Cough is one of the most common complaints in all age groups, yet its management is often misunderstood. While over-the-counter (OTC) phlegm syrup are widely available, their indiscriminate use, especially in children, can be ineffective and sometimes harmful.

Most coughs, especially due to viral infections, solve on their own within 1-2 weeks. The key is to identify the type of cough, target the underlying cause, and use the simplest, safest measures.

Today India. Specially talked with Dr. Anurag Agarwal, Advisor, Internal Medicine, Fortis Escorts Hospital, Faridabad, to get expert insight on safe use of cough drugs in ages And how parents and adults can manage cough without unnecessary drugs.

Major principles for cough management

• Treat the cause: viral cold, allergies, asthma, or acid reflux should be addressed instead of masking direct symptoms.

• Match the drug for the type of cough: Dry/irritable cough responds to suppression, while wet/productive coughs are beneficial.

• Avoid multi-unit “all-in-one” syrup until it is specifically determined.

• Never use codeine or opioid syrup in children; Adults should only use them when determined.

• First give priority to non-drug measures, especially in children.

Baby (0-6 months)

• No OTC cough or cold syrup

• Use nose saline droplets, gentle suction, humidifier, honest position and persistent feed

• Difficulty breathing, bad feeding, fever, or if the child is with less than 3 months of cough, seek immediate medical care

6-12 months

• Avoid cough syrup and honey

• Saline drop

• Search for pediatric care in case of fever, rapid breathing, wheezing or poor intake

1-2 years

• OTC syrup is largely ineffective and can be side effects

• Safe option: honey (1 year, 2.5 ml as required), warm fluid, saline drop, humidifier

• Look at a pediatrician if night cough persists, wheezing develops, or sleep/food is disturbed

2-4 years

Usually avoid antimicrobes and decongestnts until a pediatrician is advised by a pediatrician.

• Non-digested measures remain the first-power; Honey 2.5-5 ml as required

• If the medicine is required, single-clock products are preferred

• Dry cough: dextromethorphon (pediatric dose)

• Wet cough: Guafenine (pediatric dose)

• Until it is determined

4-6 years

• Non-digested measures should be given priority

• Dry cough: dextromethorphon if label permit

• Wet cough: guifenine

• Allergic cough: Pediatric cetirizine or levosetirizine can help

• Avoid multi-interaction syrup and decgestants until clearly needed

6-12 years

1. A similar approach for 4-6 years

2. Solo-government option

3. Drought: dextromethorphan (age/weight-based)

4. Wet: Guesinine; Embroxole or bromhexine if determined

5. Allergies/post-nuscia: non-shedal antihistamine; Barn

6. Avoid codeine and tamper with the first generation antihistamine during the day

Teen (12-18 years)

Manage like adults but avoid codine and followCodin; Educate about dextromethorphon misuse

• Dry cough: dextromethorphan

• Wet cough: cafenen; Embroxole/bromhexine advised

• Allergic cough: non-satisfied antihistamine; Intranic steroid spray if recommended

Adults

• Dry/irritable cough: dextromethorphon (especially at night); Levodropropizine only under doctor guidance

• Wet/Producer cough: cafenen; Embroxole or bromhexine to thin mucus; Maintain hygiene

• Allergies/Post-Nasle Dip: Non-Seding Antihistamine; Consider intrangeal steroids for rhinitis

• Bhata related cough: The lifestyle initial dinner, changes the height of the head, avoids trigger foods; Acid suppression under doctor supervision

• Avoid codine until the prescribed codine

Old adult

• Prefer non-Sheding options; Avoid the first generation antihistamine due to drowsiness and fall

• Check drug interactions and comoridities before using cough drugs

Pregnancy and breastfeeding

• Prefer non-drug measures: saline, honey (if not diabetes), warm liquids

• Syrup only under maternity guidance; Avoid codeine and, in early pregnancy, decgestants

• Dextromethorphon or gaFenne can be considered short -lived when recommended

What to avoid at any age

• Codein/Opioid Syrup in children; Adults are determined only

• Multi-event “kitchen-sync” syrup

• Decongestants in young children or adults with high BP, heart disease, thyroid disease, glaucoma, or prostate issues

• Antibiotics without a strong bacterial infection

• Alcohol containing syrup; Chinese free option for diabetes

Dosage and safety tips

• Always use measurement devices provided; Age/weight dose

• Never combine double-blows or products with the same component

• Interaction: dextromethorphon + MAOIS/Linezolid or some antidepressants risk serotonin syndrome

• Antihistamines spoil driving driving; Avoid alcohol

• Buy from reputed pharmacies; Check batch/expiry and CDSCO advisors

When medical care immediately

Fast/Lebord Breathing, Chest Pain, Blue Lips, Noise Breathing, Acudion, Acudion, Dehydration

• High fever, hupping sound, or suspected inhaled object

• Cough> 2-3 weeks, blood, weight loss, night sweat (consider TB)

• Asthma/COPD, heart/lung disease, or recurrent severe cough

• Baby <3 months with any cough

Children: Avoid most of the syrup; Use saline, humidifier and honey (> 1 year). If necessary, use single-clock products at pediatric doses under medical guidance.

Adults: Select single-clock drug matching the type of cough; Avoid opioids and unnecessary combo. Always check for interaction and medical conditions. Look for medical care for red flags or prolonged cough.

Avoid self-medication; Evidence-based, targeted treatment is the safest.