Coughing, whether chronic or acute, can significantly impact one’s daily life and quality of living. It is a primary symptom of medical importance in more than half of new clinical visits to primary care providers.
Chronic coughing is attributed to three main disease processes: chronic airway diseases (asthma and COPD), post-nasal drip, and gastroesophageal reflux disease (GERD). Acute coughing may be linked to common colds, asthma exacerbations, or upper respiratory tract infections like bronchitis. A cough can be either dry, not producing mucus, or wet, accompanied by the expulsion of mucus from the respiratory tract. Dry coughs often have a consistent hoarse sound, while wet coughs may produce a gurgling effect as mucus moves through the airways.
Delsym (dextromethorphan) and Robitussin (dextromethorphan) are two over-the-counter cough suppressant medications designed to provide temporary relief from coughing. They are part of a product line under the same trade name, offering combination medicines to address various cough and cold symptoms such as chest congestion, runny nose, nasal congestion, and fever.
Delsym contains the active ingredient dextromethorphan, which acts centrally in the brain to suppress coughing by reducing the excitability of the cough center. What sets Delsym apart is its patented time-release formulation, providing 12 hours of cough relief compared to the typical 4 to 6 hours provided by other non-time-released cough syrups.
Available in a 30 mg/5 ml suspension with a patented dextromethorphan polistirex molecule, Delsym comes in three and five ounces and is suitable for children aged 4 years and older.
Similarly, Robitussin is an over-the-counter cough suppressant with dextromethorphan as its active ingredient. Robitussin 12-Hour Cough Relief is also a time-release formulation with 30 mg/5 ml dextromethorphan polistirex.
Robitussin is available in three and five ounces in orange and grape flavors and can be used by children aged 4 years and older.
Both Delsym and Robitussin are indicated for the temporary relief of coughing, particularly non-productive coughs associated with the common cold and bronchitis.
In terms of effectiveness, clinical studies have shown that dextromethorphan, present in both Delsym and Robitussin, provides a similar level of cough suppression as codeine. Patients reported greater decreases in cough intensity with dextromethorphan compared to codeine. As dextromethorphan is not an opioid and is available without a prescription, it is generally considered a first-line treatment for cough suppression.
The Journal of Family Practice has published findings suggesting that dextromethorphan provides better cough relief compared to other remedies like antihistamines, decongestants, and expectorants. Expectorants may be more appropriate for patients with a wet, productive cough to help clear mucus from the airways.
Delsym and Robitussin have a similar side effect profile due to their long-acting dextromethorphan content. Side effects are generally limited and mild, including dizziness, fatigue, and drowsiness. Allergic reactions could occur in patients sensitive to dextromethorphan or other ingredients in the suspensions.
It’s essential to use Delsym and Robitussin according to the package directions and your healthcare provider’s advice, as they have been associated with abuse when combined with opioid products, potentially leading to serotonergic side effects.
Regarding drug interactions, both medications should be avoided in patients taking monoamine oxidase inhibitors (MAOIs) due to the risk of serotonin syndrome. Concurrent use of dextromethorphan with memantine, a drug used in patients with dementia and Alzheimer’s, may lead to agitation and dizziness, especially in patients who are already prone to these symptoms.
It’s worth noting that Delsym and Robitussin are not intended for the treatment of chronic coughs. If your cough persists for more than one week or is accompanied by fever, rash, or nausea and vomiting, you should seek immediate medical attention.
While both medications are safe for use in children aged 4 years and older, the FDA recommends not using dextromethorphan-containing products, including Delsym and Robitussin, in children under the age of six due to the risk of fatal overdoses.
For pregnant women, the safety of Delsym and Robitussin has not been conclusively established, so their use during pregnancy should be evaluated based on the potential benefits versus risks.
In summary, Delsym and Robitussin are similar in their effectiveness as cough suppressants, offering temporary relief from coughing caused by acute processes like the common cold. They are preferred over codeine-based formulations due to their non-opioid nature and availability without a prescription. However, if your cough persists or worsens, it is essential to seek medical attention as it may be a sign of a more serious condition.
