January 9, 2006

No evidence cough syrups work: panel

By Maggie Fox, Health and Science Correspondent

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

"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.


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

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.