Cough products explained: syrups, tablets, lozenges and sprays

Cough products come in four main formats: syrups, tablets, lozenges and sprays. The format matters less than the active ingredient, and a shop that sorts its cough shelf by what is inside each pack will save its staff a lot of guesswork. Below we go through the products we carry by format, quote what each label says, and set out the points where a customer should be handed to a pharmacist.

Start with the active ingredient

The three medicated cough products in our range all contain an ingredient aimed at phlegm:

• Guaifenesin is an expectorant. It is in Cofen 100.
• Bromhexine and ambroxol are mucolytics, meaning they are used to thin mucus. Bromhexine is in Mucolix Elixir and ambroxol is in Mucosolvan.

All three labels describe them for coughs with phlegm. None of them is labelled as a cough suppressant for a dry, tickly cough, and staff should not offer them as one. A customer who describes a dry cough, or who is unsure what kind of cough they have, is a customer for the pharmacist.

Syrups

Syrups are the format most people picture, and they come with the most label detail.

Cofen 100 Cough Mixture (100ml) states that each teaspoon (5ml) contains guaifenesin USP 100mg. The pack describes it as an adult formula for loosening phlegm, orange flavoured, and non-drowsy. Its usage line reads: "Adults: take one to two teaspoons (5mL to 10mL) every 2 to 3 hours." There is one specific warning on the listing, that guaifenesin is contraindicated during a particular urine test, which is the kind of detail a pharmacist will want to check with the customer.

Mucolix Elixir (90ml) is a colourless, kiwi-flavoured syrup containing bromhexine hydrochloride 4mg per 5ml. The ingredient list also shows sodium benzoate and a small amount of ethanol as preservatives, which some customers will ask about. The label gives separate directions for adults and children over 12, children 6 to 12 and children 2 to 6, and states that it "is not recommended for children below 2 years old without medical advice". The listing names possible side effects including nausea, diarrhoea and indigestion.

Syrups need a measuring device. Check whether a cup or spoon is in the carton and, if not, keep spare dosing cups at the counter.

Tablets

Mucosolvan Cough Relief Tablet contains ambroxol HCl 30mg and comes in a pack of 50. Its label reads: "Take 1 tablet 3 times daily with liquid." Tablets suit customers who dislike the taste of syrup or who want something to carry to work. The 50-count also makes it a sensible line for clinic retail corners.

Lozenges

Lozenges sit between medicine and confectionery in shoppers' minds, which is why they sell well near the till. The Propoliz Lozenges we carry come in three variants: MIXS (15 per pack), Honey, Lime and Ginger (8 per pack) and Vitamin C (8 per pack). Each lists propolis extract alongside flavourings; the MIXS version lists xylitol and licorice and is labelled sugar-free. The usage line is "Take 1 lozenge at a time to dissolve slowly in the mouth every 2-3 hours or as often as needed."

Lozenges are not suitable for young children because of the choking risk, so a parent asking for a child should be pointed to the pharmacist.

Sprays

The Propoliz Mouth and Throat Spray (15ml) lists honey, peppermint oil, spearmint oil and menthol, and its description mentions Brazilian green propolis extract. Its directions are to "Spray 2-3 times a day into mouth and throat as needed." Sprays are compact and popular with people who use their voice for work. We cover the propolis range in more depth in our guide to propolis throat sprays and lozenges.

Laying out the shelf

• Group the medicated syrups and tablets together, labelled by ingredient, with lozenges and sprays alongside.
• Put adult-only products, such as Cofen 100, on a separate row from products with children's directions so the wrong bottle is not grabbed.
• Expect demand to rise during flu season and haze periods. Our seasonal stocking calendar has more on timing.
• The listings do not give storage temperatures, so read each carton on arrival and keep stock out of direct sun.

When to call the pharmacist

Cough medicines are medicines, and the honest answer for many questions is "let me get the pharmacist". Refer the customer when:

• the cough is for a child, particularly under the age on the label
• they are pregnant, breastfeeding, or take other regular medicines
• the cough has lasted more than a short while, or keeps coming back
• they mention breathlessness, chest pain, fever, or blood in their phlegm
• they cannot say whether the cough is dry or chesty

Anyone with symptoms that worry them should speak to a pharmacist or doctor. Medicines sold in Singapore are regulated by the Health Sciences Authority (HSA), and businesses should check with HSA what applies to them before selling any of these lines.

Putting together an order

You can see every cough, cold and throat line in our health category, including Cofen 100. Build your list in the enquiry basket and we will come back with prices, minimum quantities and what is in stock.