No evidence cough syrups work: panel

WASHINGTON (Reuters) - Over-the-counter cough medicines do little good and may harm children, U.S. experts said in new guidelines released on Monday.

Adults are better off using older nonprescription antihistamines and decongestants to stop the flow of mucus that causes the cough, the American College of Chest Physicians said in its guidelines.

"Cough is the number one reason why patients seek medical attention," Dr. Richard Irwin of the University of Massachusetts Medical School, who chaired the guidelines panel, said in a statement.

"There is no clinical evidence that over-the-counter cough expectorants or suppressants actually relieve cough," Irwin added.

"There is considerable evidence that older type antihistamines help to reduce cough, so, unless there are contraindications to using these medicines, why not take something that has been proven to work?"

Dr. Peter Dicpinigaitis, a panel member who runs a cough clinic at the Montefiore Medical Center in New York, said cough medications might help some patients. But they carry the risk of oversedation -- especially dangerous to children, he said in a telephone interview.

The older-generation antihistamines that work against cough include chlorpheniramine, he said. Newer, brand-name antihistamines such as Claritin and Zyrtec do not help coughs, Dicpinigaitis said.

RESOLVING ON ITS OWN

Under new guidelines, adults with acute cough or upper airway cough syndrome, commonly known as postnasal drip, should use an older variety of antihistamine with a decongestant.

And while coughs in children are worrisome and annoying, cough syrup is not the answer, Irwin said.

"Cough is very common in children. However, cough and cold medicines are not useful in children and can actually be harmful," he said. "In most cases, a cough that is unrelated to chronic lung conditions, environmental influences, or other specific factors, will resolve on its own."

The guidelines follow several studies that have suggested that nonprescription cough remedies do little more than offer comfort to desperate patients.

Researchers reported in July of 2004 that dextromethorphan, often listed on labels as DM, and diphenhydramine, an antihistamine, do not offer any more relief to children suffering from cough than sugar water does.

The study, published in the journal Pediatrics, showed that children usually recovered quickly whatever the treatment.

Francis Sullivan, a spokesman for Wyeth Consumer Healthcare, which makes the popular cough treatment Robitussin, said he does not expect the guidelines to affect sales.

"The FDA (U.S. Food and Drug Administration) has concluded that these drugs are safe and they work," Sullivan said in a telephone interview.

In general, analysts say, drug makers make more profit off their prescription products than on over-the-counter medications.

In 2000 the FDA warned against the use of common over-the- counter cold remedies and diet pills containing phenylpropanolamine (PPA) after researchers found it raised the risk of stroke in women.