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Guaifenesin INN or guaiphenesin (former BAN), also glyceryl guaiacolate, is an expectorant drug sold over the counter and usually taken orally to assist the bringing up (expectoration) of phlegm from the airways in acute respiratory tract infections
History
Similar medicines derived from the guaiac tree were in use as a generic remedy by American indigenous peoples when explorers reached North America in the 16th century. The Spanish encountered guaiacum wood "when they conquered Santo Domingo; it was soon brought back to Europe, where it acquired an immense reputation in the sixteenth century as a cure for syphilis and certain other diseases..."
The 1955 edition of the Textbook of Pharmacognosy states: "Guaiacum has a local stimulant action which is sometimes useful in sore throat. The resin is used in chronic gout and rheumatism, whilst the wood is an ingredient in the compound concentrated solution of sarsaparilla, which was formerly much used as an alternative in syphilis."
Guaifenesin was first approved by the Food and Drug Administration (FDA) in 1952. Although previously deemed "Generally Regarded as Safe" in its original approval, the drug received a New Drug Application for the extended-release version, which won approval on July 12, 2002. Because of this, the FDA then issued letters to other manufacturers of timed-release guaifenesin to stop marketing their unapproved versions, leaving Adams Respiratory Therapeutics in control of the market. Adams was subsequently acquired by Reckitt Benckiser, based on the strength of the marketing generated by Adams' Mucinex brand.
Cough
The principal use of guaifenesin is in the treatment of coughing. A Cochrane Collaboration meta-analysis of over-the-counter medicines for acute cough in children and adults concluded that there was not enough high-quality clinical data to prove or disprove the effectiveness of any examined drug including guaifenesin. Guaifenesin is sometimes combined with dextromethorphan, an antitussive, such as in Mucinex DM or Robitussin DM.
Other uses
The guaifenesin protocol uses guaifenesin as an unapproved fibromyalgia treatment, despite the fact that a one-year double-blind study indicates that the treatment performs no better than placebo.Guaifenesin has not been approved by the FDA for the treatment of fibromyalgia. Based on a small, non-blinded study,Guaifenesin has been promoted to facilitiate conception, by thinning and increasing cervical mucus, during the few days before ovulation.
Mechanism of action
Guaifenesin is thought to act as an expectorant by increasing the volume and reducing the viscosity of secretions in the trachea and bronchi. It has been said to aid in the flow of respiratory tract secretions, allowing ciliary movement to carry the loosened secretions upward toward the pharynx.Thus, it may increase the efficiency of the cough reflex and facilitate removal of the secretions.
Veterinary use
Guaifenesin's neurological properties first became known in the late 1940s. Guaifenesin is a centrally acting muscle relaxant used routinely in large-animal veterinary surgery. Guaifenesin is used in combination with, for example, propofol, since guaifenesin does not produce analgesia nor does it produce unconsciousness
Children should not use products that contain codeine after certain surgeries (including tonsil/adenoid removal). Also, for children younger than 12 years, do not use codeine to treat cough or pain unless specifically directed by the doctor. Some children are more sensitive to codeine and have had very serious (rarely fatal) breathing problems such as slow/shallow breathing (see also Side Effects section). Talk with your doctor or pharmacist about the risks and benefits of this medication.
This combination medication is used to temporarily treat cough and runny/stuffy nose (nasal congestion) caused by infections (such as the common cold), allergies (such as hay fever), and other breathing illnesses. This product is usually not used for ongoing cough from smoking or long-term breathing problems (such as chronic bronchitis, emphysema) unless directed by your doctor. Guaifenesin is an expectorant. It works by thinning and loosening mucus in the airways, clearing congestion, and making breathing easier. Pseudoephedrine is a decongestant (sympathomimetic). It reduces nasal congestion by narrowing the blood vessels in the nose.
If you are self-treating with this medication, it is important to read the package instructions carefully before you start using this product to be sure it is right for you. (See also Precautions section.)
Cough-and-cold products have not been shown to be safe or effective in children younger than 6 years. Therefore, do not use this product to treat cold symptoms in children younger than 6 years unless specifically directed by the doctor. Some long-acting products are not recommended for use in children younger than 12 years. Ask your doctor or pharmacist for more details about using your product safely.
These products do not cure or shorten the length of the common cold and may cause serious side effects. To decrease the risk for serious side effects, carefully follow all dosage directions. Do not give other cough-and-cold medication that might contain the same or similar ingredients (see also Drug Interactions section). Ask the doctor or pharmacist about other ways to relieve cough and cold symptoms (such as drinking enough fluids, using a humidifier or saline nose drops/spray).
How to use guaifenesin Oral
Take this medication by mouth with or without food, usually every 12 hours with a full glass of water or as directed by your doctor. If stomach upset occurs, take with food or milk. If you are self-treating, follow all directions on the product package. To prevent trouble sleeping, do not take this medication close to bedtime. If you are uncertain about any of the information, ask your doctor or pharmacist.
Swallow the capsules whole and do not open them. Do not crush or chew the capsules or tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.
Dosage is based on your age, medical condition, and response to treatment. Do not take more than 2 doses in a day. Do not increase your dose or take this drug more often than directed.
Drink plenty of fluids while taking this medication. Fluids will help to break up mucus and clear congestion.
Caffeine can increase the side effects of this medication. Avoid drinking large amounts of beverages containing caffeine (coffee, tea, colas), eating large amounts of chocolate, or taking nonprescription products that contain caffeine.
Tell your doctor if your condition is accompanied by fever, severe sore throat, rash, persistent headache, or if it persists, returns, or worsens after 7 days. These may be signs of a serious medical problem. Seek immediate medical attention if you think you may have a serious medical problem.
Nausea or headache may occur. If either of these effects persist or worsen, tell your doctor or pharmacist promptly.
If your doctor has directed you to use this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor immediately if any of these unlikely but serious side effects occur: dizziness, fainting, fast/irregular/pounding heartbeat, mental/mood changes (such as anxiety, confusion, nervousness, irritability), shaking (tremor), trouble sleeping, difficult/painful urination.
A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
Before taking this medication, tell your doctor or pharmacist if you are allergic to pseudoephedrine or guaifenesin; or if you have any other allergies. Also tell your doctor if you have had a bad reaction to similar drugs (sympathomimetics such as ephedrine, phenylephrine). This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: breathing problems (such as emphysema, chronic bronchitis, asthma, smoker's cough), cough with blood or large amounts of mucus, high blood pressure, heart disease (such as chest pain, heart failure, heart attack), fast/slow/irregular heartbeat, diabetes, a certain eye problem (glaucoma), difficulty urinating (such as due to enlarged prostate), overactive thyroid (hyperthyroidism).
This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Caution is advised when using this product in children because they may be more sensitive to its side effects, especially nervousness, irritability, and high blood pressure. (See also Uses Section.)
Older adults may be more sensitive to the side effects of this drug, especially fast/irregular heartbeat, dizziness, problems urinating, trouble sleeping, or confusion.
During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.
The pseudoephedrine in this product passes into breast milk and may have undesirable effects on a nursing infant. It is unknown if guaifenesin passes into breast milk. Discuss the risks and benefits with your doctor before breast-feeding.
The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.
To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor's approval.
Some drugs that may interact with this product include: other decongestants (taken by mouth or sprayed into the nose), tricyclic antidepressants (such as nortriptyline, amitriptyline).
Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.
Pseudoephedrine may decrease the effectiveness of some blood pressure medications (such as beta blockers, reserpine, guanethidine, methyldopa, mecamylamine).
Check the labels on all your medicines (such as cough-and-cold products, diet aids) because they may contain ingredients that could increase your heart rate or blood pressure. Before using these products with this medication, ask your pharmacist how to use them safely.
Pseudoephedrine and guaifenesin are available in both prescription and nonprescription products. Check the labels of all your medications carefully to make sure you are not taking more than one product containing these medications.
The guaifenesin in this product can affect the results of certain lab tests (such as urine levels of certain acids). Make sure laboratory personnel and all your doctors know you use this drug.
This document does not contain all possible drug interactions. Keep a list of all the products you use. Share this list with your doctor and pharmacist to lessen your risk for serious medication problems.
If overdose is suspected, contact a poison control center or emergency room immediately. Symptoms of overdose may include: severe dizziness/fainting, fast irregular heartbeat, slow/fast/shallow breathing, hallucinations, seizures.
Notes
If your doctor prescribed this medication, do not share this medication with others.
Keep all regular medical and laboratory appointments.
This medication is for temporary use only. Do not take this medication for more than 7 days unless your doctor tells you to do so. Tell your doctor if your condition lasts longer than 7 days.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
Storage
Store at room temperature away from light and moisture. Do not store in the bathroom. Different brands of this medication have different storage needs. Check the product package for instructions on how to store your brand, or ask your pharmacist. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Information last revised October 2013. Copyright(c) 2013 First Databank, Inc.
