Cough-Remedy Caution

The worst thing for a cough may be cough medicine, says the Medical Letter, a biweekly newsletter edited by physicians for physicians. Taking aim at nonprescription cough syrups and elixirs, which contain as many as five drugs, the editors warn that "there are no reports of well-controlled trials" showing that such mixtures are effective. Nor, warns the Letter, are they safe.

Multiple-drug remedies include a cough suppressant like codeine or dex-tromethorplran, which may be useful if a doctor prescribes the right amount (about 20 milligrams for adults, five to 15 for children). But most drugstore cough remedies lack sufficient amounts. Worse, their other ingredients can interact with additional drugs the buyer may be taking--for example, tranquilizers, antidepressants or drugs for high blood pressure. This can cause a "blood-pressure crisis." Moreover, some cough elixirs contain from 43% to 50% ethyl alcohol, the equivalent of 100-proof whisky. Some teen-agers are buying such brands as popular "kick inducers."

Calling for better research and prescription controls the Medical Letter advises: "Cough is a protective reflex; its severity should be diminished, but when there are copious secretions, it should not be suppressed by large doses of an antitussive agent." In most cases, the best remedy is an old-fashioned regimen of warm drinks and steam inhalation. Beyond that, "the familiar throat-tickling irritation can often be relieved by a candy drop."

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