Over the counter inhaler for cough
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Over-the-Counter Inhalers for Cough: Efficacy and Insights
Introduction to Over-the-Counter Inhalers for Cough
Cough is a common symptom associated with various respiratory conditions, and over-the-counter (OTC) inhalers are often sought for relief. This article synthesizes research findings on the efficacy of OTC inhalers and other related treatments for cough.
Menthol Inhalers for Cough Relief
Menthol as an Antitussive Agent
Menthol is a widely used ingredient in OTC cough remedies. A study investigated its effectiveness in reducing cough induced by citric acid in healthy subjects. The results demonstrated that inhaling menthol significantly reduced the frequency of evoked coughs compared to placebos such as pine oil or air1. This suggests that menthol inhalers can be an effective antitussive agent for managing cough symptoms.
Sodium Cromoglicate Inhalers for Chronic Cough
PA101 in Idiopathic Pulmonary Fibrosis (IPF) and Chronic Idiopathic Cough (CIC)
A novel formulation of sodium cromoglicate, known as PA101, was tested for its efficacy in patients with IPF and chronic cough. The study found that PA101 significantly reduced daytime cough frequency in IPF patients by 31.1% compared to placebo. However, no significant benefit was observed in patients with CIC2. This indicates that while PA101 may be beneficial for IPF-related cough, its effectiveness in other chronic cough conditions remains uncertain.
General Efficacy of OTC Cough Medications
Mixed Results in Adults and Children
A comprehensive review of OTC cough medications, including antitussives, expectorants, mucolytics, and antihistamine-decongestant combinations, revealed mixed results. In adults, some studies showed benefits for certain medications like guaifenesin and mucolytics, while others, such as codeine and antihistamines, were no more effective than placebo3 4. Similarly, in children, most OTC medications, including antitussives and antihistamines, did not show significant efficacy over placebo3 4.
Need for Higher Quality Evidence
The review concluded that there is no strong evidence supporting the effectiveness of OTC medications for acute cough. The studies often had conflicting results and varied in design, making it difficult to draw definitive conclusions3 4. This highlights the need for more rigorous research to determine the true efficacy of these treatments.
Conclusion
While menthol inhalers have shown promise in reducing cough frequency, the overall efficacy of OTC inhalers and other cough medications remains inconclusive. Sodium cromoglicate (PA101) may offer relief for IPF-related cough but not for other chronic cough conditions. Given the mixed results and the need for higher quality evidence, individuals should consult healthcare professionals for personalized advice on managing cough symptoms.
Sources and full results
Most relevant research papers on this topic
Effect of inhaled menthol on citric acid induced cough in normal subjects.
Inhaled menthol effectively reduces citric acid-induced cough in healthy subjects compared to placebos.
RCT
Highly CitedA novel formulation of inhaled sodium cromoglicate (PA101) in idiopathic pulmonary fibrosis and chronic cough: a randomised, double-blind, proof-of-concept, phase 2 trial.
Inhaled PA101 significantly reduced daytime cough frequency in patients with idiopathic pulmonary fibrosis compared to placebo, but showed no treatment benefit for chronic idiopathic cough.
RCT
Rigorous JournalHighly CitedOver-the-counter medications for acute cough in children and adults in ambulatory settings.
Antihistamine-decongestant combinations are significantly more effective than placebo in reducing acute cough symptoms in adults.
Meta-AnalysisHighly CitedOver-the-counter medications for acute cough in children and adults in ambulatory settings.
There is no clear evidence for or against the effectiveness of over-the-counter medicines in acute cough, with conflicting results and uncertainty regarding clinical relevance.
Meta-AnalysisHighly CitedOver-the-counter (OTC) medications for acute cough in children and adults in ambulatory settings.
There is no clear evidence for or against the effectiveness of over-the-counter medicines in acute cough in children and adults.
Meta-Analysis
Very Rigorous JournalHighly CitedOver-the-counter (OTC) medications to reduce cough as an adjunct to antibiotics for acute pneumonia in children and adults.
OTC cough medications, such as mucolytics, show no significant difference in primary outcome between children and adults with pneumonia, but may reduce secondary outcomes.
Meta-AnalysisVery Rigorous JournalOver-the-counter (OTC) medications to reduce cough as an adjunct to antibiotics for acute pneumonia in children and adults.
There is insufficient evidence to recommend over-the-counter cough medications as an adjunctive treatment for acute pneumonia in children and adults.
Meta-AnalysisCough as an adverse effect on inhalation pharmaceutical products
Inhalation pharmaceutical products may cause cough due to factors such as inhaler device, drug, dose, excipients, and formulation characteristics, which may stimulate cough receptors and reduce drug delivery to the lungs.
Very Rigorous JournalOver-the-counter (OTC) medications to reduce cough as an adjunct to antibiotics for acute pneumonia in children and adults.
OTC medications for cough associated with pneumonia show insufficient evidence to determine their effectiveness as an adjunct to antibiotics in children and adults.
Meta-AnalysisVery Rigorous JournalInhalation of menthol reduces capsaicin cough sensitivity and influences inspiratory flows in chronic cough.
Pre-inhalation of menthol reduces cough sensitivity to capsaicin and influences inspiratory flows in patients with chronic cough.
RCT