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How To Select An Expectorant

When I was at my hairdresser’s last week, he asked me, “I was at the grocery last week looking for Mucinex® but instead of just a couple of choices, I found a whole section of it, all saying Mucinex® on the box! How do I pick the one that’s best for me?”

The original Mucinex® tablets are still out there, containing only one ingredient: guaifenesin, pronounced gweye-FEN-ah-SIN. Guaifenesin works as an expectorant and has been sold for decades as the main ingredient in Robitussin® cough syrup.

Guaifenesin was developed by the A.H. Robbins company in 1949 and introduced as a prescription cough syrup called Robitussin®. By the time I graduated from pharmacy school 30 years later in 1979, Robitussin® was the most popular prescribed cough medicine in the country, with various formulations like Robitussin PE, Robitussin AC, and Robitussin DM. Whether alone or combined with a decongestant, an antihistamine or a cough suppressant, Robitussin was a best seller both as a prescription and non-prescription cough medicine.

Guaifenesin an expectorant. It works by increasing the fluid in your sinuses, throat, and lungs, to help liquefy sticky phlegm and mucus so that you can cough it up and out. Although they are both called cough medicines, an expectorant works differently than a cough suppressant. Cough suppressants dampen down your cough, helping you get much needed rest at night but don’t deal with stubborn gunky phlegm like an expectorant can.

Eventually guaifenesin moved beyond just Robitussin® syrup and as tablets it was sold as the prescription medicines Entex®, Entex LA®, and Entex® PE, a combination of guaifenesin and pseudoephedrine (Sudafed®). These were very popular in relieving symptoms of throat and lung congestion and sinusitis. When the patent protection on them expired, the company applied to the Food and Drug Administration (FDA) to sell the exact same formulations over-the-counter, and Mucinex® and Mucinex-D® were born.

Adding a decongestant to guaifenesin can help with sinusitis and a stubborn, non-productive cough. Mucinex-D® is the non-prescription equivalent of Entex® PE. It’s available right next to the original Sudafed®, and like Sudafed® you’ll need to sign for it.

Robitussin® and Mucinex® each contain guaifenesin. So, which one should you choose? Robitussin® cough syrup contains 100mg/5ml or 100mg per teaspoonful, while Mucinex® has 600mg per tablet and Mucinex® Maximum Strength has 1200mg in each tablet. Robitussin liquid is designed for children over the age of 2 up to age 12. The adult dose of guaifenesin of 1200mg to 2400mg per day is best supplied by taking tablets of Mucinex®.

Mucinex® tablets are available both as short acting and long-acting forms. I recommend buying the 600mg long acting tablets which last 12 hours. Some people get queasiness at the higher doses, so I suggest you the 600mg tablets so you can see which dose is best for you.

If you need an expectorant, avoid Mucinex® Allergy! One of the reasons there are so many products with Mucinex® on them is that companies often take advantage of the familiarity of popular brand names and use those names on related and sometimes even completely unrelated products. This is called “extending the product line” and can create lots of confusion. Mucinex Allergy® doesn’t have any guaifenesin in it at all. Instead it has fexofenadine, the same antihistamine found in Allegra®.

Here are 5 tips when selecting an expectorant:

  1. Mucinex® contains an expectorant, not a cough suppressant. Expectorants work by increasing fluid in your sinuses, throat and lungs to help liquefy thick sticky mucus, but don’t dampen a cough. If you need to cough less, take a cough suppressant instead, like dextromethorphan (Delsym®).
  2. When you have a cough or cold, drink plenty of fluids to help liquefy your secretions. If you suffer from stubborn thick mucus in your throat or lungs, Mucinex® can help thin and liquefying that sticky phlegm, helping you cough it up and out of there.
  3. Adding a decongestant like pseudoephedrine (Sudafed®) to an expectorant like guaifenesin can to help it work even better. I recommend choosing Mucinex-D®, which you’ll need to sign for at the pharmacy counter.
  4. Avoid Mucinex Allergy® unless you have allergies; it doesn’t have an expectorant in it and so it can’t help relievebyour dry cough.
  5. The best Mucinex® to start with is the 600mg long-acting tablets. Use 1-2 tablets every 12 hours. If your stomach bothers you, decrease the dose.
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  • ABOUT DR. LOUISE

    Dr. Achey graduated from Washington State University’s school of pharmacy in 1979, and completed her Doctor of Pharmacy from Idaho State University in 1994.

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