Controlling chronic cough

Your healthcare team will discuss the pros and cons of different medications and work with you to choose the best option for you.

Often you will be asked to take medication for a couple of months to see if there is any change in your cough. You may be asked “rate” your cough (for example, how often you are coughing, if your cough is interrupting your sleep). This will help you and your healthcare provider know if the medication is working.

Ipratropium is used to relax the muscles around your airways so that you can breathe easier. Ipratropium bromide comes in an inhaler or puffer.

Amitriptyline is an antidepressant medication that is sometimes used for chronic pain. Some research has shown that it can lessen chronic cough.

Your healthcare team may give you a low dose of slow-release morphine if your cough is interfering with your daily life and other treatments have not helped.

Gabapentin and pregabalin are anti-seizure medications that have been shown to lessen the cough for some people.

Behaviour modification therapy, typically delivered by speech and language therapists, involves teaching people to have more control over their cough symptoms and includes education, strategies to suppress the cough, vocal hygiene training and counselling.

The therapist will teach you ways to suppress your cough, using swallowing or relaxed breathing. They will also help you identify what causes you to cough and how you can avoid these triggers. They will also help you with any anxiety you feel because of your chronic cough.

If you smoke, the best thing you can do is quit. There is help available for you. Start with your healthcare team. There is also information available on our website.

Smoke from tobacco, wood fire or other sources can irritate your lungs and cause you to cough. Make your home smoke free and avoid sources of smoke outside your home. Avoid environments where irritants such as smoke, dust, pollen or pollution may be present.

Water or other fluids can help thin mucus and soothe your throat. Honey or lemon (or both) in hot water and tea is also soothing. Make sure the temperature of the fluid is not too hot to cause burns or hurt your mouth and throat.

Sucking on hard candy or cough drops can soothe your throat. Hard candy may work as well as cough drops, so choose whatever drops or candy you prefer. Medicated cough suppressant lozenges (cough drops) or expectorant (cough syrup) are not recommended for chronic cough and are not recommended for children under 14.

You should do what you can to keep yourself from getting infections that can make your cough worse.

• Ask your healthcare team about recommended vaccinations to prevent flu, RSV, pneumonia and COVID-19.
• Wash your hands or use hand sanitizer.
• Avoid being around people who may be sick. If you do get sick, stay home so that you don’t get worse. Consider wearing a mask if you are around large groups of people, may be around people who are sick or are sick yourself.
• Always remember to cover your cough and keep tissues on hand to cover your mouth when you cough.