Do Cough Syrups or Medications Work?

How cough syrups work, plus a recipe to make cough drops at home.

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No medicine cabinet is fully stocked without some good old cherry-flavored cough syrup—or at least that’s how it feels during cold and flu season. But does that cough syrup even work? And, will it work for the type of cough you have?

Colds and flu can produce a wet—phlegmy—cough or a dry one that doesn't expel mucus from your lungs. Gastroesophageal reflux disease (GERD), COVID-19, and asthma can also produce coughs. Some coughing is uncontrollable like those brought on by smoking, chronic obstructive pulmonary disease (COPD), and tuberculosis. Then, there's the barking cough caused by croup.

Mother with syringe giving medicine to her daughter

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How Does Cough Syrup Work?

In theory, this is how different ingredients in over-the-counter cough syrups are supposed to work:

  • Antitussive drugs like dextromethorphan (often listed as DM or DXM) block the body’s cough reflex.
  • Expectorants thin mucus to make it easier to cough.
  • Decongestants help open airways by narrowing blood vessels.
  • Antihistamines help reduce swelling in the nose and throat.

But despite all that, most studies on the topic have found little to no evidence that over-the-counter cold medicines actually work to suppress or stop coughing. In many cases, they’ve performed no better than a placebo. “This is one of those more-research-is-needed type situations,” the video explained.

This video from the American Chemical Society (ACS) gives us the scoop. Spoiler alert: Not really.

Which Remedies Work?

If you have a cough, you could try these suggested remedies recommended in the ACS video:

And some studies have suggested that honey—in hot tea with lemon, for example—may help more than doing nothing at all.

Cough syrups do have one known benefit: They can make you drowsy and help you get to sleep, which is likely very much needed. (Cough syrup is not recommended for children under the age of 4.) Just don’t take more than instructed because that can be seriously dangerous.

The video’s also full of interesting tidbits about why we cough in the first place, when to see a doctor, and what old-timey cough syrup used to be made of before modern-day medicine came along.

Homemade Cough Drop

You could also make a homemade cough drop by combining:

  • ¼ cup freshly squeezed orange juice
  • 1 Tablespoon freshly squeezed lemon juice
  • 2 Tablespoons water
  • 2 Tablespoons orange blossom honey
  • ½ teaspoon ground cloves
  • ½ teaspoon ground ginger
  • 1 cup turbinado—raw—sugar
  • Zest from one medium orange

Stir all these ingredients together in a small pot and simmer them for 20 minutes. Strain to remove seeds and large pieces of zest and continue to simmer and reduce until the liquid mixture reaches 300° F. (149° C.). Spoon the warm mixture into candy molds and freeze for 5-10 minutes. Unmold the frozen drops and wrap them individually in wax paper.

A Quick Review

There is very little evidence that cough syrup actually works for a cough and many studies show that it works no better than a placebo.

According to the American Chemical Society, you are likely better off sticking with some basic home remedies such as drinking plenty of fluids, using a humidifier, and sucking on cough drops or hard candy.

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  1. Smith SM, Schroeder K, Fahey T. Over-the-counter (OTC) medications for acute cough in children and adults in community settingsCochrane Database Syst Rev. 2014;2014(11):CD001831. doi:10.1002/14651858.CD001831.pub5

  2. Goldman RD. Honey for treatment of cough in children. Can Fam Physician. 2014;60(12):1107-8, 1110.

  3. Food and Drug Administration. Use caution when giving kids cough and cold products.

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