Finding the Best Medicine for a Cough with COVID-19

October 14, 2025 •

4 min read

Up to 70% of people with symptomatic COVID-19 experience a cough, and while choosing the right treatment can be challenging, understanding what is the best medicine for a cough with COVID-19 depends on the specific type of cough. Effective management often involves a combination of over-the-counter remedies and supportive home care.

Quick Summary

Selecting the right medication for a COVID-19 cough depends on whether it is dry or wet. Options range from specific over-the-counter suppressants and expectorants to supportive home care and, for high-risk individuals, prescription antivirals.

Key Points

Match the medication to the cough type: Use a suppressant like dextromethorphan for a dry cough and an expectorant like guaifenesin for a wet cough.
Focus on supportive care: For mild symptoms, home remedies like staying hydrated, using a humidifier, and drinking warm tea with honey are highly effective.
Consider prescription antivirals for high-risk cases: High-risk patients should consult their doctor early about treatments like Paxlovid, which can reduce the risk of severe illness.
Avoid multi-ingredient products if possible: To prevent taking unnecessary or potentially harmful drugs, choose single-ingredient medications that target only your specific symptoms.
Elevate your head at night: Sleeping with your head propped up can prevent mucus from pooling in your throat and triggering a cough.
Know when to seek medical help: If a cough is severe, persistent for more than three weeks, or accompanied by difficulty breathing, chest pain, or coughing up blood, see a doctor immediately.

Coughing is one of the most prevalent symptoms of COVID-19, often presenting as a dry, persistent hack in many cases, but can also be productive (wet). The discomfort can be significant, disrupting sleep and daily activities. However, the approach to treating this symptom is not one-size-fits-all and depends entirely on the nature of the cough itself. While medication can offer relief, it's crucial to remember that over-the-counter (OTC) options only manage the symptom and do not treat the underlying viral infection. A combination of medical and non-pharmacological interventions is often recommended for effective symptom management.

Understanding the COVID-19 Cough

The most common COVID-19 cough is dry and persistent, resulting from irritation of the respiratory tract as the virus multiplies. This "unproductive" cough can be exhausting and feel like a constant tickle in the throat. In a smaller number of cases, COVID-19 can cause a wet or productive cough, where mucus or phlegm is brought up from the lungs. It's essential to differentiate between these two types, as they require different treatment approaches.

Over-the-Counter Solutions for Symptom Relief

For most people with mild-to-moderate symptoms, OTC medications can provide sufficient relief. It's important to select products that target only the symptoms you have to avoid unnecessary side effects.

For a Dry Cough (Suppressants): A cough suppressant, or antitussive, works by calming the cough reflex. Dextromethorphan, commonly found in products like Robitussin and Delsym, is the active ingredient recommended for controlling a persistent dry cough. Some earlier research in lab settings raised questions about its use with COVID-19, but there is no definitive human evidence to suggest it should be avoided, and many health bodies continue to recommend it.

For a Wet Cough (Expectorants): An expectorant is a medication that helps loosen and thin mucus in the airways, making it easier to cough up. Guaifenesin, the active ingredient in Mucinex, is often recommended for a wet or productive cough. For this medication to be most effective, it is essential to stay well-hydrated.

For Postnasal Drip: If a cough is caused by mucus dripping down the back of the throat, antihistamines like cetirizine (Zyrtec) or loratadine (Claritin) and decongestants such as pseudoephedrine (Sudafed) may help. However, avoid oral decongestants containing phenylephrine, as the FDA has found it ineffective. Pseudoephedrine can also raise blood pressure, so those with hypertension should exercise caution and consult their doctor.

The Power of Home Remedies

Supportive home care is a cornerstone of managing COVID-19 symptoms, including cough. These strategies are effective on their own for mild cases and can be combined with medication for more severe symptoms.

Stay Hydrated: Drinking plenty of fluids like water, warm tea with honey, or broth helps thin mucus and keeps your throat moist. Hydration is also crucial for preventing dehydration, especially if you have a fever.
Use a Humidifier: Adding moisture to the air can soothe an irritated throat and ease coughing, particularly a dry cough.
Inhale Steam: A hot shower or steam inhalation can help loosen mucus and hydrate airways.
Honey for a Sore Throat: A teaspoon of honey in warm water or tea can be very soothing for an irritated throat. Note that honey should not be given to children under one year of age.
Elevate Your Head: When sleeping, propping your head up with extra pillows can prevent mucus from pooling in the back of your throat, which often triggers nighttime coughing.
Suck on Lozenges: Cough drops or hard candy can keep the mouth and throat moist, reducing the urge to cough.

Prescription Options for High-Risk Cases

For high-risk individuals or those with severe symptoms, prescription medications may be necessary. Antiviral treatments like Paxlovid (nirmatrelvir/ritonavir) are recommended for those at risk of severe disease, including hospitalization or death. These must be started within five days of symptom onset to be most effective.

If OTC medications fail to control a severe or persistent cough, a doctor might prescribe stronger options like benzonatate capsules, which numb the airways and lungs, or a short-term codeine-based cough syrup. These are potent and should only be used under medical supervision.

Comparison Table: OTC Cough Medication for COVID-19


Type of Cough	Recommended OTC Medicine	Example Brands	How it Works	Key Considerations
Dry (Unproductive)	Dextromethorphan	Delsym, Robitussin Cough	Suppresses the cough reflex	Not for children under 4; potential interaction warnings
Wet (Productive)	Guaifenesin	Mucinex, Robitussin Chest Congestion	Thins and loosens mucus	Requires ample hydration to be effective
Postnasal Drip	Antihistamines, Pseudoephedrine	Zyrtec, Sudafed	Reduces mucus production and irritation	Avoid pseudoephedrine with high blood pressure; check labels for combinations

When to Seek Medical Attention

While most COVID-19 coughs can be managed at home, certain symptoms warrant professional medical advice. Seek immediate help if you experience:

Difficulty breathing or severe shortness of breath.
Persistent chest pain or pressure.
Confusion or an inability to stay awake.
Pale, gray, or blue-colored lips, skin, or nail beds.

Contact your doctor if your cough persists for more than three weeks, if it's disrupting your sleep, or if you begin coughing up blood. A long-lasting cough can sometimes indicate a secondary infection or a persistent post-viral condition that requires specific treatment.

Conclusion

There is no single best medicine for a cough with COVID-19, but rather an approach tailored to your specific symptoms. For a dry, tickly cough, an over-the-counter suppressant like dextromethorphan is typically recommended. If you have a wet, phlegmy cough, an expectorant like guaifenesin, combined with plenty of fluids, can help. For high-risk individuals, early access to prescription antivirals may be an option to prevent severe illness. For most people, a blend of targeted OTC medication and supportive home remedies—including rest, hydration, and steam—is the most effective way to find relief. Always consult a healthcare professional if symptoms worsen, linger, or if you have underlying health conditions.

Mayo Clinic: COVID-19 Diagnosis and treatment

GoodRx: The Best Cough Medicine

Drugs.com: How do I Treat Cough and Sore Throat if I have COVID-19?

Frequently Asked Questions

No, over-the-counter medicines do not treat or cure the virus itself. They are designed to relieve the symptoms of the cough, providing comfort while your body fights the infection.

A dry cough, which is more common with COVID-19, is unproductive and is caused by inflammation in the airways. A wet or productive cough involves bringing up mucus or phlegm from the lungs.

You should choose an expectorant like guaifenesin for a wet, productive cough to help loosen and thin the mucus. A cough suppressant like dextromethorphan is best for a dry, non-productive cough.

Yes, home remedies such as staying hydrated, using a humidifier, and drinking warm fluids with honey can effectively soothe an irritated throat and ease a cough, especially in mild cases.

No, children, especially those under 4 years old, should not be given over-the-counter cough medicine without consulting a pediatrician. Home remedies are often recommended for young children.

If OTC options are not sufficient, a doctor may prescribe a stronger, short-term medication. These include prescription-strength guaifenesin, benzonatate for a severe dry cough, or a codeine-based syrup.

A persistent cough that lasts for more than three weeks, disrupts sleep, or is accompanied by worsening symptoms warrants a call to your doctor. In some cases, a lingering cough is a post-viral symptom that can be managed with specific therapies.