What to Know About Expectorants

An expectorant is a type of cough medicine that thins and loosens mucus. These medications are typically used for managing chest congestion, especially when symptoms are caused by a lot of mucus. Expectorants are a mucoactive class of drugs—those that clear mucus from the airways.

Guaifenesin is the most commonly used expectorant. It is the active ingredient in Mucinex 404 and Robitussin. Expectorants come in different forms, including over-the-counter (OTC) liquids, pills, and tablets.

This article goes over what kinds of expectorants there are, why you might want to use one, and what you should know before taking expectorants for your symptoms. 

Uses

Expectorants are commonly used for symptoms of short-term (acute) respiratory tract infections, like the common cold, pneumonia, or bronchitis.

These infections can cause a buildup of phlegm in your throat or lungs. It is often hard to cough up this thick mucus, and you can develop a nagging cough and chest discomfort when the mucus builds up. 

Expectorants thin respiratory secretions in your airways so that you can cough up extra mucus more effectively. These medications help by lubricating the airway passages.

Coughing up phlegm reduces discomfort from chest congestion. Coughing up debris and infectious material like bacteria and viruses may also lower the risk of infection.

Types of Expectorants

There are many brand-name over-the-counter (OTC) products and prescriptions with guaifenesin in them. It is also available in generic form. Combination expectorants can relieve cold symptoms in a few ways. 

Robitussin DM and Mucinex DM are a combination of guaifenesin and dextromethorphan. Mucaphed is a combination of guaifenesin and phenylephrine (the active ingredient in Sudafed PE).

Natural Expectorants

While there are some home remedies that can act like an expectorant, they’re not the same as an OTC or prescription product. 

These remedies can help with symptoms but do not treat the underlying cause of symptoms.

Examples of natural expectorants include:

• Honey: Honey is a popular sore throat remedy and may also help with a cough. It can be taken by spoonful or added to tea. Just remember that babies under 1 year old cannot have honey. 
• Ginger: Ginger may help with a stuffy nose and chesty cough. You can get lozenges made with ginger or use some fresh ginger to add to tea. (It might even be more helpful if you add honey, too.)
• Garlic: Garlic might help with common cold symptoms, including a cough. While you can add fresh garlic to hot water to make a soothing drink, the taste might be a little too strong. Instead, try adding it to hot water to create steam you can inhale to help clear up a cough.
• Eucalyptus: Many natural cough remedies have eucalyptus in them. You can use the oil to make steam to breathe in to help ease congestion and cough, but you should not consume it by mouth. 
• Menthol: Minty cool menthol is another popular natural ingredient in cough and cold products. You can use it to help with a cough as well as make a sore throat feel better.
• Water: Believe it or not, simply staying hydrated by drinking plenty of water will go a long way to helping clear up mucus, soothe throat irritation, and calm a cough. 

Off-Label Uses

Sometimes, expectorants are used to manage congestion associated with chronic respiratory conditions like chronic obstructive pulmonary disease (COPD) or emphysema. If you have a chronic respiratory condition, you should not use an expectorant unless your healthcare provider recommends it.

Guaifenesin has been explored in the management of fibromyalgia, but researchers are not sure why it might help and providers do not officially consider it a treatment for the condition.

Before Taking

You usually will not need to have any medical tests before using an expectorant. Your provider may recommend that you use one early in the course of your illness—as soon as it becomes clear that mucus is causing your symptoms. 

However, you should not take an expectorant if you had a serious (adverse) reaction to using one in the past. 

Precautions and Contraindications

Talk to your provider before using an expectorant if you are pregnant or breastfeeding. If you have developed any type of allergic reaction or intolerance to expectorants in the past, you should not use them. 

You should also be careful when driving or using machinery while you’re taking an expectorant because the medications can make you drowsy or dizzy.

Expectorants often come as combination medications. It’s important that you read the labels carefully and make sure you know what all the ingredients are. Even if you can safely take an expectorant, there might be other ingredients in the product that would not be safe for you to take.

Some combination medications also have pain-relieving ingredients in them. If you are already taking another pain reliever like Tylenol, check if the cold product has any pain medicines in it to make sure you don't take too much.

Combination expectorants can help relieve cold symptoms because they can use more than one mechanism of action at the same time.

There are different brands of guaifenesin, as well as generics. Robitussin DM and Mucinex DM are composed of a combination of guaifenesin and dextromethorphan. Mucaphed is a combination of guaifenesin and phenylephrine.

Dosage

If you’re taking an expectorant, follow your healthcare provider’s or pharmacist’s instructions. Always read the medication package carefully and make sure you understand them. 

In terms of timing your doses, long-acting versions of expectorants are taken less often than the regular versions. Make sure you know which kind you are taking and how many times a day you can take them.

Do not crush pills. Measure liquid formulations using the measuring tools that come with the medication. And drink plenty of fluids when taking an expectorant.

Store your medication according to the package instructions and away from pets and children. 

Side Effects

Expectorants do not commonly cause serious side effects. The most common side effects of expectorants include dizziness, drowsiness, and rash.

Combination expectorants are more likely to cause side effects. Dextromethorphan (the main ingredient in Robitussin DM and Mucinex DM) can cause drowsiness, dizziness, nervousness, restlessness, nausea, and vomiting.

Warnings and Interactions

Phenylephrine (found in Mucaphed), can cause high blood pressure and a slowed heart rate (bradycardia). The drug can also interact with antidepressants and heart medications.

Summary

Your provider might suggest you take an OTC expectorant to help clear up congestion because these medications work to thin mucus and make it easier to cough up.

There are many expectorant products to choose from and some have other medications that help with common cold symptoms in them, too. Make sure that you check the labels carefully and know all the ingredients that are in a product you plan to take. You should always check with your provider or pharmacist before starting an expectorant. 

Keep in mind that home remedies for a cough and cold can also help you feel better.