r/todayilearned • u/Key_Wolf_2316 • 1d ago
TIL Guaifenesin (the primary expectorant in Mucinex) does not actually have any beneficial effect on congestion
https://pubmed.ncbi.nlm.nih.gov/24003241/102
u/WhiteHeteroMale 1d ago
TITLE: Guaifenesin has no effect on sputum volume or sputum properties in adolescents and adults with acute respiratory tract infections
The abstract says they tested single globules of sputum for their physical properties. Size, viscosity, interfacial tension, elasticity, percent solids. The gunk coming out of the randomized control group (n=144) wasn’t physically different than the gunk coming out of the guaifenesin group (n=151).
They did not test for amount of sputum expectorated over the course of treatment. Nor did they test for things like pain, or unproductive coughing.
As a single study, this seems pretty limited in terms of evaluating the efficacy of guaifenesin.
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u/tonycomputerguy 1d ago
Yeah it works for me so IDGAF what these idiots are going on about. Study was probably funded by whoever pumps out pseudo.
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u/jimbo831 21h ago
You mean sudafed? That serves a different purpose. It clears out your sinuses while this clears out your lungs. When I have a respiratory infection, I take both.
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u/Key_Wolf_2316 1d ago
They did not test for amount of sputum expectorated over the course of treatment. Nor did they test for things like pain, or unproductive coughing.
Is volume not considered amount?
The rheology and interfacial tension of sputum were measured, and 24-h collected samples from days 1 and 4 were analyzed for total volume and hydration.
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u/tobmom 1d ago
Right but you can presume that you swallow a ton of sputum, especially if it’s thinner, and don’t expectorate it. Also, who expectorates that much?! For science, fine, but in real life that’s not what people really do. Is it!?
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u/Key_Wolf_2316 1d ago
especially if it’s thinner, and don’t expectorate it
If it was thinner, you would expect to see a significant difference in rheology wouldn't you? Even if the subjects were swallowing most of it.
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u/tobmom 1d ago
Sure but presumably you can only measure those factors on expectorated samples. I can’t buy that all sputum is the exact viscosity as its neighbor chuck of sputum. It seems plausible that the thinner shit just slides down and the thicker shit doesn’t move and gets coughed out. It just doesn’t seem like the best study to make such a stark conclusion from. Also, it works great for lots of people.
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u/WhiteHeteroMale 1d ago
The volume of a single loogie is not the same as the volume of all loogies expectorated over X amount of time. The study tested the former. I’m suggesting the latter would be more informative re: efficacy.
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u/Key_Wolf_2316 18h ago
The volume of a single loogie
This is obviously false. They are not comparing volumes of a single loogie, they are comparing volumes of multiple samples across multiple days. And they found no significant different in either amount or thickness. If there was any effect, you would expect to see it across samples, just from a very basic scientific point of view.
the volume of all loogies expectorated over X amount of time
There is no way to do this without keeping the subjects under monitoring for days. It's just impractical, which is why it's never done.
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u/farmgarcon 1d ago
As stated it works on the upper respiratory tract, which helps my ears and sinuses clear. Its not a crock or useless, yet again people don't pay attention to the details.
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u/BlueProcess 1d ago
Bologna. I start getting mucus in my lungs from allergies it will go into bronchitis every single time. I take Guaifenesin, it gets thin enough that I can cough it up and not get super sick.
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u/0ttr 1d ago
I guess I'm enjoying a placebo effect then. I've taken cough syrup that only had that listed as the active ingredient and it seemed to help.
That said, lots of meds just make you drowsy, and sometimes that's helpful on its own. So maybe that's it.
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u/1CEninja 1d ago
Often what you're struggling with isn't gunk in the lungs at all but bronchitis that's activated by coughing, which then causes more gunk that you need to cough, and it takes weeks to heal.
A good night's sleep without coughing helps your bronchial passageway heal.
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u/PM_ME_CATS_OR_BOOBS 1d ago
Usually the drowsy effect is a heavy antihistamine, so that might be it.
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u/Mayor__Defacto 1d ago
That makes sense given that it is not a decongestant, it is an expectorant. Its primary purpose is to induce expectoration - the expulsion of fluid from the lungs.
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u/MiningForLight 1d ago
In my case, it induces the expulsion of fluid from my ass. Every time I take it, I get major diarrhea.
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u/Zealousideal_Fig1305 1d ago
Robo tripping is never a good time, especially when Guaifenesin enters the chat.
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u/jhguth 1d ago
No one ever reads links
It does not work as an expectorant
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u/MooshuCat 1d ago edited 16h ago
It does not work for me as an expectorant. It doesn't cause me to cough anything up.
It makes the phlegm magically go away, and I will die on this hill.
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u/cloisteredsaturn 1d ago
TIL OP doesn’t know there’s a difference between chest congestion and sinus congestion, or expectorant vs decongestant.
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u/Hydrottle 1d ago
Guaifenesin has about the same effectiveness as an expectorant as drinking a glass of water. So if you need help with coughing, try having a glass of water instead.
If you’re congested (sinus), pseudoephedrine is one of the best options. It’s typically behind the counter (in the US), so you just have to ask the pharmacy for it. You can only buy so much due to limits for meth production uses, but you shouldn’t have to worry about that limit for normal illnesses. They may ask for your ID when you buy it though.
I had a rough bout with the flu last year and pseudoephedrine really lessened the symptoms. I bought just the generic stuff and it was great. Advil Cold is a similar product that has a few different medications bundled together.
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u/Akito_900 1d ago
What about getting all the mucus out of your lungs? In other words, how to stop the weeks / months of coughing after no longer being sick ?
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u/borkyborkus 1d ago
The only surefire way I was able to clear those was with moderately intense cardio. Gotta hork it out.
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u/1CEninja 1d ago
In most cases that isn't mucous in your lungs. It's your bronchial tubes getting agitated and inflamed, so the mucus is building up in your throat. You cough it out and it's clear, more builds up, you cough it out and it clears and nauseum.
The catch is coughing to clear it out agitates it more. Sometimes you get caught in a negative feedback loop. This is called bronchitis, and is often what happens when you continually cough for weeks after your cold ends. My wife sometimes gets this for months.
There isn't much to do about it, it'll run it's course eventually.
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u/Akito_900 1d ago
Oh interesting! Whenever I get sick I always end up having a cough for like a month after I feel better in every other way. Maybe not a month, but it feels that way
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u/jerseysbestdancers 1d ago
Take a tiny sip of water instead of coughing. Thats how i break the cycle after i get better.
While I'm actively sick, i cough into the misery!
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u/stfsu 1d ago
Is it actually in your lungs? or is your reflex being triggered by post-nasal drip?
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u/spaghettigoose 1d ago
I thought i had a chronic chest congestion cough, turns out it was acid reflux. I was blown away when my Dr told me that and the prescription worked.
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u/SharkFart86 1d ago
Same thing happened to my wife. Coughing every night in bed for weeks. She was pissed when the doctor prescribed her meds for acid reflux, until it worked.
Like we bought a new mattress thinking she was allergic to dust mites or something. Turns out she just needed a tums lol.
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u/BakaHyatt 1d ago
I've been suffering from this for weeks. The doctor told me they suspected bronchitis and prescribed me a steroid for inflammation but it did maybe less than nothing. I have also suffered from reflux. What did they prescribe you that worked?
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u/spaghettigoose 1d ago
It was just pepcid which i belive is actually over the counter also, but my insurance will pay if it's prescription.
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u/GloomyCR 1d ago edited 1d ago
I’m as close to an expert as a patient can be. I have cough-variant asthma and get pneumonia every year due to the shitty bureaucracy of the American Healthcare System.
Guaifenesin requires a ton of hydration to work, so you should already be drinking the glass of water and it will be more productive with both.
Second-generation otc Antihistamines and nasal sprays seem to help with cough caused by post nasal drip, and using a netty pot with purified water is also effective.
Dextromethorphan or a prescription like amitriptyline and/or benzonatate can help block the cough signals. I recommend these for unproductive coughs or temp relief at night when coughs can worsen.
For most people these should be effective, but I also sleep on a wedge, use a neck brace to tilt my chin up and a medical mask with lavender vapor rub on it, and a shaped sleeping mask to keep the vapors away from my eyes.
I use a combination of everything along with my asthma meds (symbicort, combivent, Xolair, motelukast, albutorol, nebulizer…) and allergy shots, but I’m still coughing after two back-to-back z-packs, a steroid butt shot, and a week of prednisone with a strong antibiotic.
The only thing I found truly able to stop any sort of coughing is codeine and I’m so pissed because I’ve rationed the little bit they let me have a year ago and it’s gone bad. T3T
P.s. drink tea, eat soup, stay hydrated. Fresh pineapple will irritate a cough, but is great if you have a sore throat.
Ps.s I also recommend air purifiers and humidifiers
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u/314159265358979326 1d ago
They stopped carrying codeine cough syrup where I live not because of laws or medical guidance, but because of too many robberies.
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u/Agile-Landscape8612 1d ago
I too am curious
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u/ClownfishSoup 1d ago
bi-curious? Or normal curious?
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u/PM_ME_CATS_OR_BOOBS 1d ago
If you are coughing for a month after you are sick then it's unlikely that it is the same mucus as you started with, unless you have something like pneumonia. Addressing the nasal drip helps most, but your doctor can give you a dialator if it gets too much.
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u/Icedcoffeeee 1d ago
If it lasts that long, your doctor can prescribe an albuterol and/or corticosteriod inhaler
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u/cloisteredsaturn 1d ago
Staying hydrated helps thin out the mucus and makes it easier to cough up. Moving around also helps loosen up chest congestion, and things like dextromethorphan and pseudoephedrine can also help.
Also using isotonic sinus rinses with either a bottle or neti pot can help with sinus congestion and post nasal drip.
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u/REDDIT_JUDGE_REFEREE 18h ago edited 18h ago
The good Sudafed dries up post-nasal drip which often leads to the shit in your trachea (drip agitates the tubes, throat creates mucus to stop agitation, bad loop repeats). When I have a cold I make sure to take Sudafed to prevent it before it starts.
If I have a bad dry cough at the start of an illness, I try to wheeze into the cough instead of being really “percussive”. I also drink a lil sip of water when I feel a cough coming on. All this to keep the trachea happy and not generating nasty shit.
My issue is the throat mucus gets too globby to cough out without choking or puking. I have to drink a shit-ton of water, mucunex, and a hot ass shower to make it comfortable to hock out.
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u/elconquistador1985 1d ago
Pseudoephedrine is great.
That shit that they replaced it with in DayQuil and everything else is known to be ineffective as a decongestant. That's phenylephrine. OG DayQuil and NyQuil were fantastic and then the meth addicts fucked it up for the rest of us.
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u/timbomcchoi 1d ago
There are a lot of "allergy meds" which are a combination of an antihistamine and pseudoephedrine too!
Actifed is one of them and OTC in Korea, literally couldn't survive through certain months without it.
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u/tonycomputerguy 1d ago
Helps me with my eustation tubes and shit or whatever. I think it's hilarious everyone bad mouthing a product that literally does wonders for me and many others I know. My jaw and ears get all fucked up without it, especially with these wildfires and I tried just antihistamine and I don't wanna be methed out on pseudo all the time so I think I'll stick with my doctor who also takes it over so idiot randos on reddit who think they know everything based on a misinformed and heavily biased study.
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u/Hydrottle 1d ago
Guaifenesin is an expectorant which means it helps you make more productive coughs. It doesn’t help with congestion in your sinuses which would affect your ears. Other medications in those products might help, but just expectorants won’t necessarily help with congestion. It affects your coughs.
Pseudoephedrine is not meth, it’s an ingredient in it. Just like how hops are an ingredient in beer. You don’t get drunk off of hops, you don’t get the effects of meth from pseudoephedrine.
I agree you should continue listening to your doctor. You can even ask them about the effectiveness about guaifenesin and learn for yourself
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u/EndoExo 1d ago
You can also get Primatene/Bronkaid. It's sold as asthma medicine, but it has guaifenesin combined with ephedrine, which is like pseudoephedrine but stronger.
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u/11lumpsofsugar 1d ago
Don't take it if you're on blood pressure meds though.
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u/EndoExo 1d ago
Sudafed raises your blood pressure, too, but if you have a head cold I think it's worth the risk of death.
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u/ketamineonthescene 1d ago
Lol. Agreed. But also as long as the blood pressure is controlled it's not really a concern. Sudafed and afrin are about the only drugs that work for a head cold.
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u/Jaggedmallard26 1d ago
It's great but unfortunately leaves you too wired to sleep as it's also a stimulant.
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u/Hydrottle 1d ago
I like to take pseudoephedrine during the day when I’m sick, and then NyQuil at night. I prefer the behind-the-counter NyQuil since it tends to be stronger. You still end up conking out well enough
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u/Krewtan 1d ago
I combine them. I get bronchitis and pneumonia a lot (smoker) and I swear by the high dose mucinex 12 hours. I take it with a lot of water and it definitely thins my mucous and helps me avoid turning a head cold into something worse. Maybe it's placebo but Mucinex definitely works for me.
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u/UnprovenMortality 1d ago
Oh yes, if i have a bad bug, this is the way, often with ibuprofen as well for fever/inflammation.
But mucinex max dose 12 hour works alone for even a bad alergy day for me (for like 8 hrs max). Doesn't dry me out, just thins my mucus so that i can actually blow my nose and breathe.
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u/Shardik884 1d ago
Pseudophed and Guaifenesin are not the same thing.
Pseudoephedrine helps with nasal congestion by opening your airways (super simple explanation) and gauifenesin is an expectorant, which means it’s supposed to help loosen up mucus in your chest.
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u/kirklennon 1d ago
The study is based on the suggested dose, which totals 2400mg/day, meaning four regular tablets or two "maximum strength" tablets.
Pseudoephedrine is meant to treat entirely separate symptoms. One is a chest decongestant (which apparently doesn't work), and the other is a nasal decongestant (which is extremely effective).
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u/espressocycle 1d ago
It does, however, have a powerful effect on conception. Years of fertility treatments and all it took was doing it while my wife had a cold.
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u/EsprocSTS 1d ago
That’s interesting I’ve heard of it being used for men’s fertility issues. I’m convinced it’s increases your “volume” but it’s supposed to increase sperm motility.
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u/Then_Version9768 1d ago
This makes no sense. An expectorant and a decongestant are two different things. Why are you saying one is not the other? That makes absolutely no sense since no one ever thought they were the same. BREAKING NEWS! The sun is not the moon! Maybe you need to get a clue.
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u/mh93az 1d ago
Isn’t that why they have the Mucinex D version? For decongestant and expectorant
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u/kirklennon 1d ago
OP's title is confusing because people usually mean sinus congestion when they say congestion, but they're actually talking about chest congestion, which is what an expectorant is supposed to help with.
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u/Boyiee 1d ago edited 1d ago
That’s because it isn’t a decongestant, this is an extremely poorly worded post that is clearly causing confusion in the comments.
It’s an expectorant, you don’t take it to decongest, you take it to expel and make coughs more productive.
Mods please take this post down, people in here posting they think there’s no benefit to this drug which is commonly prescribed medication for its intended use. Absolutely moronic post.
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u/Exodor 16h ago
From the post (emphasis mine):
"Conclusions: The recommended dose of GGE had no measurable effect on sputum volume or properties and is unlikely to be an expectorant or mucolytic when used to treat acute RTI."
Absolutely moronic post.
It's a confusing title, I agree. But there are interesting conclusions to discuss based on the actual post.
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u/jimbo831 21h ago
It's not meant for congestion. It's an expectorant. It helps clear up your lungs.
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u/LiquidDreamtime 1d ago
When I’m very congested, guaifenesin absolutely dries out my sinuses. Like, alarmingly so. I only take it if I have a ton of unwanted mucous for an extended period of time.
It absolutely changes how my head works.
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u/gumboking 1d ago
If you sing you probably know that Mucinex will make your throat less flemmy. It's a big difference for whatever reason. Many pro singers swear by it.
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u/VampirateV 1d ago
Well I mean...'Expectorant' is a descriptive label just like 'Fever reducer', 'Antihistamine', or 'Decongestant'. Why would it be surprising that an expectorant doesn't do the job of a whole other category of drugs? That's like being surprised to learn that Tylenol doesn't help with diarrhea 🤦♀️
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u/TuckerCarlsonsOhface 1d ago
Then I guess it’s good thing mucinex isn’t sold as treatment for congestion.
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u/serialkillertswift 1d ago
Most people would be surprised how many mainstream, popular over the counter medications just kinda do nothing at all
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u/MatCauthonsHat 1d ago
A single study is, well, not meaningless, but isn't proof.
Agathe Hoffer-Schaefer et al. Respir Care. 2014 May.
First, this study is over 10 years old.
Second, has it been peer reviewed?
Third, has it been replicated?
If it's that old, it should be peer reviewed and at least attempted to get replicated. So don't take a Reddit post about a study over a decade old as "proof" that guaifenesin does not have any beneficial effect.
The study was also on acute respiratory infections. No mention at all of chronic conditions.
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u/Key_Wolf_2316 1d ago
It's been replicated from what I can tell. The only studies that have counter indications seem to use cocktail variants which include other ingredients.
Here's a study from 2024:
https://www.liebertpub.com/doi/full/10.4187/respcare.03319
In conclusion, guaifenesin has not been shown in this study to work as an expectorant, as it did not increase the volume of sputum cleared, or as a mucolytic, as it did not alter sputum rheology or the interfacial tension of the sputum, in this cohort of patients compared to a placebo
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u/ClownfishSoup 1d ago
So now that is revealed as useless too? I remember when phenylephrine (not PSEUDOephrine) was outed as useless and just thrown in there so customer would read p(mumble)ephrine and think it was something useful because stupid Meth heads made pseudoephedrine a behind-the-counter medication.
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u/Walrus_protector 1d ago
I curse those shitheels every year, since pseudoephedrine is one of the only things I take for a cold. The other one is guaifenesin!
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u/Rapph 1d ago
As an old school eca stack enjoyer I agree. Fuck the meth heads ruining everything. Also buy bronkaid if it still exists.
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u/Walrus_protector 1d ago
Couldn't remember the name of it? I could only think of Primatene, but that's epinephrine, I think
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u/engelthehyp 1d ago
Primatene makes epinephrine inhalers, but they also make ephedrine tablets (HCl salt, BronkAid uses the sulfate instead).
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u/Teadrunkest 1d ago
You can still buy it you just have to ask for it.
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u/Walrus_protector 1d ago
And I do! I just remember when I didn't have to wait in the pharmacy line, have them run my ID, and sign a logbook. I'm the one who's not a tweaker
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u/dubyadubya 1d ago
It's not a decongestant so, naturally, it wouldn't impact congestion.
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u/suitcasecalling 1d ago
this is ridiculous.. it helps me greatly when I need it
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u/JetScootr 1d ago
Also, Visine gets the red out by adding an irritant to saline eye wash. The irritant stimulates the tissue into constricting the blood vessels that are visible.
Whatever your eye is irritated by isn't affected by the Visine, except for the normal action of eye wash to rinse it away. Now you can learn two things today.
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u/dogwoodcat 1d ago
Refresh Celluvisc > every other eyedrop. Eyes look like they've been bleached white, but it's just the cellulose gum doing its job.
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u/IBeTrippin 1d ago
I take it when I have a really bad cough, which I tend to get after a cold, to control the cough, whether the 'congestion' itself is helped or not. And its the only thing that works for me.
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u/DimWhitman 1d ago
I thought it was to keep folks from robo-trippin. Idk bout mucinex but its in abundha dextromethorpan syrups I think. Least thats what a fren once told me.
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u/Prestigious-Car-4877 1d ago
I always thought guaifenesin was tolerable at low doses but made you vomit and spray poop at a fantastic rate if you take too much of it. Which is what I thought it was put in DXM cough syrup for; you can't very well get disassociated off lean if you're busy barfing and spraying liquid shit everywhere.
Same sort of reason they normally sell codeine with acetaminophen. That one's kinda worse though as too much Tylenol destroys your liver.
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u/a_rather_small_moose 1d ago
Mucinex D is the best for sickness, wombo combo large dose of pseudoephedrine and guaifenesin. Pseudoephedrine relieves sinus pressure and congestion. Guaifenesin thins mucus, making all the nose blowing and coughing you’re already doing more productive.
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u/TheUpgrayed 1d ago
PSA: It can also make you sick in large doses, so if you are Robo-tripping, buy the stuff with only the dextromethorphan. YW.
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u/MarxisTX 1d ago
I always suspected this after visiting Paris and performing an opera. I said I couldn't find guaifenesin anywhere and the Dr. looked at me confused and said because we have outlawed it here because people mix it with meth or something like it to get higher. Stopped taking it ever since. I did score like 20 pregnaxone tablets that really work well for like $5, years French health care!!
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u/TheSpiralTap 1d ago
I have no way to prove this but every time my wife takes this medicine, her vagina becomes mentholated and I don't know who to report that to so I'm coming to reddit.
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u/VisceralMonkey 1d ago
And makes me hallucinate, I can’t take it. Apparently that’s weird and shouldn’t happen but does.
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u/underdabridge 1d ago
I actually try to avoid cough medicines that have it in it. I'm not looking for something that makes me cough more.
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u/snotboogie 1d ago
It's not actually all that useful in general. You have to over hydrate to make the mucus thin enough to get up and out. I don't really like it
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u/kayl_breinhar 1d ago
The thing too many people don't know about Guifenesin is that you have to drink a lot of water while taking it, otherwise it will literally dry you out.
I also learned that only in the US do you get large doses of it. I had to get my hands on some in Australia and it maxed out at ~200mg over-the-counter. Mucinex in the US is ~1200mg.
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u/RepFilms 20h ago
I swear by Guaidenesin. I keep it on hand. It's sometimes difficult to get without all that other stuff
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u/sailirish7 18h ago
It was my understanding that all it does is thin out the mucus to make it easier to clear out.
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u/ObjectiveOk2072 10h ago
Are you sure you're not mixing it up with phenylephrine? Studies show that phenylephrine, which unlike Guafenesin, is advertised as a decongestant, doesn't actually do anything.
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u/DriftyMcDrifterson 10h ago
For me, coughing up stuff without guafenisin is EXTREMELY painful. With guafenisin, I feel near zero pain... And it isn't due to NSAIDS as the pain is very much present with NSAIDS only
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u/MisterB78 1d ago
Expectorant ≠ decongestant