Please help me cough!
October 1, 2010 6:24 PM   Subscribe

Why doesn't an expectorant help loosen my cough when I have a cold?

I have a bad cold with a tight chest. Instead of taking a cough medicine with both an expectorant and suppressant (seems oxymoronic to me), I want to take something that "loosens" the cough and makes it productive: an expectorant, right? But I have tried taking Mucinex and a generic version (containing Guaifenesin) at different times, and it seems to have the opposite effect. My chest tightens, I don't cough, feel dried out and my throat is so dry it's difficult to talk. Exactly the opposite of what I'm looking for. Why?? Anyone have experience with this? Yes, I'll keep drinking tea with honey and trying to breathe over vapor in the meantime.
posted by mefireader to Health & Fitness (11 answers total) 4 users marked this as a favorite
You don't need an expectorant. What you need is for your doctor to give you an albuterol inhaler. (Not available OTC, but not usually very controversial either.)

It's been generic for a long time and it's pretty cheap.

It was developed as a treatment for asthma, and I assume you are not asthmatic. But when you've got a really bad chest infection, it tends to make the pipes in your lung shrink, and that's the "tightness" you're feeling. Albuterol will loosen it right up and make it easier for you to deep-cough and get that junk out of there.
posted by Chocolate Pickle at 6:37 PM on October 1, 2010

I suffer from mild asthma (I never use my red Symbicort, and only use my rescuer inhaler during hayfever season) and when I get a serious cold (a viral infection) my chest gets very tight indeed, and I find that I need an inhaler. Sometimes it gets so bad that nothing works, and I have been prescribed presnidone, a nasty steroid that really, really works.

So, you may be suffering from a form of asthma induced by a chest cold (viral infection). It may be a good idea to see if a doctor will prescribe you an inhaler of some kind. You need to mention the word "asthma".
posted by KokuRyu at 6:50 PM on October 1, 2010

I would avoid using inhalers with a cold.... they open the alveoli temporarily, which is a bad idea at a time when phlegm is susceptible to infection -- this could lead to bronchitis or pneumonia. I speak from experience here (and put two & two together afterward), though I am not a doctor. The phlegm has is serving a purpose to ward off infection and as long as it doesn't get too thick where it gets trapped (nonproductive cough or chest pain) then you're ok. I know that there's some mixed opinions about guifenesin, and I'm not sure myself, but I have a doctor/friend who works at the Mayo Clinic who swears up and down it's a good idea, so you might as well keep dosing it. Make sure you're drinking a LOT of water -- your post didn't say anything about that... tea has caffeine (if that's the kind you're taking) which makes it a diuretic, and it's not much liquid to begin with. Go for quarts of whole water a day and that might allow the guifenesin to work better.
posted by crapmatic at 6:57 PM on October 1, 2010

You mentioned that you had tried breathing over vapor, but have you tried running a really hot shower and just sitting in the steamy room for 10 minutes? I've found that to be way more effective than the whole towel-over head-and-pot-method. When I try that I'm hunched over the bowl/pot and don't take full breaths whereas in the steamy room I can sit up straight and try to breathe more deeply.

As for treatment, I've never been offered an albuterol treatment except for one time when I was practically blue in the face from trying to breathe through the amount of mucus glommed up in my lungs. Obviously, you know how bad you're feeling, but I'm not sure what you're describing warrants an inhaler yet. Keep drinking lots of liquids (not just tea, crapmatic is correct) and keep taking the guaifenisin. And if this is still really bothering you, you could go to the doctor (you don't indicate your insurance status so I am guessing this is a possibility).
posted by Mouse Army at 7:03 PM on October 1, 2010

P.S. Real TheraFlu may help a lot here -- in my opinion it makes chest congestion much more tolerable and less uncomfortable. Unfortunately Real TheraFlu, which I swear by (and which others seem to agree with) was pulled off the shelf in the US several years ago due to the meth panic and you now have to order it from Canada (NeoCitran). The "real" ingredient cocktail is basically acetominophen, dextromethorphan, and pseudoephedrine, so if you get those a la carte you can probably combine them and get some relief. I'm not sure if hot vapors (from the hot beverage formulation) are part of the trifecta or not, though, but there you go... I don't know why it makes colds so much better but it does. Good luck
posted by crapmatic at 7:05 PM on October 1, 2010

To answer your direct question (why doesn't guaifenesin help) it may simply be that you don't take enough. When I get those kinds of diseases, I take Robitussin DM.

But I take twice the dose they prescribe. I weigh 230 (overweight), and their dose is for everyone over age 12. They set the dosage accordingly, and so big people like me get underdosed. When I take double dose, it means I'm getting the same dose per body-weight as a 13 year old girl.

I find that if I take the prescribed dosage, it doesn't do a thing for me. Taking double works really well, however.
posted by Chocolate Pickle at 7:36 PM on October 1, 2010

I take guaifenesin on a regular basis for mild chest congestion caused by allergies, and even though I sometimes take three times the suggested dose the relief is never dramatic. When I really need to get things loosened up I rely on hot peppers. Hot salsa. A bowl of chili with jalepeno peppers. Something doused heavily with Tobasco sauce. Anything hot enough to make your nose run will loosen up your chest too.

Many years ago I had a bad flu that left me sick with asthma and chest congestion for weeks afterwards. Meds I got from the doctor weren't really helping, so any time I got really desperate to breathe I'd eat peppers and get hours of relief that way.

And yeah, lots of water like crapmatic said. When you're less than adequately hydrated your mucus is going to be thick and sticky and hard to cough up/blow out.
posted by Serene Empress Dork at 7:52 PM on October 1, 2010 [1 favorite]

BTW, Albuterol inhalers are not generic in the US. The generic versions use a propellant that depletes the ozone layer, and the exception for ozone-depleting substances in medical devices expired. Finding a suitable substitute required a lot of research money, and only one company found one; so, in the US, you can only buy the non-generic version (Ventolin) until the patent on the propellant expires in 2012.

Still only $30, though, I think.
posted by jrockway at 10:29 PM on October 1, 2010 [1 favorite]

Best answer: Guaifenesin only works if the problem is thick, intractable mucus. If that's not the problem, it won't work.

(And don't take the -D versions, the guaifenesin and the decongestant work against each other.)

A tight chest is generally bronchitis which is inflammation of the big tubes in the lungs. (Where asthma is inflammation on the smaller ones.) See if an NSAID with lots of water doesn't help things.

Or go to the doctor and have them listen to your lungs and let them tell you what is wrong and how to go about fixing it.
posted by gjc at 5:56 AM on October 2, 2010 [1 favorite]

I agree with gjc's point- a tight chest may have little to do with mucus. I had a horribly tight chest when I had pertussis last year, but coughs were non-productive.
posted by oneirodynia at 8:12 AM on October 2, 2010

Response by poster: Thanks everybody. Steamy room and warm compresses helped me out considerably. Good idea on the spicy food too. Interesting idea on taking more of it, but I think I'll skip the guaifenesin for now and see the doctor if it doesn't clear up soon. Thanks again.
posted by mefireader at 8:32 PM on October 2, 2010 [1 favorite]

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