An article published in Multidisciplinary Respiratory Medicine stated that guaifenesin – a mucoactive drug, acts by loosening mucus in the airways and making coughs more productive. It is used for relief of wet cough and chest congestion due to the common cold and remains the only legally marketed expectorant in the US.

The authors elaborated that an ingredient in numerous over-the-counter (OTC) cough/cold medications, guaifenesin has a secondary indication for use in stable chronic bronchitis. Clinical pharmacology and patient studies support the clinical utility of guaifenesin in respiratory conditions where mucus hypersecretion is prevalent – acute upper respiratory tract infections (URTIs), stable chronic bronchitis and possibly rhinosinusitis.

Guaifenesin has a well-established and favorable safety and tolerability profile in adult and pediatric populations. Its dosing range (200-400 mg 4-hourly, up to 6 times daily) allows flexible dose titration to allow an increase of plasma concentrations. Multiple daily doses are needed to maintain 24-hour therapeutic effect with immediate-release formulations. In addition, extended-release guaifenesin tablet formulations are available, providing convenience with 12-hourly dosing and portability compared to liquids.

Guaifenesin is considered as a safe and effective expectorant for the treatment of mucus-related symptoms in acute URTIs and stable chronic bronchitis. Its clinical efficacy has been demonstrated most widely in chronic respiratory conditions, where excess mucus production and cough are more stable symptoms.

Furthermore, progress is being made to establish clinical models and measures that are more appropriate for studying symptomatic relief with guaifenesin in acute respiratory infections. This will help generate the up-to-date and high-quality data needed to optimize guaifenesins effectiveness in established uses, and in new respiratory indications associated with mucus hypersecretion.

Source: Multidisciplinary Respiratory Medicine. 2017 Dec 11;12:31. doi: 10.1186/s40248-017-0113-4.