Cough in adults

Key points about cough in adults

  • A cough is not usually serious and will generally go away within a few weeks.
  • There are things you can do to make life easier while you’ve got a cough. It’s also good to know when you should seek medical advice.
  • A cough, with or without other respiratory symptoms such as fever or runny nose, could also be a COVID infection. Test for COVID-19 and stay home until well or sure this isn’t COVID.

 

 

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In most cases, treatment for cough is not necessary. Mild, short-term coughs are likely to be due to a viral infection that will get better on its own within a few weeks. Antibiotics are only prescribed if your cough is caused by a bacterial infection.

You can care for yourself by:

  • resting
  • drinking plenty of fluids, including lemon and honey drinks
  • sleeping with your head propped up on pillows
  • avoiding smoke, and if you smoke quitting smoking
  • using cough medicine – it doesn’t cure a cough but may give you some relief from it (see below)
  • using your inhaler if you have asthma
  • taking antihistamines if you have hayfever.

There are a number of cough medicines available on the market. They may be sold in combination with other medicines in cold and cough products, or as cough mixtures or cough lozenges. There is little evidence to suggest that cough medicine is any more effective than simple home remedies (eg, honey, saltwater gargles and warm drinks). They're not suitable for everyone and may have side effects. If you're not sure, talk to your pharmacist. Examples of cough medicines include:

  • cough suppressants – used for dry coughs and may control the urge to cough such as dextromethorphan, pholcodine (unavailable in Aotearoa New Zealand after 12 January 2024) and codeine (only available on a prescription from your healthcare provider). Read more about why pholcodine is now unavailable(external link).
  • expectorants – used for productive coughs. They loosen mucus making it easier to cough up.

There are many causes of cough, the most common being viral infections such as a cold or the flu. Other common causes include smoking, allergies (such as hay fever), asthma and bronchitis. Cough may also be a sign of gastro-oesophageal reflux disease (GORD). In this video, Dr Shah, a GP, describes the common causes of cough and when you should see your doctor.

Video: Cough

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(NHS, UK, 2015)

Contact a healthcare provider or call Healthline 0800 611 116 for advice:

  • If you a have a cough and you're short of breath.
  • If you cough up blood.
  • If you have unexplained problems like weight loss or a high temperature (fever).

The most common cause of a cough is a viral infection such as a cold or the flu. Other common causes include:

Rarely, a cough may be caused by:

Remember to cover your cough and wear a mask when you are out of the home, or around others so you don’t spread your bugs. You can reduce your chances of getting a cough by following these winter tips for staying well.

Other clinical resources

Chronic persistent cough in adults(external link) Patient Info Professional, UK, 2017
Chronic cough in adults(external link) Auckland Regional HealthPathways, NZ
Gibson P, Wang G, McGarvey L, Vertigan AE, Altman KW, Birring SS. Treatment of unexplained chronic cough: CHEST guideline and expert panel report(external link)  Chest. 2016; 149 (1); 27–44. 

Continuing professional development

Management of chronic refractory cough(external link) BMJ online learning module. (The Royal New Zealand College of General Practitioners (RNZCGP) provides free access to BMJ Learning for its members.)

Podcast

Chronic cough – Fiona Horwood

Dr Fiona Horwood talks about the management of chronic cough in primary care. Fiona is clinical head of general medicine and a respiratory physician at Counties Manukau DHB. Fiona overviews the basics of the cough mechanism and its various causes as well as when to seek further tests/interventions.

(external link) 

(Goodfellow podcast, NZ, 2017)

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