Aside from codeine, dextromethorphan, and diphenhydramine, are there other effective cough suppressants?

The answer is no. None of the other ingredients you'll find in the market today have met the US Food and Drug Administration's standards for efficacy. In fact, some ingredients may be bad for your health and should be avoided.

The last rule applies to so-called shotgun remedies or cough medicines that contain a lot of ingredients. In many cases, these combinations are irrational and without basis. For instance, some products contain expectorants that supposedly loosen phlegm. At the same time, they also have a cough suppressant that stops coughing and prevents a person from spitting out phlegm!

"A survey of prescribing guides from 12 regions of the world found that well over third of the 2,198 cough and cold preparations listed contained more than three ingredients. A staggering 86 percent of all the products listed contained ingredients deemed by independent sources to be ineffective in the treatment of cough. And, to add injury to insult, 55 percent of the products contained ingredients liable to cause harmful adverse reactions. The situation is not improving (as more recent studies show)," according to Andrew Chetley in “Problem Drugs.”

Other irrational cough remedies combine cough suppressants like dextromethorphan with different ingredients in an effort to make the whole mixture more effective. However, experts warn that such combinations do not necessarily make a better product or an effective cough syrup.

"Many cough medications also contain painkillers, decongestants, or antihistamines. Most of us in the medical profession, however, believe that these combination products are not terribly effective, and can even cause further problems. All too often they do not provide a sufficient dose of a necessary active ingredient, while containing drugs that are not needed for the treatment of your illness. They may also contain an ingredient to which you may respond badly, thus complicating the illness and its diagnosis. Stick to single-ingredient products whenever possible and familiarize yourself with the ingredients most appropriate for a particular symptom in order to select the best medication," said Drs. Michael D. Mitchell and Marvin S. Eiger in “The Pill Book.”

To benefit most from the above suppressants, choose products that contain only one effective active ingredient. You can save money and minimize side effects that way. Cough drops or tablets are preferable than syrups since the latter are expensive and contain many questionable ingredients.

"Regardless of which antitussive you choose - codeine or dextromethorphan - take it 'straight' in tablet form. There's no need to gag on a syrup that often tastes terrible, may depress an already impaired appetite, and usually contains sugar, which you want to avoid if you are diabetic (although there are sugar-free cough syrups.) The point is, none of the added ingredients in the syrup is going to help your cough," said Dr. Isadore Rosenfeld of the New York Hospital - Memorial Sloan-Kettering Cancer Center in “The Best Treatment.”

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