General Information

When you have a chesty cough (wet, productive or phlegmy) your chest feels heavy and you may cough up mucus or phlegm. A chesty cough may follow a sore throat or a cold and can be worse in the morning.

Coughs and colds are often caused by a virus, so antibiotics are not suitable treatment. Sometimes cough medicines can relieve symptoms, but they should not be given to children under six years old, and given only cautiously to older children between the ages of 6 to 12 years.

A chesty cough can sometimes be a sign of another problem, such as asthma, heart failure, chronic bronchitis or a respiratory infection. The longer a cough lasts, the more likely it is that there may be an underlying, more serious cause.

People who smoke, have low immunity or older people, can be prone to serious complications such as bronchitis and pneumonia.

See Your Pharmacist or Medical Professional

• if the person with the chesty cough is under two years old
• if you cough up blood, which may look like coffee granules
• if you cough up mucus of any colour, especially frothy pink or dark green
• if you have a high temperature (above 39°C)
• if your cough has changed, such as from a dry cough to a chesty cough
• if you have other symptoms, such as chest pain, wheezing, difficulty breathing, a fever, weight loss, persistent headache, sore ears or a rash
• if your cough is mainly at night if you are a smoker
• if you experience severe and sudden symptoms of the flu (these can include muscle aches and pains, tiredness, headache and fever)
• if your chesty cough has lasted more than five days, or has worsened
• if you have high blood pressure, a heart condition, diabetes, thyroid problems, a respiratory illness such as asthma, or if you are taking other medicines
• if you are pregnant or breastfeeding (some medicines may not be suitable)
• if you have allergies to any medicines

It is important to speak to a health professional before taking any cough medicine, as many products are for a dry, tickly cough not a chesty cough.

Treatment Tips

• keep warm, get lots of bed rest and drink plenty of water
• gargle with plain or salt water for one minute, three times a day; this can ease symptoms of sore throat associated with coughing
• steam from a hot shower may help break down the mucus, making it easier to cough up and can clear sinuses
• coughs and colds are spread by contact with others, such as through shaking hands and sharing drink bottles
• cover your mouth when you sneeze or cough, then wash your hands with soap
• use tissues not handkerchiefs, as they carry less risk of infection

Treatment Options

• cough medicines for chesty coughs loosen or break down mucus in your lungs, making it easier to cough up
• it is important to cough up the mucus; cough medicines that suppress coughs are not recommended as this can lead to further infections
• guaiphenesin or bromhexine are the first-choice treatments for chesty coughs, but it is important to remember that while they may help with relieving your cough symptoms, they will not cure the underlying condition causing the cough
• the syrup in cough medicines can also coat the throat to relieve irritation
• medicines for pain and fever, such as paracetamol or ibuprofen, can relieve throats that are sore from coughing
• lozenges like Strepsils or Difflam, which contain antibacterial, antiinflammatory agents can be used, and Difflam sore throat spray, which has anti-inflammatory, can be used as well
• stronger lozenges or throat spray containing anaesthetics can be used to relieve severe discomfort
• some cough medicines and cold remedies contain antihistamines to dry up a runny nose
• with chesty coughs, antihistamines make it harder to remove mucus from your lungs and should be avoided
• some ingredients in cough medicines can interact with other medicines, so always check before using
• cough mixtures often contain multiple ingredients, so match ingredients to your symptoms; sometimes you only need one ingredient
• combination products can contain ingredients that are not suitable for taking during pregnancy; check with your pharmacist
• single ingredient products with guaiphenesin or bromhexine are safe in pregnancy

Available Options

Expectorants, e.g. guaiphenesin

[GENERAL SALE]
e.g. guaiphenesin (Vicks Cough Syrup for Chesty Coughs)

[PHARMACY ONLY]
e.g. guaiphenesin + bromhexine (Dimetapp Chesty Cough Elixir, Duro-Tuss Chesty Cough Liquid Forte, Robitussin Chesty Cough Forte Oral Liquid)

[PHARMACIST ONLY]
e.g. guaiphenesin + pseudoephedrine* (Robitussin Chesty Cough & Nasal Congestion PS Oral Liquid)

• expectorants help you to cough up phlegm, and most commonly include guaiphenesin and ammonium chloride
• they are available as capsules or tablets, lozenges or cough liquids; some are sugar-free
• pseudoephedrine is a nasal decongestant that unblocks your nose; it may cause a rapid heartbeat, anxiety, restlessness, trouble sleeping and a dry mouth
• any products with pseudoephedrine will need to be recorded prior to sale in the pharmacy
• it is important to tell your health professional if you have any medical conditions before taking any cough mixtures
• check that you are not taking more than the recommended dose if using products with similar ingredients, particularly for paracetamol

Mucolytics, e.g. bromhexine

[PHARMACY ONLY]
e.g. bromhexine (Bisolvon Chesty Tablets, Bisolvon Chesty Oral Liquid, Bisolvon Chesty Forte Oral Liquid, Duro-Tuss Chesty Cough Liquid Regular)

[PHARMACIST ONLY]
e.g. bromhexine + pseudoephedrine* (Durotuss Chesty Cough Liquid plus Nasal Decongestant)

• bromhexine is a mucolytic (helps break down thick, sticky mucus in your chest, making it easier to cough up)
• bromhexine can occasionally cause stomach upsets
• pseudoephedrine is a nasal decongestant that unblocks your nose; it may cause a rapid heartbeat, anxiety, restlessness, trouble sleeping and a dry mouth
• pseudoephedrine is found in a number of medicines. Check you do not take more than the recommended amount

Other

e.g. Hedera helix (Benadryl Children’s Cough 2 Years, Duro-Tuss Children’s Cough Liquid, Little Coughs, Bronchodual).

More Information

Availability of medicines

• GENERAL SALE available through pharmacies and possibly other retail outlets.
• PHARMACY ONLY available for sale through pharmacies only.
• PHARMACIST ONLY may only be sold by a pharmacist.

*Pseudoephedrine is a Controlled Drug and products containing it may not be available at all pharmacies.

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