What Do They Prescribe for a COVID Cough? A Guide to Relief

October 6, 2025 •

4 min read

While most people with COVID-19 recover within a few weeks, a persistent cough can linger much longer. So, what do they prescribe for a COVID cough, and what steps can you take to find relief from this frustrating symptom?

Quick Summary

An overview of prescribed and over-the-counter medications used to treat acute and lingering coughs associated with COVID-19, including their mechanisms, use cases, and effectiveness for symptom relief.

Key Points

OTC Options: Dextromethorphan (for dry coughs) and guaifenesin (for wet coughs) are common first-line treatments for COVID cough symptoms.
Prescription Relief: For persistent coughs, doctors may prescribe benzonatate to numb lung receptors or inhaled corticosteroids to reduce airway inflammation.
Long COVID Cough: A cough that lasts for weeks or months after the initial infection may be due to airway hypersensitivity and inflammation, requiring medical evaluation.
Hydration is Key: Drinking plenty of fluids like water, tea, or broth helps thin mucus and soothe an irritated throat, aiding any medication you take.
Home Remedies Help: Using a humidifier, taking a teaspoon of honey, and sucking on lozenges can provide significant symptomatic relief.
Distinguish Your Cough: Treatment depends on whether your cough is dry (non-productive) or wet (productive); use a suppressant for dry coughs and an expectorant for wet ones.
Seek Medical Advice: Consult a doctor if your cough is severe, lasts more than a few weeks, or is accompanied by chest pain or difficulty breathing.

Understanding the COVID Cough: Why Does It Linger?

A cough is a common symptom of COVID-19, but it can feel different from a typical cold. The virus can cause significant inflammation in the respiratory tract. This inflammation can lead to airway hypersensitivity, where the nerves that trigger a cough become overly sensitive. As a result, even minor irritants like cold air or talking can set off a coughing fit. The cough can be dry and hacking or productive (producing mucus). An acute cough from the initial infection usually lasts one to three weeks, but a post-viral cough can persist for weeks or even months as part of 'long COVID'.

First Line of Defense: Over-the-Counter (OTC) Medications

For most mild to moderate COVID-related coughs, treatment starts with readily available over-the-counter options aimed at managing symptoms. It's crucial to choose the right type of medication based on your cough.

For a Dry, Hacking Cough

An antitussive, or cough suppressant, is the recommended choice for a dry cough that doesn't produce mucus. The most common active ingredient is dextromethorphan. This medication works by decreasing the activity in the part of the brain that causes coughing. It can be particularly helpful for coughs that disrupt sleep or daily activities. Products containing dextromethorphan include Delsym and Robitussin.

For a Wet, Productive Cough

If your cough brings up mucus or phlegm, an expectorant is more appropriate. Guaifenesin is the primary expectorant found in OTC medications like Mucinex and some versions of Robitussin. It works by thinning the mucus in your airways, making it easier to cough up and clear out. Staying well-hydrated by drinking plenty of water is essential to help guaifenesin work effectively.

When OTC Isn't Enough: What Do They Prescribe for a COVID Cough?

If OTC remedies fail to provide relief or the cough is severe and persistent, a healthcare provider may recommend prescription medications.

Benzonatate (Tessalon Perles): This is a non-narcotic prescription medication frequently used for a persistent COVID cough. It works differently than OTC suppressants by numbing the stretch receptors in the lungs and airways, which helps to calm the cough reflex.
Inhaled Corticosteroids (e.g., Budesonide): For lingering post-COVID coughs driven by inflammation, doctors may prescribe an inhaler containing a steroid. These medications reduce inflammation directly in the airways, helping to decrease cough-triggering irritation. Some studies have shown they can improve lung function in patients with post-COVID chronic cough.
Narcotic Cough Suppressants: In some cases, for a distressing cough in adults, a doctor might prescribe a short-term course of a codeine-based medication to suppress the cough reflex. These are used with caution due to their side effects and potential for dependency.
Other Asthma Medications: Medications like Montelukast (Singulair) or Albuterol inhalers may also be prescribed. Montelukast blocks inflammatory mediators, while albuterol helps relax the airways to ease breathing and coughing.

It is important to note that antiviral medications like Paxlovid are prescribed to treat the COVID-19 infection itself in high-risk patients to prevent severe disease, not specifically to treat the cough symptom, although symptom relief may occur as the infection clears.

Comparison of Common COVID Cough Treatments


Medication/Approach	Type	How It Works	Best For...
Dextromethorphan	OTC Antitussive	Suppresses the cough reflex in the brain.	Dry, hacking coughs that interfere with rest.
Guaifenesin	OTC Expectorant	Thins mucus, making it easier to clear from the airways.	Wet, productive coughs with chest congestion.
Benzonatate	Prescription	Numbs the stretch receptors in the lungs and airways.	Persistent, irritating dry coughs not resolved by OTC options.
Inhaled Corticosteroids	Prescription	Reduces inflammation directly in the airways.	Lingering, post-viral coughs associated with inflammation.
Honey & Hydration	Home Remedy	Soothes the throat and thins mucus.	All types of coughs, to provide comfort and support.

Non-Pharmacological Approaches and Home Remedies

Alongside medication, several home strategies can provide significant relief:

Stay Hydrated: Drinking plenty of fluids, especially warm beverages like tea or broth, helps keep the throat moist and thins mucus.
Use a Humidifier: Adding moisture to the air with a cool-mist humidifier can ease coughing by preventing your airways from drying out.
Try Honey: A teaspoon of honey can soothe an irritated throat and may help calm a cough. It should not be given to children under one year old.
Elevate Your Head: When sleeping, use extra pillows to elevate your head. This helps prevent mucus from pooling in the back of your throat, which can trigger coughing at night.
Suck on Lozenges: Medicated cough drops or even hard candy can help keep your throat moist and reduce the urge to cough.

Conclusion: A Stepped Approach to Relief

Managing a COVID cough involves a combination of symptom identification and targeted treatment. The first step is often using over-the-counter medications—dextromethorphan for dry coughs and guaifenesin for wet coughs—supported by home remedies like hydration and humidity. If the cough persists, becomes severe, or significantly impacts your quality of life, it is crucial to consult a healthcare provider. They can determine if a prescription medication like benzonatate or an inhaled steroid is necessary to address underlying inflammation or hypersensitivity. Always seek medical advice if your cough is accompanied by shortness of breath, high fever, or chest pain.

For more information on outpatient treatment, you can visit the CDC's Clinical Care page for COVID-19.

Frequently Asked Questions

Yes, many standard over-the-counter cough syrups containing dextromethorphan (for dry coughs) or guaifenesin (for wet coughs) can be used to manage COVID cough symptoms.

Benzonatate, a non-narcotic medication that numbs the cough reflex receptors in the lungs, is frequently prescribed for persistent COVID coughs that don't respond to OTC remedies.

An acute cough from COVID-19 typically lasts for about one to two weeks. However, a post-viral cough can linger for three to eight weeks, or even longer in cases of long COVID.

No, antibiotics are not effective against viral illnesses like COVID-19. They would only be prescribed if you develop a secondary bacterial infection, such as bacterial pneumonia.

Yes, for a lingering cough caused by inflammation, a doctor may prescribe an inhaled corticosteroid, like those used for asthma, to reduce inflammation in the airways.

Generally, it is better to use an expectorant like guaifenesin for a wet, productive cough to help clear mucus from the lungs. A suppressant might be counterproductive as coughing helps clear the airways.

To manage a nighttime cough, try elevating your head with extra pillows to prevent mucus from dripping down your throat. Using a humidifier in your bedroom and drinking a warm beverage before bed can also help.