Training: Coughs
Chapter 1: Clinical Overview

Part 5: Pharmacy Medicines

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Dextromethorphan

  • There are a number of brands, strengths and forms, such as lozenges and oral liquids.

    Note: The ingredient Pholcodine which was included in many dry cough preparations was recalled in 2023 in Australia by the TGA and is no longer available.

  • You or your pharmacist should advise the patient on the correct dosage and side effects.

    Side effects are not common but may include blurred vision, drowsiness, dizziness, vomiting and confusion.

    As a cough suppressant Dextromethorphan should not be used for a chesty cough when there is lots of mucous, or in asthma, COPD or pneumonia.

    Tip: Patients taking antidepressant medicines, should NOT take dextromethorphan.

  • Patients who have a dry cough that has lasted less than three weeks.
    Patients who are not taking any antidepressant medicines.

  • https://www.healthdirect.gov.au/medicines/brand/amt,53246011000036104/robitussin-dry-cough-forte

Dihydrocodeine

  • This is a Pharmacist-Only medicine

    Note: This is kept in the dispensary and requires the pharmacist to recommend it and provide advice to the patient.

  • Your pharmacist will advise the patient on the correct dosage and side effects.

    This medicine is classified as an opioid. The use of opioids comes with side effects including life-threatening breathing problems and the risk of abuse, misuse, and addiction. They should be taken with care. 

  • Patients with stubborn, unproductive dry coughs.

  • https://www.healthdirect.gov.au/medicines/brand/amt,53421011000036105/rikodeine

Bromhexine

  • There are a number of brands, strengths and forms, such as oral liquids and softgel capsules.

    Note: This is an expectorant, used for chesty coughs to help loosen mucous and thin bronchial (lung) secretions so that mucous can be more easily coughed out.

  • You or your pharmacist should advise the patient on the correct dosage.

    Guaifenesin may be used in pregnancy and when breastfeeding, at the recommended dose.

    Guaifenesin should not be used in children under six years of age, or in children 6-11 except on advice from a pharmacist or doctor.

  • Patients with a chesty cough that has lasted less than three weeks.

Guaifenesin

Senega and Ammonia

Associated Pharmacy Medicines

  • There are a number of brands, strengths and forms available.

    Note: These products may assist with some of the other symptoms that a patient is suffering with, such as runny nose.

  • You or your pharmacist should advise the patient on the most suitable products for them and the correct dosages, side effects and precautions.

  • Patients with other symptoms that are associated to their cough.

Cold, Flu and Sinus preparations

Complementary Medicines

  • Immune support with multiple ingredients, the main active ingredient is Andrographis.

    Note: This product is part of the Bioceuticals range of complementary medicines.

  • Andrographis decreases the severity of symptoms of mild upper respiratory tract infections, including sore throat, headache, runny nose, cough, fatigue and restless sleep.

    Vegan formula combining clinically trialed andrographis and immune-supporting nutrients.

  • Patients who want immune support from complimentary medicines.

    Patients who want a vegan option.

  • https://www.bioceuticals.com.au

BioCeuticals ArmaForce

  • Helps maintain a healthy immune system function.

    There are many brands available and these two ingredients may be in a combined formulation or available separately.

  • May reduce the duration and severity of mild upper respiratory tract infections, such as runny nose.

  • Patients who want immune support from complimentary medicines.

Vitamin C and Zinc

  • Helps to restore the balance of ‘good’ bacteria in the body, especially useful after antibiotics.

  • Patients who want to rebuild immunity and probiotics after a course of antibiotics.

Probiotics