Some people experience mild symptoms from COVID-19, while others become severely ill. In general, symptoms tend to be milder in vaccinated people. However, a cough is a symptom that occurs in the majority of patients with mild to severe illness. Up to 70% of people with symptomatic COVID develop a cough. In particular, the omicron variant of the coronavirus has been found to cause symptoms of a bad cold, such as stuffy nose, coughing, body aches, and fatigue. COVID coughs tend to come on quickly and can last for 2-4 weeks. Some people can find themselves coughing for months after recovering from COVID.

Over-the-counter (OTC) and prescription medicines are available to calm a cough caused by COVID. Please keep reading to find out which cough medicine you should pick at the pharmacy to treat a COVID cough.

What does a COVID cough feel like?

A COVID cough does not feel any different from the cough produced by other viral or bacterial respiratory infections. It’s not possible to diagnose COVID only on the basis of coughing. A severe cough could be from a common illness such as the common cold. The only way to tell whether you have COVID is to get tested. If you feel ill and/or have been exposed to someone sick with COVID, it’s best to get tested and start treatment as soon as possible if you are at a high risk of becoming severely ill from COVID-19.

What are the best over-the-counter medicines for COVID cough?
Dry Cough

COVID-19 typically produces a dry cough. Over-the-counter antitussives (cough suppressants) like dextromethorphan (Robitussin, Delsym) are very effective in treating non-productive or dry coughs by controlling the cough reflex.

Menthol cough drops or lozenges may also help with a COVID-19 cough. They have a cooling effect of soothing your irritated throat and help to open up the airways, thus reducing coughing.

Productive Cough

If you have a wet or productive cough with phlegm or mucus, guaifenesin (Mucinex) may be the better choice of cough medicine. It works by thinning or loosening mucus and makes it easier to cough up, thereby making breathing easier.

Postnasal Drip

Mucus dripping down the throat is called postnasal drip. It can irritate the throat tissue and lead to coughing. Newer and non-drowsy antihistamines, like loratadine (Claritin) or cetirizine (Zyrtec), and decongestants like pseudoephedrine (Sudafed) may help relieve a cough triggered by postnasal drip.

Combination Cough Medicines

OTC cough medicines, like Mucinex DM, often contain dextromethorphan (a cough suppressant) and guaifenesin (an expectorant). To help with other cold and flu symptoms, many OTC products contain combinations of cough medicines and other ingredients like pain relievers (acetaminophen, ibuprofen), decongestants (phenylephrine), or antihistamines in nighttime products to help with sleep—examples include Dimetapp Cold and Allergy, DayQuil, NyQuil, Theraflu, and others.

Remember that cough medicines do not kill the virus that causes COVID-19. However, they can improve your cough symptoms and help you get some rest, especially at night if coughing makes it difficult to sleep.

What are the prescription cough medicines for COVID-19?

If over-the-counter medicines do not provide relief from coughing, your healthcare provider may give you prescription medications such as:

Codeine cough suppressants: These are narcotic medicines (for example, promethazine/codeine) and can only be used for short-term relief of cough in adults.
Benzonatate (Tessalon): This is a prescription, non-narcotic cough medication that works by numbing the airways and air sacs in the lungs. It is approved for use in adults and children over the age of 10 years.
Albuterol inhaler (ProAir, Proventil): This is a rescue medicine for quick relief from asthma symptoms, shortness of breath, and wheezing; these inhalers can be used to help with difficulty breathing and coughing due to COVID-19.
Montelukast (Singulair): This asthma medicine works by blocking the effects of inflammatory mediators and is believed to be helpful during antiviral infections due to its antioxidant properties.

How to treat mild symptoms of COVID cough?

Patients with mild COVID-19 symptoms may not need to take cough medications. Some of the measures that may help to reduce coughing include:

Hydrate and loosen up mucus by drinking warm water or beverages like tea or broth. Adding a teaspoon of honey to hot tea or water to help soothe an irritated throat.
Steam inhalation to soothe and hydrate the tissues of the mouth, nose, and throat. Keep in mind that children under 1 year should not consume honey.
Salt water gargles.
Cough drops or lozenges.
Lying on your side or sitting upright can help to reduce coughing compared to lying on your back.

Should I avoid cough medicine that contains dextromethorphan if I have COVID?

A research paper published at the beginning of the COVID-19 pandemic found that the cough suppressant, dextromethorphan, helps increase the rate of replication (multiplying) of SARS-COV-2, the virus that causes COVID-19. The authors of this research added that more research is needed to find out which medications are safe to take during the coronavirus infection.

One important thing to consider is that this study was tested using cells in a lab and not on human beings. Based on this major factor, there is not enough evidence to conclude that dextromethorphan is not safe to take if someone is COVID-19 positive. So should you still avoid dextromethorphan with a coronavirus infection? It is completely up to you. If you decide not to use this cough medicine just for your peace of mind, there are other natural remedies to soothe a cough that you can look into.

Wrapping up

If you have tested positive for COVID-19 and are bothered by a cough, treatments are available to provide relief. Some cough medicines for COVID-19 are available over the counter, while others must be prescribed by a healthcare provider. The important thing is to test for COVID-19 as soon as you feel ill and to start treatment soon after a positive diagnosis.

Do not delay getting in touch with your healthcare provider or pharmacist, even if your symptoms are mild at the present time. Starting treatment early can help to limit the severity of the COVID-19 disease. The good news is that most people with mild COVID-19 do not need hospitalization and can recover at home.

References:

https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(21)00125-9/fulltext
https://www.nature.com/articles/s41586-020-2286-9
https://www.uchealth.org/today/coronavirus-drugs-for-home-and-hospital/
https://www.frontiersin.org/articles/10.3389/fphar.2020.01344/full

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