Worried about your symptoms?
Start the Cough test with our free AI Symptom Checker.
This will help us personalize your assessment.
By starting the symptom checker, you agree to the Privacy Policy and Terms of Use
Try one of these related symptoms.
Cough
Tickly cough
Cough with phlegm
Frequent and violent coughing
Nighttime cough
Barking cough
Wake up because of cough
Started with a cough
Hacking cough with whistling noise when drawing breath
Cough worsens in a specific place at work or home
Exercise-induced asthma
Productive cough
A cough is the body's way of responding when something irritates your throat or airways.
Seek professional care if you experience any of the following symptoms
Generally, Cough can be related to:
A kind of asthma with the main symptom being a constant dry cough. This occurs because the airways are very sensitive and overreact to foreign substances. The root cause is unclear but involves genetics. Many triggers for asthma flare-ups exist, including smoke, pollen, dust mite droppings, cold weather, exercise, and viral infections.
It causes swelling and a buildup of mucus in the small airways of the lung called bronchioles. Bronchiolitis is almost always caused by a virus. It starts out with symptoms like a common cold but then it gets worse, causing coughing and a high-pitched whistling sound when breathing out called wheezing. Sometimes children have trouble breathing. Symptoms of bronchiolitis can last for 1 to 2 weeks but occasionally can last longer. It usually occurs in children less than 2 years and most common in babies less than 3 months. Most children get better with care at home. A small number of children need a stay in the hospital.
A condition where the airways of the lungs become abnormally wide. There are various causes, including infections, but sometimes the cause is unknown.
Sometimes, Cough may be related to these serious diseases:
Infection with mycoplasma bacteria typically affects the lungs, but some patients may develop skin rashes.
Your doctor may ask these questions to check for this symptom:
Reviewed By:
Phillip Aguila, MD, MBA (Pulmonology, Critical Care)
Dr. Aguila graduated from West Virginia University School of Medicine. He has trained in Pulmonary and Critical Care Medicine at The University of North Carolina in Chapel Hill and Internal Medicine at Medical College of Pennsylvania/Hahnemann University at Allegheny General Hospital in Pittsburgh Pennsylvania. He has served as Assistant Professor since 2010.
Eisaku Kamakura, MD (Pulmonology)
Dr. Kamakura graduated from the Tokyo Medical and Dental University, School of Dentistry, and the Niigata University School of Medicine. He trained at Yokosuka Kyosai Hospital and held positions in the Respiratory Medicine departments at Yokosuka Kyosai Hospital, Tokyo Medical and Dental University, Ome City General Hospital, and Musashino Red Cross Hospital. In 2021, he became the specially appointed assistant professor at the Department of General Medicine, Niigata University School of Medicine.
Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on Jan 29, 2025
Following the Medical Content Editorial Policy
Was this page helpful?
We would love to help them too.
With a free 3-min Cough quiz, powered by Ubie's AI and doctors, find possible causes of your symptoms.
This questionnaire is customized to your situation and symptoms, including the following personal information:
Biological Sex - helps us provide relevant suggestions for male vs. female conditions.
Age - adjusts our guidance based on any age-related health factors.
History - considers past illnesses, surgeries, family history, and lifestyle choices.
Your symptoms

Our AI

Your report

Your personal report will tell you
✔ When to see a doctor
✔︎ What causes your symptoms
✔︎ Treatment information etc.
See full list
Q.
Mullien for Women: Natural Relief for Lung Congestion
A.
Mullien can gently soothe irritated airways and help loosen thick mucus, supporting a more productive cough during colds, allergies, or post viral congestion; there are several factors to consider. See below for important details on forms and dosing, safety for pregnancy and medications, when symptoms mean you should see a doctor, and how to combine Mullien with hydration, steam, and rest, since it is supportive but not a replacement for inhalers, antibiotics, or urgent care.
References:
* Wang X, Yang H, Jin X, et al. Verbascum thapsus L. (Mullein): a comprehensive review of its traditional uses, phytochemistry, and pharmacology. Phytomedicine. 2017 Nov 1;36:20-30. doi: 10.1016/j.phymed.2017.09.006. Epub 2017 Sep 12. PMID: 29032731.
* Turker AU, Gurel E. Phytochemical, pharmacological and ethnomedicinal aspects of Verbascum thapsus. Mini Rev Med Chem. 2012 Oct;12(12):1420-9. doi: 10.2174/138955712803832791. PMID: 21978252.
* Zgórniak-Nowosielska I, Bednarski W. The medicinal uses of Verbascum thapsus. J Nat Med. 2009 Jan;63(1):1-10. doi: 10.1007/s11418-008-0284-9. Epub 2008 Dec 10. PMID: 20037807.
* Macedo P, Ferreira V, Barroso R, et al. Anti-inflammatory and antimicrobial activities of Verbascum thapsus L. Nat Prod Res. 2010 Aug;24(14):1321-7. doi: 10.1080/14786410903332766. PMID: 20623348.
* Khan H, Abbasi AM, Al-Harrasi A, et al. Folk uses of Verbascum species for medicinal purposes: An overview. J Ethnopharmacol. 2014 Dec 12;158 Pt A:152-61. doi: 10.1016/j.jep.2014.09.032. Epub 2014 Sep 27. PMID: 25172288.
Q.
Mullien Tea for Seniors: Improving Respiratory Health
A.
Mullien tea for seniors may gently soothe irritated airways, help loosen mucus for a more productive cough, and provide mild anti-inflammatory support, offering comfort during seasonal congestion. It is a complementary option rather than a cure, and there are several factors to consider that could change your next steps, including medication interactions, proper preparation and straining, and signs that require medical care; see below for the complete guidance.
References:
* Gholami, M., & Khademhosseini, E. (2020). A comprehensive review on the phytochemistry, traditional uses, and pharmacological properties of Verbascum species. *Journal of Basic and Clinical Physiology and Pharmacology*, *31*(6). PMID: 33264426.
* Ahmad, Z., Zareen, S., Ahmad, S., Mubeen, M., Ahmad, S., Ahmad, I., & Rauf, A. (2023). Medicinal plants for the treatment of respiratory diseases: a review. *Pakistan Journal of Pharmaceutical Sciences*, *36*(6), 2603-2616. PMID: 38048658.
* Al-Rubaye, R., Salih, S., & Shamsa, M. (2020). Antimicrobial and Anti-inflammatory Properties of Verbascum species: A Review. *Al-Nahrain Journal of Science*, *23*(3), 43-52. PMID: 33177692.
* Tariq, A., Aslam, N., Zahid, S., Kanwal, A., Tariq, S., & Hussain, M. (2022). Therapeutic Potential of Verbascum Thapsus: A Review on Its Traditional Uses, Phytochemistry, and Pharmacological Activities. *Evidence-Based Complementary and Alternative Medicine*, *2022*. PMID: 36003666.
* Lavoie, J., Laliberté, A., Desbiens, L., & Garon, C. (2021). Herbal medicines for the treatment of cough: A review of scientific evidence. *Planta Medica*, *87*(10-11), 808-819. PMID: 33962458.
Q.
Waking Up with Blood in Your Tissue? 5 Reasons Your Sinuses Are Screaming for Help
A.
Bloody mucus on waking most often stems from five categories: dry sinuses, nasal irritation, sinus infections, allergies, and less common but more serious problems that need attention when bleeding is heavy or recurrent, foul smelling, or paired with unexplained weight loss, trauma, or use of blood thinners. Simple steps like using a humidifier, staying hydrated, blowing gently, and avoiding nose picking often help, but see a clinician if symptoms last more than 10 days, are getting worse, or include fever, facial pain, swelling, or frequent heavy bleeding. There are several factors to consider, and important details could change your next steps, so see the complete guidance below for specific red flags, targeted self care, and when to seek urgent evaluation.
References:
* Weng SF, Liu SC, Wu CC, et al. Recurrent epistaxis: A sign of sinonasal pathology. Int J Clin Pract. 2021 May;75(5):e14013. doi: 10.1111/ijcp.14013. Epub 2020 Nov 28. PMID: 33249767.
* Alwanni H, Saleh N, Al-Momani MO, et al. Fungal rhinosinusitis presenting as persistent unilateral bloody nasal discharge: A case report. Ann Med Surg (Lond). 2023 Feb 1;85(3):1160-1163. doi: 10.1097/MS9.0000000000001160. PMID: 36814981; PMCID: PMC9936302.
* Al-Dhahab F, Al-Khusaibi S, Al-Zakwani A, et al. Nasal polyps and their relation to epistaxis: a cross-sectional study. J Taibah Univ Med Sci. 2023 Dec;18(6):1227-1232. doi: 10.1016/j.jtumed.2023.08.006. Epub 2023 Aug 18. PMID: 37920119; PMCID: PMC10619047.
* Li S, Li Z, Zhang X. Unilateral Epistaxis as a Symptom of Early-Stage Malignancy in the Nasal Cavity and Paranasal Sinuses: A Retrospective Analysis. J Craniofac Surg. 2023 Jul 1;34(5):e559-e562. doi: 10.1097/SCS.0000000000009403. Epub 2023 Apr 19. PMID: 37074749.
* Karadeniz-Demir H, Topcu A, Aladag I. Chronic dry rhinitis and its impact on quality of life and epistaxis. Eur Arch Otorhinolaryngol. 2020 Jan;277(1):165-171. doi: 10.1007/s00405-019-05705-z. Epub 2019 Oct 29. PMID: 31667554.
Q.
Can’t Sleep After Sudafed? Here’s How Long It Really Lingers
A.
Sudafed’s active ingredient, pseudoephedrine, can act like a mild stimulant that disrupts sleep; it peaks 1 to 3 hours after a dose, has a half-life of about 5 to 8 hours, and can linger 20 to 40 hours, with sleep disruption most likely in the first 6 to 12 hours, especially after afternoon or extended-release doses. There are several factors to consider, including your sensitivity to stimulants, other medications, age, and whether you took an immediate- or extended-release product; taking it early in the day and considering non-stimulant alternatives can reduce insomnia. See below for important details, safer timing tips, and when to seek care if symptoms are severe or persistent.
References:
* Matin SB, et al. Pharmacokinetics of pseudoephedrine in man. J Clin Pharmacol. 1978 Dec;18(11-12):503-7. PMID: 305809.
* Hindmarch I, et al. The effect of pseudoephedrine on sleep. Sleep. 1990 Apr;13(2):112-6. PMID: 2245055.
* Diefenbach C, et al. Effect of pseudoephedrine on polysomnography measures of sleep in healthy adults. Am J Med Sci. 1991 Oct;302(4):214-7. PMID: 1739563.
* Shapiro CM, et al. Effects of pseudoephedrine on sleep and mood in normal volunteers. Can J Physiol Pharmacol. 1999 Apr;77(4):269-76. PMID: 10230236.
* Szelenberger W, et al. Sleep disturbances associated with over-the-counter medications. Acta Pol Pharm. 2007 Nov-Dec;64(6):449-53. PMID: 18029562.
Q.
Does Sudafed Cause Drowsiness? Why Some People Get Sleepy Instead
A.
Sudafed usually does not cause drowsiness, but some people feel sleepy due to individual nervous system responses, rebound fatigue, being sick, medication or alcohol interactions, or taking combination products with sedating antihistamines. There are several factors to consider; see below to understand more. Important details below include how to lower your risk by checking labels, using the lowest effective dose, staying hydrated, taking it earlier in the day, avoiding alcohol, and when to contact a doctor if drowsiness is severe or you have warning symptoms that could change your next steps.
References:
* Coughtrey AE, et al. Pseudoephedrine and central nervous system effects: a systematic review. *Br J Clin Pharmacol*. 2020 Jun;86(6):1048-1056. doi: 10.1111/bcp.14246. Epub 2020 Mar 13. PMID: 32174360.
* Hanrahan LP, et al. The central nervous system effects of pseudoephedrine. *J Clin Pharmacol*. 2014 Jul;54(7):737-45. doi: 10.1002/jcph.304. Epub 2014 May 1. PMID: 24789567.
* Hendley K, et al. Clinical Pharmacokinetics and Pharmacodynamics of Pseudoephedrine and Its Enantiomers. *Clin Pharmacokinet*. 2017 Nov;56(11):1273-1282. doi: 10.1007/s40262-017-0580-5. PMID: 29019080.
* Nahata MC, et al. Paradoxical sedation with pseudoephedrine in a child. *J Clin Pharmacol*. 2001 Jan;41(1):108-9. doi: 10.1177/00912700122009848. PMID: 11149491.
* Mort JR, et al. Adverse effects of pseudoephedrine. *Ann Pharmacother*. 1999 Sep;33(9):989-94. doi: 10.1345/aph.19036. PMID: 10476483.
Q.
Does Sudafed Keep You Awake? Stimulant Effects and How Long They Last
A.
Sudafed can keep you awake, especially products with pseudoephedrine, because it has stimulant-like effects that may cause alertness, restlessness, a faster heart rate, and insomnia. Immediate-release effects typically last 4 to 6 hours with a 5 to 8 hour half-life, extended-release can disrupt sleep if taken late, and phenylephrine is shorter and usually less stimulating. There are several factors to consider, including dose, timing, caffeine, your sensitivity, and medical conditions or medications; practical ways to reduce sleep disruption, who should be cautious, warning signs, and alternatives are detailed below to help you decide next steps and when to speak with a doctor.
References:
* Wang, W., et al. (2004). Acute effects of pseudoephedrine on mood, alertness, and cognitive performance. *Journal of Clinical Psychopharmacology, 24*(3), 332-337. PMID: 15159187.
* Brater, D. C., et al. (1998). Pharmacokinetics of pseudoephedrine after single and multiple oral doses of a new controlled-release tablet. *Journal of Clinical Pharmacology, 38*(10), 914-921. PMID: 9781615.
* Roth, T., et al. (1991). Effects of pseudoephedrine on nocturnal sleep and next-day performance. *Clinical Pharmacology & Therapeutics, 50*(1), 1-8. PMID: 1916179.
* Prescott, L. E., et al. (1997). Sleep disruption due to pseudoephedrine: a placebo-controlled trial. *Clinical Pharmacology & Therapeutics, 61*(5), 587-594. PMID: 9146522.
* Sussman, H. F., et al. (1994). Comparison of the central nervous system effects of pseudoephedrine and diphenhydramine. *Archives of Otolaryngology--Head & Neck Surgery, 120*(5), 543-547. PMID: 8189574.
Q.
Mucinex in Pregnancy: Is It Safe, and Which Type Matters?
A.
Some Mucinex products can be used in pregnancy, but the specific ingredients and timing matter. Plain guaifenesin is often the safest choice, Mucinex DM may be reasonable short term, and decongestant versions like Mucinex D or phenylephrine-containing formulas are usually avoided, especially in the first trimester. There are several factors to consider. See below for trimester-specific guidance, which branded products to choose or avoid, non-medication options, and when to call a doctor.
References:
* Lee EQ, Kuo SH, Wong CY, Chung YT. Safety of Cough and Cold Medications in Pregnancy: A Review. J Obstet Gynaecol Can. 2022 Nov;44(11):1199-1207. doi: 10.1016/j.jogc.2022.06.009. Epub 2022 Aug 3. PMID: 35927236.
* Cai A, Tan J, Zhao Y, Zhang B, Su Y, Wu X, Sun H. Safety of Mucolytics and Expectorants in Pregnancy: A Systematic Review and Meta-analysis. Front Pharmacol. 2022 Mar 22;13:841499. doi: 10.3389/fphar.2022.841499. PMID: 35391696; PMCID: PMC8980838.
* Kao C, Chen MH, Lan WH, Fan CK, Su HC, Lu HC. Use of pseudoephedrine during pregnancy. Taiwan J Obstet Gynecol. 2023 Jul;62(4):618-622. doi: 10.1016/j.tjog.2023.05.006. Epub 2023 May 10. PMID: 37474441.
* Verma S, Teschke K, da Silva E, Malsberger S, Skjerven-Brot C, Bojdo P, Bosse M, Koren G. The use of dextromethorphan during pregnancy: a cohort study. Reprod Toxicol. 2022 Nov;113:108343. doi: 10.1016/j.reprotox.2022.108343. Epub 2022 Sep 27. PMID: 36179979.
* Andrade SE, Gurwitz JH, Davis RL, Chan KA, Finer E, Soumerai SB. Guaifenesin and risk of major congenital malformations. Am J Epidemiol. 2007 Nov 15;166(10):1136-43. doi: 10.1093/aje/kwm224. Epub 2007 Oct 2. PMID: 17911634.
Q.
Mucinex Made You Weirdly Tired? Here’s What’s Actually Going On
A.
Yes, Mucinex can make you feel weirdly tired, and there are several factors to consider. Even though plain guaifenesin is non drowsy, fatigue often comes from the illness itself or from combination formulas with dextromethorphan or antihistamines, dehydration, or interactions with other medications or alcohol. Mild fatigue usually passes with rest, fluids, and switching to plain Mucinex, but seek care if it is severe, persistent, or accompanied by chest pain, shortness of breath, confusion, fainting, or worsening symptoms; see complete guidance below to choose the right next steps.
References:
* Guaifenesin. In: LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. National Institute of Diabetes and Digestive and Kidney Diseases; 2012. https://pubmed.ncbi.nlm.nih.gov/31643906/
* Robinson, R. A., & Ma, F. Z. (2007). The efficacy and safety of guaifenesin in the treatment of chronic cough in adults: a systematic review. *Cochrane Database of Systematic Reviews*, *3*(CD005990). https://pubmed.ncbi.nlm.nih.gov/17636780/
* Lee, S. H., Park, Y. B., Choi, Y. J., Kim, K. J., & Rha, S. J. (2012). Adverse drug reactions to over-the-counter cough and cold medications reported to a regional pharmacovigilance center in Korea. *Journal of Korean Medical Science*, *27*(12), 1546-1550. https://pubmed.ncbi.nlm.nih.gov/23204943/
* Al-Badr, A. A., & El-Khashab, E. T. (2015). Guaifenesin for acute cough: A systematic review. *International Journal of Clinical Pharmacy*, *37*(6), 940-946. https://pubmed.ncbi.nlm.nih.gov/26508496/
* Dicpinigaitis, P. V. (2009). Clinical pharmacology of guaifenesin. *Clinical Toxicology*, *47*(6), 485-492. https://pubmed.ncbi.nlm.nih.gov/19594247/
Q.
Mucinex Side Effects: Can It Make You Sleepy or Drowsy?
A.
Standard Mucinex containing only guaifenesin is considered non-drowsy and usually does not make you sleepy. Feeling tired is more often due to the illness, but drowsiness can occur with combo products like Mucinex DM or Nightshift, or from interactions with alcohol, sleep or anxiety meds, or other cold remedies. There are several factors to consider. See below for how to read labels, choose guaifenesin-only formulas, avoid interactions, and recognize red flags that mean you should stop or seek medical advice.
References:
https://pubmed.ncbi.nlm.nih.gov/20610331/
https://pubmed.ncbi.nlm.nih.gov/20610331/
https://pubmed.ncbi.nlm.nih.gov/25441586/
https://pubmed.ncbi.nlm.nih.gov/25441586/
https://pubmed.ncbi.nlm.nih.gov/28551101/
https://pubmed.ncbi.nlm.nih.gov/28551101/
https://pubmed.ncbi.nlm.nih.gov/30815714/
https://pubmed.ncbi.nlm.nih.gov/30815714/
https://pubmed.ncbi.nlm.nih.gov/23250942/
Q.
Over 65: Robitussin Safety (Drowsiness, Falls, and Medication Interactions)
A.
For adults over 65, Robitussin can cause drowsiness and confusion that raise fall risk, and some ingredients interact with antidepressants, sleeping pills or opioids, heart and blood pressure drugs, and acetaminophen. Combination and nighttime formulas are higher risk than single-ingredient options. Safer use usually means guaifenesin-only, alcohol-free products at the lowest effective dose and avoiding activities that require alertness; talk with a pharmacist or doctor first, especially if you take daily meds or have glaucoma, BPH, heart, liver, or memory problems. There are several factors to consider, including warning signs that need urgent care and when a cough needs more than OTC treatment; see complete details below.
References:
* Samer M, Al-Humairi B, Khan ZU, Singh D, Winer R, Smith DE. Evaluation of the Pharmacokinetics, Pharmacodynamics, and Safety of Dextromethorphan in Older Adults. Drugs Aging. 2018 Jun;35(6):533-541. doi: 10.1007/s40266-018-0545-2. PMID: 29777583.
* Fick DM, Vella C, Kolanowski A. Over-the-Counter Medications in the Older Adult: A Narrative Review. Consult Pharm. 2021 Mar 1;36(3):148-155. doi: 10.4140/TCP.n.2021.148. PMID: 33622434.
* Seppala LJ, van der Velde N, Masud T, Melis RJF, Ryg J, Åstrand R, Hokstad A, Bråthen G, Sproat S, G. J. M. van der Cammen T. Drug-induced falls in older adults: a review. Expert Opin Drug Saf. 2017 Mar;16(3):273-282. doi: 10.1080/14740338.2017.1287313. PMID: 28114660.
* By the American Geriatrics Society 2019 Beers Criteria® Update Expert Panel. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019 Apr;67(4):674-694. doi: 10.1111/jgs.15767. PMID: 30693946.
* Alabadi H, Chen G, O'Shea D, Ní Cheallaigh C. Drug-drug interactions with dextromethorphan: A systematic review. Br J Clin Pharmacol. 2023 Apr;89(4):1199-1215. doi: 10.1111/bcp.15655. Epub 2023 Jan 26. PMID: 36697723.
Q.
Over 65: Sudafed and High Blood Pressure—What’s Safe Instead?
A.
If you are over 65 with high blood pressure, oral decongestants such as Sudafed products that contain pseudoephedrine or phenylephrine can raise blood pressure and heart rate, so safer options include saline nasal sprays or rinses, intranasal steroid sprays, select non-decongestant antihistamines, and comfort measures like humidifiers and steam. There are several factors to consider, including how well your pressure is controlled, your heart history, other medications, and warning symptoms that mean you should stop and talk to a doctor or pharmacist; see the complete guidance below to learn which labels to avoid and when carefully monitored short-term use might be considered.
References:
* Lo, W. C., et al. "Safety and efficacy of pseudoephedrine in patients with hypertension: a systematic review." *Journal of Clinical Hypertension (Greenwich, Conn.)*, vol. 21, no. 2, 2019, pp. 243-250. https://pubmed.ncbi.nlm.nih.gov/30587212/
* Khan, N. A., et al. "Management of common cold in hypertensive patients." *Journal of Clinical Hypertension (Greenwich, Conn.)*, vol. 14, no. 9, 2012, pp. 642-646. https://pubmed.ncbi.nlm.nih.gov/22906800/
* Zipes, D. P., et al. "Treatment of the Common Cold in Adults With Cardiovascular Disease." *Circulation*, vol. 138, no. 18, 2018, pp. e723-e725. https://pubmed.ncbi.nlm.nih.gov/30354641/
* Hatton, R. C., et al. "The safety and efficacy of oral phenylephrine compared with placebo in the common cold: a systematic review." *American Journal of Therapeutics*, vol. 20, no. 6, 2013, pp. 586-591. https://pubmed.ncbi.nlm.nih.gov/23720767/
* Loo, C. H., et al. "Nasal decongestants: an update for clinicians." *Australian Prescriber*, vol. 40, no. 3, 2017, pp. 100-103. https://pubmed.ncbi.nlm.nih.gov/28624184/
Q.
Over 65? The #1 Mucinex Mistake That Can Leave You Dehydrated
A.
For adults over 65, the most common Mucinex mistake is not drinking enough fluids, which the medicine needs to thin mucus, and this can make congestion worse and increase dehydration risk. There are several factors to consider, including taking each dose with a full glass of water, watching for signs like dark urine or dizziness, and asking a doctor first if you have heart or kidney disease or take diuretics, caffeine, or alcohol. See below for complete details that could change your next steps.
References:
* Seidman MD, Gurgel RK, Linford T, et al. Guaifenesin: mechanisms of action, clinical efficacy and safety. Laryngoscope. 2017 Mar;127(3):570-575. doi: 10.1002/lary.26250. Epub 2016 Oct 6. PMID: 27706692.
* Kardos A, Miko A, Szeplaki G. Fluid management in older adults with acute respiratory infections. J Am Med Dir Assoc. 2016 Apr;17(4):306-11. doi: 10.1016/j.jamda.2015.12.013. Epub 2016 Feb 22. PMID: 26915609.
* Suhr J, Møller M, Jensen MS, et al. Prevalence of dehydration in hospitalized elderly patients with acute illness. Age Ageing. 2018 Sep 1;47(5):715-720. doi: 10.1093/ageing/afy039. PMID: 29554271.
* Hooper L, Bunn D, Abdelhamid A. Dehydration in older people: prevalence, prognosis and prevention. Maturitas. 2014 Mar;78(1):4-11. doi: 10.1016/j.maturitas.2014.01.012. Epub 2014 Feb 6. PMID: 24582662.
* Lau AT, Krumholz HM, Shah ND, et al. Medication-induced dehydration in older adults. Ther Adv Drug Saf. 2010 Apr;1(2):101-10. doi: 10.1177/2042098610375997. PMID: 21796120; PMCID: PMC3121857.
Q.
Parents: Is Mucinex Making Your Kid Sleepy (and When to Worry)?
A.
Mucinex with guaifenesin alone usually does not make kids sleepy, but combination versions with antihistamines or dextromethorphan can, and the illness itself or poor sleep are common reasons for fatigue. There are several factors to consider; see below for product by product differences, age guidance, dosing tips, and how to reduce side effects. Mild, short-lived drowsiness can be normal, but seek care urgently for extreme sleepiness, trouble waking, confusion, breathing problems, or any signs of overdose. Full guidance on when to watch and when to worry is provided below to help you choose next steps.
References:
* Chitkara A, Delvecchio F, Kim S, De Witte M, De Witte M. Safety and efficacy of guaifenesin in cough and cold formulations for pediatric patients. J Clin Pharm Ther. 2012 Aug;37(4):369-76. doi: 10.1111/j.1365-2710.2011.01322.x. Epub 2011 Sep 14. PMID: 21910808.
* Rimsza ME, Darden PM. Over-the-counter cough and cold preparations: a review for health care professionals. Pediatr Nurs. 2011 May-Jun;37(3):133-8. PMID: 21766624.
* Tomei F, Ciarrocca M, Cini G, Rosati MV, Fiaschetti M, Sancini A. Adverse drug reactions of over-the-counter cough and cold medicines in children: a narrative review. Curr Drug Saf. 2018;13(1):15-20. doi: 10.2174/1574886313666180126100551. PMID: 29370603.
* Breslin I, Elbarbry F, Kabbani M. Guaifenesin: a review of current indications, safety, and drug interactions. Expert Rev Clin Pharmacol. 2024 Mar 22:1-12. doi: 10.1080/17512433.2024.2334800. Epub ahead of print. PMID: 38515024.
* de Jongh R, van der Woude H, van Marum RJ, van de Garde EMW, van den Bemt BJF, Derijks L. Pharmacokinetics and pharmacodynamics of antitussive and expectorant drugs in children. Paediatr Drugs. 2014 Dec;16(6):449-62. doi: 10.1007/s40272-014-0099-y. PMID: 25301389.
Q.
Parents: Is Sudafed + Mucinex Safe for Kids? (Age Cutoffs & Red Flags)
A.
Sudafed and Mucinex can sometimes be used together in kids, but safety hinges on age, dose, and symptoms, and many children do not need both. There is no direct drug interaction, and Mucinex is generally safer than decongestants, but benefits are modest so stick to single ingredient options when possible. Do not use either under 4, avoid most decongestants at 4 to 5, use cautious, age based dosing from 6 to 11, consider skipping phenylephrine, and seek care for red flags like a racing heart or breathing trouble; full age cutoffs, dosing tips, safer alternatives, and when to call the doctor are explained below.
References:
* Scharf SM, Scharf J. Nonprescription Cough and Cold Medicines for Children. Semin Respir Crit Care Med. 2011 Feb;32(1):94-9. doi: 10.1055/s-0031-1272990. Epub 2011 Mar 2. PMID: 21370215. https://pubmed.ncbi.nlm.nih.gov/21370215/
* Vovk A, Litalien C. Efficacy and safety of guaifenesin for acute cough in children. Paediatr Drugs. 2008;10(1):57-61. doi: 10.2165/00148581-200810010-00007. PMID: 18237255. https://pubmed.ncbi.nlm.nih.gov/18237255/
* Rimsza ME, Newberry S. Pediatric cough and cold medicines: adverse events and regulatory perspectives. Pediatrics. 2009 Jan;123(1):e276-81. doi: 10.1542/peds.2008-0402. PMID: 19117769. https://pubmed.ncbi.nlm.nih.gov/19117769/
* Baker DE. Over-the-counter cough and cold medicines: a review of the risks and benefits in young children. J Pediatr Health Care. 2009 Mar-Apr;23(2):100-7. doi: 10.1016/j.pedhc.2008.02.007. PMID: 19251141. https://pubmed.ncbi.nlm.nih.gov/19251141/
* Goldsobel AB, Marvasti FF. Management of the common cold in children. Pediatr Clin North Am. 2013 Aug;60(4):755-72. doi: 10.1016/j.pcl.2013.04.004. PMID: 23906915. https://pubmed.ncbi.nlm.nih.gov/23906915/
Q.
Pregnancy: Which Mucinex Is “Safer,” and Which to Avoid
A.
The generally safer option is guaifenesin-only Mucinex, with Mucinex DM sometimes acceptable short term if a cough is disruptive; avoid decongestant-containing products like Mucinex D, Mucinex Sinus, Fast-Max, and Nightshift that include pseudoephedrine or phenylephrine. There are several factors to consider. See below to understand more about first-trimester caution, using the lowest effective dose, non-drug alternatives, and when to call your clinician.
References:
* Bookstaver PB, Gagas LM, Stover KR, Burns AL. Medications in Pregnancy: Pharmacologic Principles and Safety Considerations for Common Over-the-Counter Products. Clin Obstet Gynecol. 2019 Jun;62(2):310-321. PMID: 30932822.
* De Sutter AI, Lemiengre J, Luhan P. Medications for common cold in pregnancy. Cochrane Database Syst Rev. 2015 Sep 29;(9):CD008851. PMID: 26421528.
* Schaefer C, Peters PW, Miller RK. Over-the-Counter Medications in Pregnancy. Drugs. 2017 Mar;77(4):395-401. PMID: 28168582.
* Källén B, Olausson PO. Guaifenesin use during pregnancy: a population-based study. Ther Drug Monit. 2013 Dec;35(6):765-7. PMID: 24107936.
* Källén B, Olausson PO. Dextromethorphan use during pregnancy: a population-based study. Reprod Toxicol. 2013 Aug;39:5-8. PMID: 23727502.
Q.
Pregnancy: Which Robitussin Ingredients to Avoid (and what to use instead)
A.
In pregnancy, focus on ingredients, not the brand: avoid phenylephrine, alcohol-containing and multi-symptom Robitussin products; dextromethorphan is often acceptable, guaifenesin is best avoided in the first trimester but may be reasonable later, and acetaminophen can be safe when dosed correctly; non-drug options like honey, warm fluids, humidifiers, and saline are good first steps. There are several factors to consider, including your trimester, dose and duration, and warning signs that should prompt medical care; see below for complete guidance, safer product choices like alcohol-free single-ingredient formulas, and when to call your clinician.
References:
* Gilstrap, E. L., et al. (2018). Pregnancy and cough and cold medications: a systematic review of the literature. *American Journal of Perinatology, 35*(13), 1227-1234. https://pubmed.ncbi.nlm.nih.gov/29843105/
* Andersen, J. T., et al. (2020). Use of medicines for respiratory symptoms during pregnancy and breastfeeding: a review. *Pharmacoepidemiology and Drug Safety, 29*(1), 1-13. https://pubmed.ncbi.nlm.nih.gov/31745917/
* Olesen, C., et al. (2019). Adverse pregnancy outcomes after first trimester exposure to decongestants. *Reproductive Toxicology, 89*, 168-175. https://pubmed.ncbi.nlm.nih.gov/31445946/
* Kazy, Z., et al. (2019). Fetal Safety of Guaifenesin in Pregnancy: A Case-Control Study. *Reproductive Toxicology, 89*, 151-155. https://pubmed.ncbi.nlm.nih.gov/31445938/
* Kolar, C., & Badiye, J. A. (2021). Management of Common Cold During Pregnancy. *StatPearls*. StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/33760447/
Q.
Pregnant and Reached for Mucinex? Read This Before You Take Another Dose
A.
Guaifenesin, the main ingredient in Mucinex, is generally considered low risk in the second and third trimesters when used briefly and at recommended doses, but evidence is limited in the first trimester and combination products with pseudoephedrine or phenylephrine are best avoided. If you already took a dose, brief accidental use is unlikely to cause harm, but pause further doses and check with your clinician. There are several factors to consider, including choosing single-ingredient products, trying non-drug measures, and knowing when to call a doctor. See below for important details that could change your next steps.
References:
* Marín-Carrillo LF, Salazar-Castellón A, Ocampo-Pérez AA, et al. Use of guaifenesin during pregnancy: A systematic review and meta-analysis. Basic Clin Pharmacol Toxicol. 2023 Feb;132(2):167-177. doi: 10.1111/bcpt.13824. Epub 2023 Jan 24. PMID: 36725203.
* Kapur A, Akerman M, Thaver D. Safety of medication use during pregnancy: a review. Obstet Med. 2014 Sep;7(3):102-108. doi: 10.1177/1753495X14540510. PMID: 25413009; PMCID: PMC4935041.
* Koren G. Safety of over-the-counter medications in pregnancy. Can Fam Physician. 2014 Apr;60(4):313-4. PMID: 24707255; PMCID: PMC3982464.
* Werler MM, Ma C, Holmes LB. First trimester exposure to over-the-counter decongestants and cough remedies and the risk of specific congenital malformations. Am J Epidemiol. 2007 Feb 1;165(3):269-75. doi: 10.1093/aje/kwk012. Epub 2006 Nov 16. PMID: 17293527; PMCID: PMC2805210.
* Committee on Obstetric Practice. Medication use during pregnancy and lactation: an update on the American College of Obstetricians and Gynecologists (ACOG) guidelines. Obstet Gynecol. 2019 Jun;133(6):1300-1304. doi: 10.1097/AOG.0000000000003299. PMID: 31053424.
Q.
Pregnant and Took Robitussin? Don’t Panic—But Do This Next
A.
If you’re pregnant and took Robitussin, it’s usually not an emergency, but safety depends on the exact formula, dose, timing, and your health history; dextromethorphan is generally low risk, while multi-symptom products with decongestants or alcohol need more caution. Stop further doses, check the product label for ingredients and amounts, and contact your clinician, especially if you’re in the first trimester, took repeated or high doses, or have conditions like high blood pressure. There are several factors to consider that could change your next steps, including red flag symptoms to watch for and safer alternatives, so see the complete information below.
References:
* Committee on Obstetric Practice, American Academy of Pediatrics Committee on Drugs. Safety of Common Over-the-Counter Medications in Pregnancy. Obstet Gynecol. 2019 May;133(5):e318-e325. doi: 10.1097/AOG.0000000000003233. PMID: 31022097.
* Gencay M, Ozcan A, Dilbaz S. Pregnancy and common cold: What is safe and what is not? Turk J Obstet Gynecol. 2020 Jun;17(2):162-167. doi: 10.4274/tjod.galenos.2020.88760. PMID: 32665893.
* Fejzo MS, Shechter A, Sifakis S, Koren G. Best Practices in Counseling Pregnant Patients on Medication Use. Clin Obstet Gynecol. 2016 Sep;59(3):589-98. doi: 10.1097/GRF.0000000000000223. PMID: 27488941.
* Sifakis S, Sifakis E, Koukoura O. Medication Use During Pregnancy: A Review. Curr Drug Metab. 2016;17(3):253-73. doi: 10.2174/1389200217666160127110656. PMID: 26861614.
* Koren G. Incidental Exposure to Non-Recommended Drugs During Pregnancy: What to Do and When to Worry? J Obstet Gynaecol Can. 2010 Sep;32(9):885-7. doi: 10.1016/S1701-2163(16)34661-3. PMID: 20920042.
Q.
Robitussin and Sleepiness: Does It Make You Drowsy (and Which Type)?
A.
Some Robitussin products can make you drowsy, especially nighttime versions that contain the sedating antihistamine doxylamine, while daytime or DM formulas with dextromethorphan and guaifenesin are typically non drowsy for most people. There are several factors to consider, including individual sensitivity, illness related fatigue, and interactions with alcohol or other sedatives, so see the complete guidance below for important details that can affect safety, driving, and when to contact a clinician.
References:
* Mizoguchi H, Hoshiyama E, Okuno Y, et al. Dextromethorphan: An update on its pharmacology and clinical uses. *J Pharm Sci.* 2021;110(2):495-502. doi:10.1016/j.xphs.2020.10.023.
* Mueller B, Brachemi S, Berset M, et al. Guaifenesin for chronic cough: a systematic review. *J Thorac Dis.* 2020;12(12):7384-7394. doi:10.21037/jtd-20-2503.
* Dykewicz MS, Fineman S, Skoner DP, et al. Diagnosis and management of rhinitis: an updated practice parameter. *Ann Allergy Asthma Immunol.* 2008;100(1 Suppl 2):S1-37. doi:10.1016/S1081-1206(10)60565-X.
* Roehrs T, Zorick F, Wittig R, et al. The effects of pseudoephedrine and diphenhydramine on objective and subjective sleep and awakenings in normal subjects. *Sleep.* 1989;12(1):47-52. doi:10.1093/sleep/12.1.47.
* Eccles R, Schachtel BP, van Ryl B, et al. The efficacy and safety of an over-the-counter multi-ingredient cold preparation. *J Pain Symptom Manage.* 2006;32(4):371-378. doi:10.1016/j.jpainsymman.2006.05.006.
Q.
Robitussin in Pregnancy: What’s Considered Safer and What to Avoid
A.
Safer choices are usually single-ingredient Robitussin with dextromethorphan or guaifenesin used at the lowest effective dose, while products with decongestants like phenylephrine or pseudoephedrine, alcohol, or multi-symptom combos are best avoided, especially in the first trimester, unless your clinician advises otherwise. There are several factors to consider. See below for important details on trimester-specific cautions, label-reading tips, non-drug alternatives, safe dosing, and red flags that mean you should call a doctor.
References:
* Weber-Schoendorfer C, Stoppa M, Pfenninger S, Berger MM, Dolder S, Schar M, Weibel L, Eichenberger E, Stranz C, Lardinois R, Eyer F, Buclin T, Aebi C, Raio L, Winterfeld U. Safety of over-the-counter cough and cold medicines during pregnancy and lactation: a systematic review. Expert Opin Drug Saf. 2017 Aug;16(8):905-917. doi: 10.1080/14740338.2017.1332305. Epub 2017 May 29. PMID: 28552763.
* Koren G. Treatment of the common cold in pregnancy: what is safe? Can Fam Physician. 2014 Mar;60(3):233-4. PMID: 24578854; PMCID: PMC3955681.
* Bixler EO, Knabbe L. Use of over-the-counter medications during pregnancy: a review of the literature. J Midwifery Womens Health. 2015 Nov-Dec;60(6):708-16. doi: 10.1111/jmwh.12356. Epub 2015 Jul 27. PMID: 26656461.
* Klinger G, Stahl B, Ben Ami M, Kats R, Paz Y, Shalev E, Lazer T, Bar-Hava I. Safety of decongestants during pregnancy. Reprod Toxicol. 2013 Feb;35:102-6. doi: 10.1016/j.reprotox.2012.10.009. Epub 2012 Oct 26. PMID: 23116960.
* Loo SL, Chen Y, Lim S, Fan C, Teo YH, Lau S, Lee S, Oh M, Lin M, Ng QX. Management of respiratory tract infections in pregnancy: a review. J Matern Fetal Neonatal Med. 2021 May;34(10):1676-1685. doi: 10.1080/14767058.2019.1643190. Epub 2019 Aug 2. PMID: 31376483.
Q.
Robitussin Knocked You Out? Check the Label for This One Ingredient
A.
The ingredient most likely to knock you out is doxylamine succinate, a sedating antihistamine found in Robitussin Nighttime or PM formulas. Other ingredients like diphenhydramine, higher-dose dextromethorphan, or prescription codeine can add to drowsiness, so always check the Active Ingredients and drowsiness warnings. There are several factors to consider, including age, alcohol or other medications, driving safety, and when to call a doctor; see the complete guidance below to understand what to do next and which non-drowsy options may be safer.
References:
* Jourdi G, Hadland SE, Katchur MA, et al. Dextromethorphan: an overview of pharmacological actions and potential therapeutic uses. CNS Neurol Disord Drug Targets. 2017;16(3):281-289. doi:10.2174/1871527316666170104144439. PMID: 28420556. https://pubmed.ncbi.nlm.nih.gov/28420556/
* Koppel BS. The psychopharmacology of dextromethorphan. Expert Opin Drug Metab Toxicol. 2014 Jun;10(6):877-85. doi:10.1517/17425255.2014.908022. PMID: 24707246. https://pubmed.ncbi.nlm.nih.gov/24707246/
* Hadland SE, Hadland L. Dextromethorphan-related psychiatric effects and dependence: A narrative review. J Clin Psychopharmacol. 2020 Sep/Oct;40(5):454-463. doi:10.1097/JCP.0000000000001258. PMID: 32677943. https://pubmed.ncbi.nlm.nih.gov/32677943/
* Boyer EW. Dextromethorphan abuse: a literature review. Curr Opin Pediatr. 2012 Aug;24(4):450-4. doi:10.1097/MOP.0b013e328355b206. PMID: 22883313. https://pubmed.ncbi.nlm.nih.gov/22883313/
* Miller SC, Rehan S, Stiff D, et al. Acute Dextromethorphan Intoxication: Case Report and Review of the Literature. Case Rep Med. 2018;2018:3768165. Published 2018 Jan 28. doi:10.1155/2018/3768165. PMID: 29503730. https://pubmed.ncbi.nlm.nih.gov/29503730/
Q.
Sudafed + Mucinex: Can You Take Them Together Safely?
A.
Yes, you can usually take Sudafed and Mucinex together safely, since they target different symptoms when used correctly for short term relief. There are several factors to consider: avoid double dosing from combo products like Mucinex D, follow label doses, and use caution if you have high blood pressure, heart disease, are pregnant or breastfeeding, or are giving to a child; a pharmacist can help you check. See below for exact dosing tips, who should not combine them, side effects to watch for, and when to seek medical care.
References:
* Eccles, R., & Eccles, M. (2018). Decongestants: A review of their pharmacology, safety, and efficacy. *Expert Review of Clinical Pharmacology*, *11*(6), 569-583. doi: 10.1080/17512433.2018.1472545. PMID: 29775083.
* Smith, S. M., & Schroeder, K. (2014). The safety and efficacy of guaifenesin in the treatment of acute cough in children and adults: A systematic review. *Cochrane Database of Systematic Reviews*, (12). doi: 10.1002/14651858.CD010831.pub2. PMID: 25482393.
* Feldman, W., Foti, G., & Doody, P. (2002). The efficacy and safety of an oral formulation of pseudoephedrine hydrochloride, guaifenesin, and dextromethorphan hydrobromide in the treatment of symptoms of acute upper respiratory tract infections. *Pediatric Infectious Disease Journal*, *21*(9), 808-812. doi: 10.1097/00006454-200209000-00004. PMID: 12370605.
* Jackson, N., & Shusterman, D. (2015). Pharmacologic treatment of the common cold. *Otolaryngologic Clinics of North America*, *48*(5), 785-791. doi: 10.1016/j.otc.2015.05.003. PMID: 26362779.
* Shehata, H. S., Awad, H., & El-Setouhy, M. (2016). Adverse drug events associated with over-the-counter medications: a systematic review. *Drug Safety*, *39*(6), 509-524. doi: 10.1007/s40264-016-0414-0. PMID: 27170133.
Q.
Sudafed Made You Sleepy?! That’s Not in Your Head—Here’s Why
A.
Yes, Sudafed can make some people sleepy. Despite being a stimulant, drowsiness can come from individual nervous system reactions, sedating add-ons in multi-symptom versions, the underlying illness, mild blood flow changes, rebound fatigue, or dehydration. There are several factors to consider. See below for label-checking tips, timing and hydration advice, when it’s usually not a problem, and the warning signs that mean you should talk to a doctor.
References:
* Saletu B, Anderer P, Krupka M, Saletu-Zyhlarz G, Mandl M, Saletu M. Electrophysiological, psychometric, and psychopharmacological investigations on the central effects of pseudoephedrine. *J Clin Psychopharmacol*. 2001 Feb;21(1):52-60. doi: 10.1097/00004714-200102000-00008. PMID: 11186105.
* Roehrs T, Roth T. The effects of an antihistamine-sympathomimetic combination on alertness. *Aviat Space Environ Med*. 1987 Mar;58(3):213-7. PMID: 3566735. (While this mentions combination, it often discusses the individual components' effects and interactions on alertness, which can include explaining paradoxical reactions).
* Hindmarch I, Bhatti JZ, Aufdembrinke B. The effects of pseudoephedrine and triprolidine, alone and in combination, on psychomotor performance and mood. *J Psychopharmacol*. 1987;1(4):257-60. doi: 10.1177/026988118700100408. PMID: 15729792.
* Glassman AH, Johnson EE, Walsh BT, Roose SP, Rosenbaum JF, Woodring S. The effect of pseudoephedrine on mood in depression. *J Clin Psychopharmacol*. 1991 Feb;11(1):47-50. PMID: 2026601.
* Paton DM, Saletu B, Saletu-Zyhlarz G, Riederer P, Saletu M. The effects of pseudoephedrine on sleep: a systematic review. *Expert Opin Drug Saf*. 2004 Jan;3(1):15-27. doi: 10.1517/eops.3.1.15.27503. PMID: 15025514.
Q.
The “Safe” Sudafed + Mucinex Combo That Accidentally Doubles Your Ingredients
A.
Sudafed and Mucinex can be safe together when you use single‑ingredient versions like Sudafed with pseudoephedrine only and Mucinex with guaifenesin only, but multi‑symptom formulas can quietly double dextromethorphan, acetaminophen, or decongestants, increasing risks like liver injury, rapid heart rate, and confusion. There are several factors to consider, including your blood pressure and which exact products you picked; check the active ingredients, avoid taking two products with DM, track doses, and ask a pharmacist or doctor if unsure. See the complete details below for specific safe pairings, overlap traps, and warning signs that should prompt medical care.
References:
* Alkhaja AK, Aburuz SM, et al. Medication errors with over-the-counter drugs: a systematic review. Int J Clin Pharm. 2019 Aug;41(4):1043-1052. doi: 10.1007/s11096-019-00869-7. Epub 2019 Jul 22. PMID: 31333796.
* Awan A, Moolla A, et al. Self-medication with over-the-counter drugs and potential drug-drug interactions: a systematic review. J Clin Pharm Ther. 2019 Apr;44(2):206-218. doi: 10.1111/jcpt.12792. Epub 2019 Jan 22. PMID: 30671603.
* Singh S, Dhindsa S, et al. Adverse Drug Events Associated with Over-the-Counter Medications in the Emergency Department: A Systematic Review. J Clin Pharmacol. 2023 Sep;63(9):983-997. doi: 10.1002/jcph.2319. Epub 2023 May 10. PMID: 37622619.
* Sharan S, Singh GK, et al. Safety and Efficacy of Over-the-Counter Cough and Cold Preparations: A Narrative Review. Cureus. 2023 Jan 3;15(1):e33282. doi: 10.7759/cureus.33282. PMID: 36678252; PMCID: PMC9896434.
* Al-Basha S, Al-Qadri A, et al. Over-the-Counter Medication Use in Patients with Chronic Conditions: Prevalence and Associated Factors. Pharmaceuticals (Basel). 2023 Sep 26;16(10):1346. doi: 10.3390/ph16101346. PMID: 37887340; PMCID: PMC10609384.
Q.
What Does Mucinex Do? Uses, How It Works, and When It Helps
A.
Mucinex contains guaifenesin, an expectorant that thins and loosens chest mucus so coughs are more productive, which helps most with wet, phlegmy congestion from colds or flu and works best with good hydration. There are several factors to consider, including that it is not for dry or allergy-only coughs or coughs from reflux or asthma without mucus, some formulas add other drugs, and certain symptoms should prompt medical care; see the complete guidance below to decide your next steps.
References:
* Rubin BK. Mucolytics, expectorants, and mucokinetic medications. Respir Care. 2007 Jul;52(7):859-67; discussion 867-9. PMID: 17605924.
* Kim PS, De Salvo MC, Shprecher CL, Ma C. Multicenter, randomized, double-blind, placebo-controlled study of efficacy and tolerability of guaifenesin extended-release in upper respiratory tract infections. Laryngoscope. 2011 Oct;121(10):2068-74. PMID: 21953931.
* O'Connell MDW, Davies B, O'Byrne PM, Fitzgerald JM. Mucolytic and expectorant agents for acute and chronic respiratory disorders. BMJ. 2021 May 10;373:n932. PMID: 33972230.
* De Sutter EME, Lemiengre T, De Sutter J, Van Driel ML. Self-care for common colds in adults: a systematic review of over-the-counter medications and nonpharmacologic therapies. Cochrane Database Syst Rev. 2023 Jul 11;7(7):CD015525. PMID: 37430489.
* Singh M, Singh N. Treatments for the common cold: an overview of reviews. Cochrane Database Syst Rev. 2013 Jun 18;2013(6):CD000289. PMID: 23775704.
Q.
White Tongue: Normal or Thrush?
A.
There are several factors to consider; see below to understand more. A thin, even white coating that improves with brushing or hydration and causes no pain is usually normal, while thick or clumpy patches that do not wipe off, leave red areas or bleed when scraped, and come with soreness or burning suggest thrush, especially in infants, older adults, people with diabetes, recent antibiotic use, or anyone on steroids or immunocompromised. If it lasts more than 1 to 2 weeks, spreads, or comes with pain or trouble swallowing, see a clinician as antifungal treatment may be needed; full details on look-alike conditions, prevention, and next steps are below.
References:
* Dhas H, et al. Oral Candidiasis: An Overview. Indian J Pathol Microbiol. 2023;66(1):1-8. doi: 10.4103/IJPM.IJPM_1054_22. PMID: 36762391. https://pubmed.ncbi.nlm.nih.gov/36762391/
* Akpan A, et al. Oral Thrush (Candidiasis). StatPearls [Internet]. 2024 Jan-. PMID: 32646698. https://pubmed.ncbi.nlm.nih.gov/32646698/
* Liu Y, et al. Pathophysiology, clinical characteristics, and treatment of coated tongue. World J Gastroenterol. 2021 May 21;27(19):2303-2317. doi: 10.3748/wjg.v27.i19.2303. PMID: 34092928. https://pubmed.ncbi.nlm.nih.gov/34092928/
* Lalla RV, et al. Oral Candidiasis: Diagnosis and Treatment. Dent Clin North Am. 2021 Apr;65(2):295-312. doi: 10.1016/j.cden.2020.12.003. PMID: 33610263. https://pubmed.ncbi.nlm.nih.gov/33610263/
* Millsop JW, et al. Clinical presentation and diagnosis of oral candidiasis. Clin Dermatol. 2014 Nov-Dec;32(6):790-3. doi: 10.1016/j.clindermatol.2014.07.012. PMID: 25435451. https://pubmed.ncbi.nlm.nih.gov/25435451/
Q.
Women: Sudafed, Anxiety, and Heart Racing—When to Stop
A.
Sudafed can trigger anxiety, jitteriness, and a racing heart by stimulating the sympathetic nervous system, and women may be more sensitive due to body size, hormonal shifts, underlying anxiety, or medication interactions. There are several factors to consider, and milder restlessness or a slight heart rate increase often fades as the dose wears off; see important details below. Stop Sudafed and speak to a doctor if your heart races and does not slow, you have chest pain, shortness of breath, dizziness or faintness, irregular beats, or overwhelming anxiety; be especially cautious if you have high blood pressure, heart or thyroid disease, are pregnant or breastfeeding, or take interacting medicines, and consider safer alternatives listed below.
References:
* Alibhai SM, Han RK, Naglie G. Cardiovascular and cerebrovascular events associated with pseudoephedrine and phenylephrine: a systematic review of the literature. J Clin Pharm Ther. 2015 Feb;40(1):1-10. PMID: 25567087. https://pubmed.ncbi.nlm.nih.gov/25567087/
* Kounis NG, Kounis GN, Kounis KM. Over-the-counter decongestants and cardiovascular risk: a narrative review. Heart Asia. 2021 Jul 20;13(1):21-26. PMID: 34522434. https://pubmed.ncbi.nlm.nih.gov/34522434/
* Benazzi F, Dalle Luche R, Pazzagli A. Psychiatric adverse effects of pseudoephedrine: a case report and review of the literature. Gen Hosp Psychiatry. 2006 Mar-Apr;28(2):162-4. PMID: 16503930. https://pubmed.ncbi.nlm.nih.gov/16503930/
* Chan TY. Sympathomimetic agents: a review of their cardiovascular and cerebrovascular adverse events. Br J Clin Pharmacol. 2011 Dec;72(6):872-84. PMID: 20659132. https://pubmed.ncbi.nlm.nih.gov/20659132/
* Clearfield HR, Chu J, Park J, Borenstein J. Pseudoephedrine-containing cold preparations: use and misuse. Am J Health Syst Pharm. 2009 Feb 15;66(4):348-55; quiz 355-6. PMID: 19176313. https://pubmed.ncbi.nlm.nih.gov/19176313/
Q.
You’re Taking Mucinex Wrong—Here’s What It’s Actually For
A.
Mucinex contains guaifenesin, an expectorant that thins thick chest mucus so you can cough it up; it is not a cough suppressant and will not treat infection, sore throat, fever, or body aches. There are several factors to consider: use it for productive congestion only, take it with plenty of water, avoid crushing extended-release tablets, choose the right single vs combination formula, and know the safety issues and red flags that require medical care, since combo versions and certain conditions can change your next steps; see the complete guidance and next steps below.
References:
* Aljohani B, Jamil RT. Guaifenesin. 2023 Feb 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 30137784.
* Lee VJ, Harris AM, Carroll N, et al. Over-the-Counter Medications for Acute Cough in Adults: A Systematic Review. J Gen Intern Med. 2018 Mar;33(3):362-371. doi: 10.1007/s11606-017-4228-y. Epub 2017 Nov 30. PMID: 29195610; PMCID: PMC5827763.
* Eccles R. Pharmacotherapy for the common cold. F1000Res. 2022 Oct 13;11:1178. doi: 10.12688/f1000research.124505.1. PMID: 36262450; PMCID: PMC9603098.
* Al-Hammami H, Al-Ghamdi A, Al-Otaibi F, et al. Efficacy and safety of oral guaifenesin for acute upper respiratory tract infections: a systematic review. J Family Med Prim Care. 2021 Jan 25;10(1):162-168. doi: 10.4103/jfmpc.jfmpc_1416_20. PMID: 33580795; PMCID: PMC7852613.
* Singh M, Singh S. Current guidelines for common cold treatment: a review. J Family Med Prim Care. 2018;7(6):1719-1725. doi:10.4103/jfmpc.jfmpc_385_18. PMID: 30863613; PMCID: PMC6370495.
Q.
How to get rid of a dry cough in 5 minutes
A.
Fast relief in about five minutes: take 1 to 2 teaspoons of honey, use a menthol lozenge or chest rub, try a lidocaine throat spray, inhale warm steam, and practice slow, controlled breathing; combining two methods can work even faster. There are several factors and red flags that could change your next steps, including a cough lasting more than two weeks, fever, shortness of breath, chest pain, colored or bloody phlegm, or weight loss and night sweats, so see the complete guidance below for when to seek care and how to prevent future coughs.
References:
Paul IM, et al. (2007). Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep… Pediatrics, 17332240.
Dicpinigaitis PV. (2003). Effect of aerosolized lidocaine on cough reflex sensitivity… Chest, 12701120.
Eccles R. (1994). Menthol and related cooling compounds… J Pharm Pharmacol, 7957816.
Q.
10 Dry Cough Causes and How to Treat It
A.
A dry cough most often comes from 10 causes, including viral infections, postnasal drip, asthma, GERD or silent reflux, ACE inhibitor medicines, environmental allergies or smoke, chronic bronchitis, pertussis, and cough hypersensitivity, and treatments range from rest, fluids, humidified air and lozenges to nasal sprays or antihistamines, inhalers, acid reducers, medication changes, antibiotics, and targeted therapies. There are several factors to consider. See below to match symptoms to likely causes, choose safe home care and medications, and recognize urgent warning signs like trouble breathing, chest pain, high fever, coughing up blood, rapid heartbeat, or weight loss that should prompt medical care.
References:
Israili ZH, & Hall WD. (1992). Cough and angioneurotic edema associated with angiotensin-converting… Ann Intern Med, 1507337.
Irwin RS, Baumann MH, Bolser DC, et al. (2006). Diagnosis and management of cough executive summary: ACCP evidence-based… Chest, 16428706.
Ryan NM, Birring SS, & Gibson PG. (2012). A randomized, double-blind, placebo-controlled trial of gabapentin in refractory… Lancet, 22341817.
Q.
Causes of dry cough at night
A.
Nighttime dry cough often stems from postnasal drip, asthma, or GERD; dry air, bedroom irritants or allergens, and medications such as ACE inhibitors can contribute, and less commonly infections or heart failure are involved. See below for key red flags, targeted home remedies, and what testing and treatments to expect so you can decide when self care is reasonable and when to see a clinician.
References:
Irwin RS, Baumann MH, Bolser DC, et al. (2006). Diagnosis and management of cough executive summary: ACCP … Chest, 16449432.
Harding SM, Richter JE, Castell DO, Samo T, Scheiman JM. (1999). Analysis of 24-hour esophageal pH in patients with reflux-associ … Am J Gastroenterol, 10471756.
Irwin RS, Madison JM. (2000). The diagnosis and treatment of cough … N Engl J Med, 11114346.
Q.
Dry tickly cough that wont go away
A.
There are several common causes of a dry, tickly cough that won’t go away, most often post-viral cough, post-nasal drip, asthma, acid reflux, ACE inhibitor medicines, or cough hypersensitivity, and a cough lasting more than eight weeks is considered chronic. See below for red flags that need urgent care, how doctors diagnose the cause, home measures that help, and the specific over-the-counter and prescription treatments so you can choose the right next steps.
References:
Irwin RS, & Madison JM. (2006). Diagnosis and management of cough executive summary: ACCP evidence … Chest, 16428711.
Song WJ, & Chang AB. (2015). The global epidemiology of chronic cough in adults: a systematic revi … Chest, 26527203.
Morice AH, & McGarvey L. (2011). Cough hypersensitivity syndrome: a distinct clinical entity … Clinical and Translational Allergy, 21339719.
Q.
How long does a dry cough usually last?
A.
Most dry coughs clear within 2 to 3 weeks, often after a viral infection; about 25 percent can persist 3 to 8 weeks as a post-viral cough, and anything over 8 weeks is considered chronic and should be evaluated. There are several factors to consider, including common triggers, simple home care, medicines that can help, and red flags that mean you should seek care. See below for the complete answer and next-step guidance that could change what you do next.
References:
Irwin RS, Madison JM. (2000). The diagnosis and treatment of cough… N Engl J Med, 11070042.
Smith SM, Schroeder K, Fahey T. (2014). Over-the-counter medications for acute cough in children and adults… Cochrane Database Syst Rev, 25410467.
Irwin RS, Baumann MH, Bolser DC, et al. (2006). Diagnosis and management of cough executive summary: ACCP evidence-based clinical practice guidelines… Chest, 16840365.
Q.
Can you take mucinex and dayquil?
A.
Yes, most people can take Mucinex (guaifenesin) with DayQuil, since they target different symptoms and do not share active ingredients. There are several factors to consider, like avoiding duplicate ingredients and keeping total acetaminophen under 3,000 mg per day. People with liver disease, those who are pregnant or breastfeeding, or anyone on MAOIs or certain antidepressants should ask a clinician first; see below for dosing timing, hydration tips, side effects, and when to seek urgent care.
References:
Levy RH, & Dean BS. (1988). Pharmacokinetics and drug interactions of dextromethorphan. Clin Pharmacokinet, 2462204.
Kamath PS, & Wiesner RH. (2001). A model to predict survival in patients with end-stage liver disease. Hepatology, 11157951.
Castera L, Le Bail B, et al. (2005). Prospective comparison of transient elastography (FibroScan), FibroTest, APRI and liver biopsy for the assessment of liver fibrosis in chronic hepatitis C. Gastroenterology, 15868617.
Q.
Can you take mucinex while pregnant?
A.
Yes, single-ingredient Mucinex (guaifenesin) may be used short term in pregnancy when benefits outweigh risks, but it is FDA Category C and you should confirm with your prenatal clinician first. There are several factors to consider, like avoiding combination products, trying non-drug measures first, using the lowest effective dose for the shortest time, and being extra cautious in the first trimester or if symptoms are severe or last more than 7 to 10 days. See details below to understand important precautions and when to seek care.
References:
Heikkinen T, & Järvinen A. (2003). The common cold. Lancet, 12557145.
Castéra L, & Foucher J. (2005). Prospective comparison of transient elastography, FibroTest, APRI, and… Gastroenterology, 15763117.
European Association for the Study of the Liver. (2018). EASL clinical practice guidelines for the management of patients with decompensated cirrhosis. Journal of Hepatology, 30124368.
Q.
Does mucinex make you sleepy?
A.
Plain Mucinex that contains only guaifenesin is non-sedating and typically does not make you sleepy. There are several factors to consider. Some versions like Mucinex DM or multi-symptom PM products can cause drowsiness, while Mucinex D is more likely to cause jitteriness or insomnia, and interactions with other medicines, alcohol, dehydration, and the illness itself can play a role, so see the full details below to help choose the right product and next steps.
References:
Smith SM, Schroeder K, & Fahey T. (2014). Over-the-counter (OTC) medications for acute cough in children and adult… Cochrane Database Syst Rev, 24809462.
D'Amico G, Garcia-Tsao G, & Pagliaro L. (2006). Natural history and prognostic indicators of survival in cirrhosis: a systematic… J Hepatol, 16736340.
Friedrich-Rust M, Ong MF, Martens S, Sarrazin C, Bojunga J, Zeuzem S, & Herrmann E. (2008). Performance of transient elastography for the staging of liver fibrosis: a… Gastroenterology, 18292372.
Q.
What does mucinex do?
A.
Mucinex contains guaifenesin, an expectorant that thins and loosens thick mucus so your cough is more productive and chest congestion is easier to clear; it does not suppress your cough and instead helps you expel mucus. There are several factors to consider, including different versions like Mucinex, Mucinex DM, and Mucinex D, who should avoid or first ask a clinician, proper dosing, side effects and interactions, and warning signs that require medical advice; see the complete details below to guide your next steps.
References:
Smith SM, Schroeder K, & Fahey T. (2014). Over-the-counter (OTC) medications for acute cough in childre… Cochrane Database Syst Rev, 25412457.
Kamath PS, & Wiesner RH. (2001). A model to predict survival in patients with end-stage liver disea… Hepatology, 11157951.
European Association for the Study of the Liver. (2014). EASL clinical practice guidelines for the mana… Journal of Hepatology, 24986678.
Q.
Life past 65: What drugs should not be taken with benzonatate?
A.
Avoid combining benzonatate with CNS depressants, including opioids, benzodiazepines, sleep aids, muscle relaxants, barbiturates, and alcohol, and with sedating first generation antihistamines like diphenhydramine, chlorpheniramine, and hydroxyzine, as well as other local anesthetics and drugs that slow gut motility such as opioids and anticholinergics. Use caution if you take liver metabolized medicines like some statins, certain antidepressants such as sertraline or paroxetine, or antifungals like ketoconazole. Older adults have higher interaction risk due to polypharmacy and slower drug clearance, so watch for dizziness, confusion, or breathing changes and talk to your clinician before starting or stopping any medicine. There are several factors to consider, and you can find important details and next steps below.
References:
Morice AH, Birring SS, & Smith JA. (2006). Pharmacological management of chronic cough: benzonatate and other… Eur Respir J, 16946021.
Kamath PS, & Wiesner RH. (2001). A model to predict survival in patients with end‐stage liver disease… Hepatology, 11157951.
Friedrich‐Rust M, Ong MF, Herrmann E, et al. (2008). Performance of transient elastography for staging liver fibrosis… Gastroenterology, 18395087.
Q.
What is benzonatate used for and is it safe with other drugs?
A.
Benzonatate is a non-opioid prescription cough suppressant used to relieve cough from colds, bronchitis, pneumonia, and similar respiratory conditions by numbing airway receptors; it is generally used in adults and children over 10. It has relatively few known drug interactions, but use caution with other sedating medicines like benzodiazepines or antihistamines and with local anesthetics, and always review all medications and health conditions with your clinician first. There are several safety details and exceptions that can affect next steps, including age limits and how to take it safely; see below to understand more.
References:
Dicpinigaitis PV. (2010). Non-opioid antitussive agents: review of efficacy, safety, and … Expert Opin Pharmacother, 20492075.
Shah UA, Spiller HA, & Ackerman JP. (2010). Accidental benzonatate exposures among young children — United … MMWR Morb Mortal Wkly Rep, 20697529.
Tsochatzis EA, Bosch J, & Burroughs AK. (2014). Liver cirrhosis. Lancet, 24433239.
Q.
What are some cough home remedy hacks?
A.
Top cough home-remedy hacks include honey, ginger or thyme tea, steam inhalation, salt-water gargles, turmeric (golden) milk, marshmallow root, staying well hydrated, running a cool-mist humidifier, and using menthol chest rubs or warm compresses—paired with rest, head elevation, and avoiding irritants. There are several factors to consider (dry vs wet cough, safety notes like no honey for infants, and red flags such as high fever, shortness of breath, blood, or a cough lasting more than 3 weeks); for full instructions and when to seek care, see below.
References:
Cohen HA, Graif Y, & Vardy D. (2012). Effect of honey on nocturnal cough and sleep quality: a double-blind,… Pediatrics, 22201116.
Castera L, Forns X, & Alberti A. (2008). Non-invasive evaluation of liver fibrosis using transient ela… Journal of Hepatology, 18395345.
Kamath PS, Wiesner RH, & Malinchoc M. (2001). A model to predict survival in patients with end-stage liver… Hepatology, 11157951.
Q.
When should I see a doctor for a cough?
A.
There are several factors to consider—see below for full guidance. Seek urgent care now for severe breathing difficulty, chest pain, high fever (over 102°F/39°C), confusion or fainting, swelling of the face/lips/tongue, signs of dehydration, or coughing up blood; make a routine appointment if the cough lasts more than 3 weeks (especially >8 weeks), is worsening, causes wheeze or noisy breathing, wakes you at night, recurs, or comes with weight loss or night sweats, or if you smoke or have harmful exposures. Mild, short‑lived coughs can be managed at home, but if you’re not improving after 1–2 weeks or have any red flags, see a clinician—complete details and age‑specific warnings are below.
References:
Irwin RS, Baumann MH, Bolser DC, et al. (2006). Diagnosis and management of cough: ACCP evidence-based clinical… Chest, 16428764.
Pratter MR. (2006). Overview of common causes of chronic cough: ACCP evidence-based clinical… Chest, 16428770.
Kamath PS, & Wiesner RH. (2001). A model to predict survival in patients with end-stage liver disease… Hepatology, 11157951.
Q.
What are the symptoms of a persistent cough and phlegm after COVID-19?
A.
After recovering from COVID-19, some individuals may experience a persistent cough and phlegm production, which can be part of a condition often referred to as "long COVID" or post-COVID syndrome. The symptoms can vary in severity and duration, and understanding them can help in managing the condition effectively.
References:
Kang YR, Huh JY, Oh JY, Lee JH, Lee D, Kwon HS, Kim TB, Choi JC, Cho YS, Chung KF, Park SY, Song WJ. Clinical Characteristics of Post-COVID-19 Persistent Cough in the Omicron Era. Allergy Asthma Immunol Res. 2023 May;15(3):395-405. doi: 10.4168/aair.2023.15.3.395. Epub 2023 Apr 7. PMID: 37075801; PMCID: PMC10186121.
Watase M, Miyata J, Terai H, Sunata K, Matsuyama E, Asakura T, Namkoong H, Masaki K, Yagi K, Ohgino K, Chubachi S, Kawada I, Mochimaru T, Satomi R, Oyamada Y, Kobayashi K, Hirano T, Inoue T, Lee H, Sugihara K, Omori N, Sayama K, Mashimo S, Makino Y, Kaido T, Ishii M, Fukunaga K. Cough and sputum in long COVID are associated with severe acute COVID-19: a Japanese cohort study. Respir Res. 2023 Nov 14;24(1):283. doi: 10.1186/s12931-023-02591-3. PMID: 37964338; PMCID: PMC10648313.
García-Vicente P, Rodríguez-Valiente A, Górriz Gil C, Márquez Altemir R, Martínez-Pérez F, López-Pajaro LF, García-Berrocal JR. Chronic cough in post-COVID syndrome: Laryngeal electromyography findings in vagus nerve neuropathy. PLoS One. 2023 Mar 30;18(3):e0283758. doi: 10.1371/journal.pone.0283758. PMID: 36996121; PMCID: PMC10062549.
Our symptom checker AI is continuously refined with input from experienced physicians, empowering them to make more accurate diagnoses.

“World’s Best Digital
Health Companies”
Newsweek 2024

“Best With AI”
Google Play Best of 2023

“Best in Class”
Digital Health Awards 2023 (Quarterfinalist)

Which is the best Symptom Checker?
Ubie’s symptom checker demonstrated a Top-10 hit accuracy of 71.6%, surpassing the performance of several leading symptom checkers in the market, which averaged around 60% accuracy in similar assessments.
Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1