note that babies under 1 year old cannot have honey.
• Ginger: Ginger may ease chest congestion and cough when used as lozenges, or add fresh ginger to tea. It might even be more helpful if you include honey, too.
• Garlic: Garlic might help with common cold symptoms, including a cough. While you can add fresh garlic to hot water to make a soothing drink, the taste might be a little too strong. Instead, try adding it to hot water to create steam you can inhale to help clear up a cough.
• Eucalyptus: Many natural cough remedies have eucalyptus in them. You can use the oil to make steam to breathe in to help ease congestion and cough, but you should not consume it by mouth.
• Menthol: Minty cool menthol is another popular natural ingredient in cough and cold products. You can use it to help with a cough as well as make a sore throat feel better.
• Ivy leaf extract: This traditional medicinal plant contains saponins, which may have expectorant properties. Extracts can be made into cough syrups and taken orally.
• Water: Believe it or not, simply staying hydrated by drinking plenty of water will go a long way to helping clear up mucus, soothe throat irritation, and calm a cough.

Off-Label Uses of Expectorants

Sometimes, expectorants are used to manage congestion associated with chronic respiratory conditions likechronic obstructive pulmonary disease (COPD)or emphysema. If you have a chronic respiratory condition, you should not use an expectorant unless your healthcare provider recommends it.

Guaifenesin has been explored inthe management of fibromyalgia, but researchers are not sure why it might help and providers do not officially consider it a treatment for the condition.

Precautions and Contraindications

Talk to your provider before using an expectorant if you are pregnant or breastfeeding. If you have developed any type of allergic reaction or intolerance to expectorants in the past, you should not use them.

You should also be careful when driving or using machinery while you’re taking an expectorant because the medications can make you drowsy or dizzy.

Expectorants often come as combination medications. It’s important to read the labels carefully and make sure you know what all the ingredients are. Even if you can safely take an expectorant, there might be other ingredients in the product that would not be safe for you to take.

Some combination medications also have pain-relieving ingredients in them. If you are already taking another pain reliever like Tylenol, check if the cold product has any pain medicines in it to make sure you don't take too much.

Dosage

If you’re taking an expectorant, follow your healthcare provider’s or pharmacist’s instructions. Always read the medication package carefully and make sure you understand them.

Follow these general guidelines:

• Do not crush pills.
• Measure liquid formulations using the measuring tools that come with the medication.
• Drink plenty of fluids when taking an expectorant.
• Store your medication according to the package instructions and away from pets and children.

Side Effects

Expectorants do not commonly cause serious side effects. The most common side effects of expectorants include dizziness, drowsiness, and rash.

Combination expectorants are more likely to cause side effects. Dextromethorphan (the main ingredient in Robitussin DM and Mucinex DM) can cause drowsiness, dizziness, nervousness, restlessness, nausea, and vomiting.

Phenylephrine (found in Mucaphed) can cause high blood pressure and a slowed heart rate (bradycardia). The drug can also interact with antidepressants and heart medications.

Summary

Your provider might suggest you take an OTC expectorant to help clear up congestion because these medications work to thin mucus and make it easier to cough up.

There are many expectorant products to choose from and some have other medications that help with common cold symptoms in them, too. Check the labels carefully and know all the ingredients that are in a product you plan to take. You should always check with your provider or pharmacist before starting an expectorant.

Keep in mind thathome remedies for a cough and coldcan also help you feel better.

By Deborah Leader, RN
Deborah Leader RN, PHN, is a registered nurse and medicalwriter who focuses on COPD.