Chest congestion and cough is linked to various breathing related conditions apart from common cold. This impacts the ability of the affected in social gatherings when the coughing is excessive or the chest congestion aggravates. Symptomatic relief from cough and congestion through prescription and OTC products continues to help the affected individuals. Guaifenesin belongs to the category of expectorants that work by clearing the mucus from the chest by thinning the phlegm/mucus. Subsequent sections offer an in-depth view of the medication and the possible side effects of guaifenesin to help individuals prevent or mitigate undesirable effects.

Overview of Guaifenesin

From approval seven decades ago, Guaifenesin has the distinction of being one of the few expectorants that continue to be used either in its original form or as an ingredient in prescription medications for cough and congestion. Available as syrup and as pills, Guaifenesin is also known to possess muscle relaxant properties apart from anticonvulsant properties.

Studies in the past have indicated the possibility of undesirable effects in underage children, and the expectorant is presently not part of formulations for children below the age of four. It is important to know the difference between expectorants and cough suppressants. The later is specifically intended to suppress the cough as the name suggests. Expectorants, are different and work by thinning the mucus, which makes it easier to cough up the bacteria and germs. This is necessary for patients diagnosed with respiratory tract infections, pneumonia, and bronchitis apart from the common cold.

Guaifenesin – mechanism of action

The properties and outcomes of the expectorant are attributed to the mechanism of action such as the increase in secretion of mucus and the thinning of the mucus. The sequence of actions includes reduction of viscosity of the mucus, making it easier for removal. This is achieved by inducing cough which in turn eliminates or purges mucopurulent matter from the airways. This helps to offer relief from the condition, despite inducing cough. It is also known to work as an NDMA antagonist, and this makes it a muscle relaxant and anticonvulsant. By flushing out mucus, the medication helps to rid the body of bacteria and viruses that may have resulted in other infections.

Dosage recommendations

As mentioned above, a safe practice is to diligently follow the dosage instructions. Dosage is determined by various factors and it is necessary to bear in mind that two patients of the same age group need not necessarily have to take the same dose. This is determined by the condition, the frequency of intake, the strength of the formulation and in certain instances, other pre-existing conditions. It is therefore wrong to assume that any ideal dosage will work for all patients. For instance, adult patients with cough are typically recommended anywhere between 200 to 400 mg of the expectorant, to be taken once in 4 hours. This is specifically for expectorants that are of the short acting formulations. For long-acting formulations, the dosage increases to anywhere between 600 to 1200 mg, to be taken once in every 12 hours.

As can be seen from the above reference information, the dosage can be “anywhere between” a range, and this will depend on the factors outlined earlier. For children, the dosages are reduced appropriately. The above information is only for the purpose of reference, and the actual dosage may differ and depend on the conditions.  Missed dosages are to be skipped and there should be no attempt to take a double dose to make up for the missed dose. This is because of the relatively shorter gap between two doses.

In the event that the condition does not improve significantly after a week of the expectorant, it is necessary to seek advice about continuation or discontinuation. Similarly, if certain undesirable effects are experienced and are persistent in nature, it is important to inform the doctor and discontinue use of the medication. Most effects, as mentioned in other sections are moderate in nature may resolve naturally without the need for treatment. However, certain conditions or outcomes may need to be treated to prevent aggravation of the condition.

Intake directions

Many interactions and side effects of medications are attributed to incorrect dosage or schedule of medications. It is necessary to follow instructions regarding use and dosage to prevent undesirable effects. For instance, users are advised to drink a lot of water when on the expectorant. This will have the desired effect of loosening the mucus and helping flush out mucus from the small airways. When consumed in the extended-release capsule form, it is best to take the medicine as a whole for the best results. However, in the event that certain users find it difficult to consume the capsule as a whole, the capsule may be prised open and the contents mixed with food.

The extended-release tablet form is not to be crushed or chewed, and whenever it needs to be broken, it is to be broken along the groove in the Centre. Tablets that do not have a groove are to be ideally taken whole.

Commonly reported side effects of guaifenesin

Medications come with the possibility of undesirable effects. This is mainly due to the mechanism of action of the medication, the properties of ingredients, possible interactions with medications, and presence of other conditions. For instance, an individual with some pre-existing condition may end up with some kind of adverse reaction to the medication. Therefore, the possibility of side effects is common to all medications and cannot be ruled out. The extent, intensity or duration may differ from person to person and this is linked to various factors including age and in certain instances, the gender.

Expectorants and other cough suppressants are typically relatively safe, with lesser undesirable outcomes. However, there are certain categories or sub-categories that may present unwanted effects. Here is a compilation of commonly or frequently reported effects of Guaifenesin. It is to be borne in mind that this list is not comprehensive in nature, nor is it exhaustive. It is intended to serve as a broad reference of the categories of effects. It is also necessary to note that all individuals may not necessarily experience side effects from the medication, some may not experience any effects whatsoever.

Possible effects that are frequently reported

Individuals on the medication may experience dizziness or end up with bouts of constipation. Effects that are regarded as frequently occurring or commonly occurring include headache and overall fatigue that is not attributed to any other condition. The outbreak of rashes may also be experienced by patients, and it is necessary to seek suitable treatment to manage the rashes, before it develops into a condition that is difficulty to handle or treat. When the expectorant is taken in higher dosages, there is the possibility of individuals experiencing nausea and vomiting and this can be handled symptomatically with typical remedies.

Preventing undesirable outcomes with simple precautions

Certain undesirable outcomes have the potential to turn in to serious conditions. For instance, allergies generally appear trivial in nature, and quickly progress in to a serious condition. The best method to prevent certain outcomes is to take necessary precautions when there is self-awareness of existing conditions. A small section of individuals is known to be allergic to certain substances. Exposure to these ingredients is known to trigger allergies. Individuals with a history of any allergic reaction in the past to specific substances are to intimate the same to the treating specialist when being prescribed expectorant. This includes allergies to food products, substances used for dyeing, chemical preservatives, animal dander and pollen.

Precautions for pediatric use

As mentioned earlier, Guaifenesin is not intended to be used by children below the age of four. This is essentially the outcome of studies that linked certain undesirable effects in under age children. While there are no specific reports that indicated effects in children due to Guaifenesin, it is essential to avoid use in children diagnosed with asthma, or children with chronic cough. It is also not advised for use in children who bring out large amount of mucus with cough. It is important to choose an alternative medication in such instances, as there is the likelihood of undesirable effects.

General precautions among other categories of users

Presently, there are no documented or anecdotal reports of different effects or additional effects among other categories of users such as the elderly or among pregnant women. While it may be safe for users of these categories, it is advisable to seek medical opinion before using expectorants in OTC formulations. The possibility of unknown effects or undesirable outcomes cannot be ruled out entirely, and it is therefore necessary to take the product only if it is absolutely necessary and if other options do not exist.

Interactions with other medications and alcohol

Guaifenesin has the distinction of being one of the relatively lesser number of medications and substances that do not have any known severe, moderate or mild interaction with other medications. Most medications come with the possibility of interactions, when taken together with other prescription/OTC formulations, or herbal remedies and supplements. However, it is always a safe practice to inform the treating specialist about the use of other medications and substances, as the doctor may then change the medication or alter the dosage.

It is standard practice to avoid drinking alcohol when on expectorants and cough suppressants. There is the possibility of some interaction, and it is therefore necessary to stay away from alcohol during the course of expectorant use. Similarly, users of the medication are also to seek advice from the doctor regarding dietary intake, as certain food products or liquids are likely to have some kind of interaction.

Smoking and Guaifenesin

With all the information about possible side effects of guaifenesin outlined above, it is time to clear a few misconceptions. The medication is essentially intended to help patients with mucus loaded cough, and is not a cough suppressant. It may therefore not be the ideal choice for individuals with dry cough or cough from smoking, unless specifically recommended by the specialist. Individuals with conditions that make the medication suitable for use; such as mucus laden cough, are advised to avoid smoking as a general precaution to help treat the condition faster.

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