11 best expectorants

*Review of the best according to the editorial board. About the selection criteria. This material is subjective, not an advertisement and is not a buying guide. It is necessary to consult with a specialist prior to purchase.

All medicines that belong to expectorants, or expectorants, serve one purpose: to effectively remove sputum from the small bronchi and the bronchi of the middle caliber.

The accumulated sputum must be expelled because it constantly irritates the sensitive endings, or receptors of the arc of the cough reflex. As a result, the patient begins to cough, bronchial spasm occurs. Sputum is a very good breeding ground for the reproduction of not only viruses but also pathogenic bacteria and fungi. Finally, trophic disorders of the bronchial mucosa caused by excessive sputum accumulation lead to chronic inflammation, which can accompany a person for years.

In some cases, sputum is poorly expectorated, there is stagnation and secondary infection with bacterial flora, and this contributes to a chronic lung infection. Drugs that help expectorate sputum by stimulating physiological mechanisms are classified as expectorants.

In other cases, physiologic sputum expectoration mechanisms work well, but the sputum is so thick that it does not expectorate on its own. Therefore, in this situation we need other drugs that act not on the mechanisms of expectoration of sputum, but on its physical and chemical properties. They help to liquefy, melt the sputum, and therefore are called mucolytics, in some cases you can meet another name – secretolytics.

Finally, there is also a third group of medications that help fight coughing. But their action is quite the opposite: they do not help at all to stimulate phlegm discharge, or its dilution, or expectoration. They simply fight the cough as an excruciating symptom that greatly reduces the quality of life. After all, not every cough needs good drainage and expectoration of sputum.

There are conditions such as those associated with over irritation of cough receptors, (after being in a smoke-filled atmosphere). And in such a case, you need drugs that inhibit either the cough center, located in the brain, or act on the receptors, which are located in the bronchi and reduce their sensitivity. As a result, cough as a symptom either becomes much less bothersome or disappears altogether. This rating of cough suppressants includes representatives of all three of these groups.

Rating of the best expectorants

Drugs that stimulate expectoration

These drugs mainly affect the ciliated, or ciliated epithelium, which covers the inner mucous membrane of the bronchi. They stimulate specific movements of the bronchioles, that is, the small bronchi, which resemble the peristalsis of the intestines. The task of the peristaltic waves of the bronchi is to move the sputum from the interior to the periphery. Also, these expectorants stimulate increased secretion by the bronchial glands, and slightly reduce sputum density, although this is not their primary function. There are quite a few herbal remedies among these, and they work effectively despite the existence of other, synthetic drugs.

Pertussin

Rating: 4.9

Opens the rating of effective and affordable expectorant drugs Pertussin. This is a complex medication, which consists of thyme (thyme) extract, supplemented with potassium bromide. In fact, Pertussin refers to two groups at once: and to stimulants, and to mucolytics. After all, potassium bromide is a compound that is very good at liquefying sputum.

The product is available as a syrup, and used in adults in a single dose of 15 ml, or one tablespoon, and children are prescribed a much smaller dose – from half a teaspoon three times a day. Individually the dosage is prescribed by the pediatrician. Pertussin is used, as well as other medicines from this group for the treatment of acute inflammatory diseases of the bronchopulmonary system – tracheitis, bronchitis, laryngitis, in the treatment of pneumonia. Produces the drug Pertussin a significant number of domestic pharmaceutical companies. Pertussin refers to a very inexpensive and popular expectorant medication. One bottle of syrup of 100 ml can already be purchased for 12 rubles.

Advantages and disadvantages

The disadvantages of Pertussin include its slow expectorant effect: it is indicated for a course of treatment, with a minimum duration of 10 days. Also, if the patient is intolerant to bromides, heartburn or allergic reactions may occur, and in case of overdose, nausea is possible. Pertussin is not indicated for everyone. Given that Pertussin contains a small amount of ethyl alcohol, it should not be prescribed to persons with severe liver damage, alcoholism, epilepsy, children under three years of age. It can not be prescribed to diabetics, since the bulk of the excipients are sugar syrup. The obvious plus of Pertussin is the lowest price of all possible drugs for expectoration in the rating, so it takes the first “people’s” place.

Mucaltin

Rating: 4.8

Mucaltin is a tablet dry extract of marshmallow, and refers to the phytopreparation, each tablet contains 50 mg of dry extract. Mucaltin is shown for pneumonia, acute and chronic bronchitis, obstructive pulmonary disease, bronchiectatic disease. The principle of action of Mucaltin – a classic for this group, and is explained by an increase in the activity of the atrial, or ciliated bronchial epithelium, increasing their peristalsis and increased bronchial secretion, which leads to effective expectoration. Mucaltin is used according to a simple scheme: 1 or 2 tablets three times a day, the remedy should be taken before meals. When prescribing Mucaltin to children, you can pre-dissolve the tablet in a small amount of water, the drug can be prescribed to children from 12 years and older. Mucaltin is produced by several domestic companies, for example, Medisorb, Pharmstandard. A pack of 30 pills will cost the patient only 41 rubles.

Advantages and disadvantages

The advantages of the expectorant Mucaltin should include good tolerability and absence of overdose symptoms, availability and low price, the possibility to combine Mucaltin together with other means for the treatment of bronchial diseases, it is allowed in pregnancy and lactation. In rare cases, there may be the occurrence of allergic reactions, and the appearance of symptoms of dyspepsia: abdominal discomfort, mild nausea. To the disadvantages of Mucaltin should be attributed its not high enough rate of onset of the effect: several days are required in order to activate the physiological mechanisms. But almost all drugs that act only on the “physiology” suffer from this disadvantage, unlike mucolytics, in which the sputum liquefies in a few hours after their use.

Licorice syrup

Rating: 4.7

Licorice root is an effective and popular expectorant of plant origin. Glycyrrhizin, which contains in licorice, increases the secretion of glands of the upper respiratory tract, which makes it easier to expectorate sputum. Licorice comes in different dosage forms, both in the form of syrup and in the form of tablets for resorption.

If we are talking about syrup, you need to consider the contraindications, which are due to the presence of 10 g of ethyl alcohol and sugar syrup. Thus, licorice syrup is undesirable to give to children, pregnant women, persons suffering from chronic alcoholism, with the consequences of cranial trauma and with epilepsy, as well as diabetics. Chewable tablets have no such restrictions.

Apply expectorant syrup in adults should be one teaspoon three times a day, diluting it in a glass of water, and in the case of tablets – one or two tablets three times a day – until complete resorption. And in both cases, if the sputum is poorly expectorated, you need plenty of warm drinking. By the way, this advice is good for all medicines that stimulate sputum separation without exception, and alkaline mineral water is especially good.

The indications for the use of different forms of licorice are exactly the same – these are inflammatory diseases of the bronchi, cough, in which there are difficulties with the elimination of sputum. Licorice syrup is produced by the Tula Pharmaceutical Factory, and the resorption tablets by Vneshtorgpharma. In the case of tablets, one pack of 50 can be purchased for 130 rubles.

Advantages and disadvantages

Licorice contributes well to the expectoration of sputum, it can be used in complex therapy with other medicines, and has no interactions. But still, sometimes patients can have side effects, signs of individual intolerance – diarrhea and allergic reactions, and if you use licorice preparations for too long, it contributes to a decrease in the concentration of potassium in the blood. This can lead to high blood pressure, changes in electrolyte metabolism in the body, and contribute to the development of peripheral edema, so use licorice must be short courses, or under medical supervision.

Cough syrup from Universal Pharma

Rating: 4.6

This drug, or medicinal product, can claim to be unique in the ranking by its simple and effective name, which carries a clear commercial benefit. It is enough for the patient, coming to the pharmacy, to say that he needs “cough syrup”, and a ready-made bottle will appear on the counter. In fact, the cough syrup is a combination of the components that were described above. This syrup contains: marshmallow, licorice, echinacea and vitamin C.

In addition to acting on the physiological mechanisms of expectoration of sputum, this syrup can be prescribed for chronic infections of the bronchopulmonary system, and has a general restorative property. This syrup is used three times a day, 2-3 teaspoons dissolved in warm water with meals. The syrup is produced by the domestic company Universal Pharma and 100 ml of syrup costs only 75 rubles.

Advantages and disadvantages

Unlike previous forms as an expectorant syrup, described above, this syrup contains no ethyl alcohol, but only sugar and potassium sorbate. Therefore, the only limitation to the use of this syrup remains diabetes, but it is indicated in children, can be used in persons suffering from alcohol dependence, in the presence of epilepsy and in the consequences of brain injuries. The effectiveness of this syrup is higher than the use of Mucaltin and licorice separately, since it is a complex drug.

The best mucolytic drugs for expectoration

Mucolytic drugs do not act on the physiological mechanisms of the bronchopulmonary system, and not on the secretion, but only on the sputum itself. Their main mechanism of action is the activation of enzymes producing the hydrolysis of sputum, or the splitting of mucus molecules (mucins) into more mobile fragments. But despite the composition of mucolytics, it is imperative to remember that together with these drugs for expectoration it is necessary to prescribe abundant and warm drinking, at least one and a half liters per day, if we are talking about the treatment of an adult. If there is a deficit of fluid, no matter how well the drug affects the structure of the sputum, it will be very difficult to expel it.

Ambroxol (Ambrobene, Ambrohexal, Ambrosal, Bronchovern, Lazolvan, Medox)

Rating: 4.9

Such a number of different synonyms, and trade names indicates the great popularity of all remedies that contain Ambroxol. We will consider one of the most popular and high-quality drugs, Ambrobene, which is produced by the German company Merkle. Ambroxol is a classic mucolytic – benzylamine. Unlike drugs of the first group, it begins to act not in a few days, but already in 30 minutes. In addition to its effect on sputum, Ambroxol has little effect on the glands and on the epithelium. This substance helps to form a surfactant, or a special fat-like lubricant that coats the smallest respiratory units, the acini, from the inside and keeps them from sticking together.

Expectorant Ambrobene shown in all diseases of the bronchopulmonary system, both acute and chronic, which is poorly formed and exits sputum. In this article, we will not elaborate on dosage regimens, because Ambrobene is available not only in tablets and in syrup, not only in capsules, which have a prolonged effect, but also in a solution for intravenous injection, and even as a solution for ultrasonic inhalation. In each of these cases, there may be a specific dosage regimen prescribed by the doctor. Ambrobene in tablets can be bought for 100 rubles., One bottle of syrup of 100 ml – for 100 rubles., And about the same price range will be the prolonged capsules and solution for intravenous injection.

Advantages and disadvantages

Since this drug is artificially synthesized, it can have, and quite often develop some side effects. It is nausea, various taste disorders, occasionally dry mouth and throat. All ambroxol preparations, including Ambrobene, are contraindicated in the first trimester of pregnancy, in later terms – only by doctor’s prescription, and after assessing the degree of risk. Ambroxol is best not prescribed in patients with severe liver and kidney dysfunction. Ambroxol is indicated for children, but under the age of two years should be treated only under the supervision of a specialist. A huge plus of Ambrobene is a very quick effect, and availability in different forms of administration.

Fluimucil (Acylcysteine, ACC)

Rating: 4.8

This expectorant, which is available as a solution for ingestion and inhalation as well as in pellets and effervescent tablets, contains acetylcysteine. Its action is based on the ability of sulfhydryl groups, or sulfur compounds with hydrogen, to break the mucopolysaccharide molecules that make up the sputum. As a result, the molecules become shorter, which reduces the viscosity of the sputum, increasing its fluidity and the ability to leave the bronchial tree.

This drug in any form is well absorbed from the gastrointestinal tract, and works equally well when used internally or inhaled. Fluimucil has a wide range of indications, and, besides traditional inflammatory bronchopulmonary diseases, it is successfully used in emphysema and cystic fibrosis, with atelectasis of the lung, when the communication of the segment with its bronchus is broken by blockage of the bronchus with a plug of dense sputum.

If we talk about effervescent tablets, the dosing regimen for adults is very convenient. One tablet of 600 mg is dissolved in half a glass of water and drunk, with a multiple of only once a day. For the use of other forms it is necessary to consult with the attending physician, especially for the initial prescription of inhalation. Flujimucil is produced by Italian pharmaceutical company Zambon, and the price of this drug is low. The most expensive form is effervescent tablets, and one pack of 20 will cost 370 rubles. But remember, one pill is enough for one day, which means this pack is enough for 3 weeks.

Advantages and disadvantages

The advantage of Fluimucil, and the undeniable, which more than makes up for the disadvantages, is its powerful liquefying action. Not every expectorant will be able to expel the dense mucus plug, which has blocked the main segmental bronchus and caused atelectasis of the lung, that is, its disconnection from breathing. But this drug has side effects: sometimes heartburn, sometimes a skin rash. Of contraindications should be considered exacerbations of peptic ulcer, for pellets – children under 2 years of age, and for effervescent tablets even under 18 years, lactation and pregnancy, as well as liver and kidney disease.

Bromhexin (Bronchotil, Paxirazol, Solvin, Flegamin)

Rating: 4.7

Bromhexin, an expectorant, is a mucolytic and a bronchial smooth muscle stimulator at the same time. Just like Ambroxol, it stimulates the synthesis of surfactant, which facilitates alveolar ventilation, and is indicated for all chronic bronchopulmonary diseases with an inflammatory component. It can also be used for thoracic injuries, in the preoperative period and after thoracic surgery in the complex therapy. Tablets containing bromhexine hydrochloride in 4 and 8 mg dosages are most commonly available. It is used in uncomplicated cases one to two tablets three times a day, depending on age, the dosage may vary, so the doctor prescribes it. In addition to tablets, there is a solution, syrup for inhalation and other forms for convenient use.

Bromhexin, like the popular Ambroxol, is produced by so many different companies. This includes Berlin-Chemie, Grindex, Nicomed and Akrichin, and other companies. The cheapest tablets can be purchased at the price of 9 rubles. For a pack of 50 tablets, and of course, this would be the domestic pharmaceutical company Ozone. By comparison, the same dosage of 8 mg, but in a pack of 25 pills instead of 50, produced by the German company Berlin-Chemie, will cost from 95 rubles.

Advantages and disadvantages

Bromhexin is a convenient and powerful drug, comes in different dosages and forms, is inexpensive, and acts as quickly as acylcysteine, or Fluimucil. But this drug has contraindications, and, in addition to individual intolerance, you should also definitely consider exacerbation of gastric and duodenal ulcers, breastfeeding and the first trimester of pregnancy. This expectorant is not recommended for children under three years of age.

Libexin Muco (Carbocysteine)

Rating: 4.6

The active ingredient in the drug Libexin Muco is carbocysteine. Carbocysteine is similar to acylcysteine, but somewhat modified. It affects the glycoproteins of the bronchial secretion and the mucus, but it is also capable of activating a special enzyme called sialic transferase. As a result, the special cells of the mucous membrane of the bronchi begin to secrete it, and this leads to a stable balance of the acid-base state of the mucus, namely, the normalization of the ratio of acidic and neutral constituents. As a result, the mucus becomes more fluid, and even helps protect and improve the regenerative properties of the bronchial membrane.

Carbocysteine is able to improve the secretion into the bronchial lumen of specific antibodies, or secretory immunoglobulins class A. The drug is indicated for all diseases in which sputum becomes very viscous and difficult to drain. The drug is also prescribed as a prophylactic agent before bronchoscopy to facilitate the procedure.

This expectorant is available as a syrup, and adult patients need to take 15ml three times a day, while children need a lower dosage, as prescribed by the doctor. The drug is produced by French company Sanofi, and a 125 ml bottle can be purchased starting from 400 rubles.

Advantages and disadvantages

One of the undeniable advantages of Libexin Muco is not only the possibility to treat diseases of the bronchopulmonary system, but also to use it to dilute the mucous secretion in diseases of ENT organs, such as chronic rhinitis and sinusitis. Libexin Muco has some contraindications, which include not only ulcer disease, as with other mucolytics, but glomerulonephritis and cystitis. It is also contraindicated in pregnant women and children under the age of two years, and special control over the intake of this drug in diabetics is required, since the syrup contains sugar.

Cough suppressants

The aim of antitussives is to suppress the cough as a process and they should only be used when the physician is sure that expectoration will not harm the patient and that inhibiting the cough centers in the brain or reducing the activity of the peripheral receptors will not harm the patient. In the case of a diagnostic error, a significant deterioration of the patient’s condition is possible.

So, when an agonizing dry cough is one of the symptoms of an acute respiratory viral infection, an inexperienced doctor may prescribe an anti-cough medicine immediately, that is, start fighting the cough, instead of stimulating the expectoration of sputum. The patient will stop experiencing excruciating sensation, but the pathological process of transformation of viral bronchitis into bacterial bronchitis will continue in the bronchi, purulent sputum will be formed and accumulate. This may result in high fever, signs of intoxication, shortness of breath, pain in the side, and pneumonia. Therefore, there are certain and specific indications for prescribing cough suppressants. It is much safer to err in the other direction, and prescribe sputum secretion agents by mistake, than to suppress the cough unnecessarily.

Of course, the strongest suppressors of the cough reflex are the so-called narcogenic drugs based on codeine phosphate – 3-methylmorphine, one of the opium alkaloids. These are drugs such as Dianin, and Estocin. But we will not dwell on those drugs for which prescription forms are required, let’s dwell on those cough medicines that can be bought without a prescription.

But before we begin to list them, we must make it clear to the reader, who will use the knowledge gained in practice, that on their own, without a doctor’s prescription, and especially for the first time and on their own, on no account can you prescribe these drugs to yourself. There is a very high chance of more harm than good.

Sinekod (butamirate)

Rating: 4.9

First of all, the name of the drug itself is interesting. Almost all drug names that say their composition give information about what the drug contains. The drug Sinekod immediately declares what it does not have. In Latin, sine codeine means “devoid of codeine,” not containing codeine. Thus, the very name of the drug states that it does not contain narcotic substances. But there are other analogues with the names Codelac, Omnitus.

Butamirate refers to central acting cough suppressants, and is available as a vanilla flavored syrup for adults, and in drops for children. Butamirat does not contain drugs, but directly affects the cough center. By the way it contributes to the expansion of the bronchi, facilitates breathing, and increases the oxygen saturation of the blood. The drug is indicated to reduce coughing in cases where it can cause harm. It is a postoperative period in thoracic (thoracic) surgery, to prevent divergence of sutures on the lungs and stumps of the bronchi, during minimally invasive interventions, such as bronchoscopy. One of the indications for taking Sinekod and its analogues, as well as other antitussive drugs is pertussis. Under this disease coughing fits are so painful and prolonged that children may turn blue and lose consciousness.

The drug is used in adults by 15 ml three or four times a day, there are measuring caps for dosing. Drops are prescribed to children depending on their age. The minimum dose of 10 drops four times a day is indicated for children from 2 months to a year, and children who have reached the age of five, the drug is prescribed as a syrup of 5 ml 3 times a day. Ask your pediatric pulmonologist for the exact dosage. The drug is produced by Swiss company Novartis and you can buy a bottle with 100 ml of syrup for the price of 175 rubles., Drops in a small vial of 20 ml cost 300 rubles.

Advantages and disadvantages

The advantage of Sinecod is the absence of drug interactions, the possibility of taking it almost from the second month of life, and the persistent effect of. A great advantage is the absence of addiction and the formation of dependence, because the drug does not contain a narcotic substance. The downsides include the rare, but still development of side effects in the form of drowsiness, nausea and rash. Sinekod is not recommended for use in the first trimester of pregnancy, as well as during breastfeeding. But this drug entered the rating as an effective and reliable, which fully meets the objectives.

Libexin (prenoxdiazine)

Rating: 4.8

Here, in the rating of cough medicines, we are again confronted with a unique drug name, and This is a very special case. As we remember, in the previous section of mucolytic drugs for expectoration we had a remedy called Libeccin Muco, or carbocysteine, one of the best means for thinning sputum. The same drug is simply called Libexin, but does not contain carbocysteine, but a special substance, prenexdiazine, and its function is quite the opposite: to affect the peripheral bronchial receptors and suppress coughing. Patients should be especially careful not to buy a drug with a very similar name, which will reduce the cough, instead of stimulating expectoration. Why such a similar name was chosen for a remedy that can easily be confused with a drug that is opposite in action is completely unclear, especially since the drugs contain very different active ingredients.

Prenoxdiazine hydrochloride is available in 100 mg per tablet, and the task of this substance is to block the cough reflex in the periphery. It slightly anaesthetizes the bronchial mucosa, which leads to decreased irritability of the cough receptors. This drug is quite strong and its anti-coughing effect is equal to that of codeine. But, unlike codeine, Libexin is not addictive and addictive.

Indications for use are any conditions that are accompanied by the appearance of an empty and unproductive cough. It may be cough of non-pulmonary origin, such as in patients with heart failure at night, when a lack of myocardial contractility overwhelms the small circulatory system with blood. Indications for taking Libexin are postoperative conditions in thoracic surgery and minimally invasive interventions.

Libexin is used one tablet three times a day, and in severe cases the dose is doubled. Children can also be prescribed the drug, but only depending on body weight. Libexin is produced by the Hungarian company Hinoin and one pack of 20 tablets costs from 350 roubles.

Advantages and disadvantages

Libexin, like Sinekod, entered the rating, first, for its safety relative to narcotic cough remedies, and second, for its good and persistent action. As for the negative aspects, you should not exceed the dosage, otherwise side effects such as dry mouth, skin rash and mild sedation may occur. The drug should be used with caution in children, and it is contraindicated in persons with lactose intolerance, which is included in the tablet as an excipient.

Falimint (acetylaminonitropropoxybenzene)

Rating: 4.7

A tablet of Faliminta contains 25 mg of an active ingredient with a name that is difficult to pronounce. By the way, if we digress from the serious topic a bit, this active substance takes the first place in the rating in terms of difficulty of pronunciation.

Falimint provides local anaesthetic, action in which the bronchial mucosa becomes kind of numb, and there is little sensitivity to irritating actions. In addition, Falimint is an antiseptic, and since it is available in absorbable tablets, it causes a feeling of minty coolness in the mouth, is refreshing, and, very importantly, does not dry out the mucous membranes, and the mouth does not feel numb.

Falimint, in addition to diseases of the bronchopulmonary system accompanied by a non-productive cough, is also shown in various inflammatory lesions of the oral cavity. These are stomatitis and gingivitis, conditions after dental interventions, sore throat, pharyngitis and laryngitis. Falimint is shown before preparing for various instrumental studies in ENT practice, to reduce the possibility of secondary infection and complications. The tablets are taken by mouth, 3 to 5 times a day, but no more than 10 tablets. The manufacturer does not recommend the long-term use of Falimint, and, of course, in order to maximize the antiseptic effect, after resorption you should not drink water or eat. The drug Falimint is produced by CJSC “Berlin-Pharma”.

Advantages and disadvantages

The advantage of Falimint is that, in addition to mild anti-coughing action, it is widely used in ENT practice, in dentistry for the treatment of a large number of diseases that occur extremely often. The main disadvantage of Falimint is the fact that, unfortunately, since 2017 it has disappeared from sale. The manufacturers explain it vaguely, sometimes talking about re-registration of the drug, sometimes complaining about problems in production, and it is still unclear whether Falimint will be sold again. There are no official statements that Falimint may pose a health hazard, so one can hope that this remedy will reappear in retail, perhaps under a different name.

Conclusion

This article reviewed the ratings of the most popular and effective drugs for stimulating sputum separation, for its liquefaction, or expectorants, and anti-cough agents that inhibit the cough reflex, both in the periphery and at the level of the cough centers of the brain. Of course, not all drugs have been considered. Leaving behind multicomponent remedies, which are mainly produced on the basis of herbal raw materials, such as Bronchikum, Doctor Mom, and so on. The fact is that the purpose of this short review was to present the key medications without which you can not do without. Additional phytopreparations, which are neglected, do not produce an effect that can be compared in strength with the above remedies, but they can be used together, as part of a complex therapy.

In conclusion, it should be said that under no circumstances should anti-cough drugs be combined with expectorants, because this will result in excessive production of sputum, but with the inhibition of the cough reflex, it will all accumulate, stagnate and become infected. In addition, when treating diseases, the main symptom of which is cough, and it is necessary to expectorate sputum, the old antihistamines such as Dimedrol, Pipolfen (Diprazin) should not be prescribed. Their side effect is to thicken sputum. Naturally, it is necessary to drink plenty of fluids, preferably alkaline, and to refuse diuretics and laxatives, which withdraw fluids from the body and prevent the qualitative work of expectorants. In the event that diuretics are shown to a patient as part of long-term therapy, for example, in the treatment of heart failure, then this issue must necessarily be resolved with the attending physician.