WASHINGTON — A panel of medical experts said Tuesday that cough medicines like Robitussin and Nyquil should continue to be sold over-the-counter, despite increased abuse among teenagers that has prompted calls to restrict sales of the products.
The Food and Drug Administration panel voted 15-9 against a proposal that would require a doctor’s note to buy medicines containing dextromethorphan, an ingredient found in more than 100 over-the-counter medications.
The FDA is not bound to follow the group’s advice, though it often does. Specifically, panelists were asked if the ingredient should be “scheduled,” a regulatory move designed to decrease access to drugs with high potential for abuse.
“For me there was no data to show us that scheduling this product would decrease abuse,” said panelist Janet Engle, professor and department head of pharmacy practice at the University of Illinois.
Abuse of dextromethorphan, dubbed “robotripping,” is popular among teenagers as an inexpensive way to get high, but it carries risks, including elevated blood pressure, heart rate and fever. Abusers can also suffer side effects from other ingredients mixed in cough medicines, such as acetaminophen, which can cause liver damage.
Types of OTC cough medicines
Over-the-counter (OTC) medicines are the medicines that are sold without doctor’s prescription. Though there are many types of OTC cough medicines, they are mainly grouped under two categories. Antitussive OTC cough medicines are those medicines that suppress your cough reflexes and used to relieve dry cough. Another category is expectorant OTC medicines used for breaking up and thinning the mucus, and cause the phlegm to be coughed out of the body. Most of the antitussive OTC medicines may contain antitussive active ingredient Dextromethorphan and expectorant OTC medicines may contain expectorant guaifenesin.
Generally cough does not need treatment. If the cough is caused by cold or flu, it will naturally be cleared on its own in few days. Cough medicines may be used if the cough is disturbing your sleep or hampering your daily activities. Cough caused by irritants such as smoke or asthma or chronic bronchitis should not be treated with cough medicines as the cough is helping you to clear your lungs.
Side effects of OTC cough medicines
Usually OTC cough medicines do not cause any side effects in healthy adults. At times they can cause irritation, giddiness or drowsiness. But in people who have may have other health problems, in elderly persons and in individuals who have been using the cough medicines for a long time, these OTC medicines may cause side effects.
Drug interactions
Most of the OTC cough medicines are combined with other active ingredients that are meant to relieve congestion in your nose and also relieve pain and fever. When you take these OTC medicines ensure that these active ingredients do not interact and cause side effects. The best way is to inquire with the pharmacist or consult your doctor.
It is advisable not to use OTC medications that are meant for the relief of multiple symptoms. For example, if you are using an OTC medicine containing an expectorant, avoid using other medications containing pain relievers such as paracetamol or ibuprofen or running nose relievers such chlorpheniramine maleate as these medicines may cause harmful side effects. Also, avoid taking medicines that contain the same ingredients as they may increase the quantities of medicines more than required and cause adverse effects.
Other reasons to consult your doctor
- It is very important to consult your doctor before you take any OTC medicines if you have any of the following signs or symptoms.
- If you have elevated body temperature, rash or headache
- If you have any breathing problems such as gasping for breath or panting
- If you are having cough for more than few weeks or have a cough that is recurring.
- If you produce hoarse whistling sound when you breathe
- If you cough thick or yellow/green colored mucus.
Points to note on a drug label
- Active ingredient: It is the main and the most important ingredient of the medicine. Most of the times it is the first item on the label. Ensure to check whether the label contains correct active ingredient and strength. Also ensure to check whether the label contains the correct strength or the quantity of the active ingredient. The active ingredient must also be in the right potency so that the medicine can provide the desired results.
- Indications: This section provides the purpose of the medicine and for which conditions to treat the medicine can be used. Ensure to ascertain that the medicine is for the right indications.
- Precautions: Provides the various safety precautions you need to take when you are taking the medications and also warns the possible side effects the medicine may cause. The section also provides the information as to who can take the medicine and for whom the medicine is not recommended.
- Dosage: Provided the information as to how much of the medicine and at what frequency the medicine needs to be taken for the medicine to be effective. The dosage may differ depending on the age such as for children and adults.
- Storage: This section provides information as to how and at what temperature the medicine should be stored for obtaining optimum results.
- Excipients: The formula of the medicine may also list out all the other inactive ingredients used in the medicine. Ensure to look for any ingredients that may trigger allergic reactions.
- Manufacturing and expiry dates: Always make it a point to buy medicine whose shelf life has not expired as the expired medicines may not be potent enough or safe enough to consume.
- Manufacturer’s details: Provides complete details of the manufacturer so that in case if required you may reach the manufacturer of the product.
Summary
OTC cough medicines are mainly two types. These are antitussives and decongestants. Antitussives suppress the cough and decongestants provide relief from congestion. Only take OTC medicine to treat cough if your sleep or regular daily activities are disturbed. At times OTC cough medicines may cause side effects such as drowsiness, dizziness or irritation. OTC medicines may interact with the medicines you are taking and cause side effects. Hence you should consult your doctor before you take any OTC medicines if you are already taking medicines for some other condition. You need to consult your doctor if you have a persistent cough or cough with thick phlegm, have fever or have any breathing problems. It is also advisable to read the label of the OTC medication before you take and follow the instructions as advised.
