Last updated: August 12, 2021

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You can't fall asleep for hours, every conversation leads to another attack and you're torn about whether or not you should go to work. Coughing interferes with an otherwise pleasant everyday life in an annoying way, but not only that: if left untreated, it can also lead to more serious illnesses.

For this reason, many people turn to cough syrup, which is supposed to promise relief. But which one is the right one and particularly effective? Our editorial team has put several cough syrups under the microscope and presents our favorites here in our cough syrup test 2022.


  • A cough is one of the most persistent symptoms of a cold. If left untreated, a cough can develop into bronchitis.
  • If you cough into your hands, you become a risk of infection and pass on the pathogens. Therefore, it is better to cough into the crook of the arm.
  • Cough syrup can alleviate the symptoms, but it cannot fight the disease. If the cough persists for several weeks, a doctor should be consulted.

The Best Cough Syrup: Our Picks

Guide: Questions you should ask yourself before buying a cough syrup

What is a cough?

Coughing is an everyday phenomenon that you may not have given much thought to. Often we ourselves are the triggers; we cough when we think that a foreign body has entered the throat.


Coughing often occurs during a cold. Although it is annoying, it is also an important defence mechanism of the body. (Image source: / sweetlouise)

If the cough is controlled by the body, there is little we can do about it. You just have to cough because your throat is scratchy.

The mucous membrane of the respiratory tract is covered by cilia. These transport mucus and foreign bodies upwards.

Only when the cilia can no longer do this because of increased mucus formation and adhesions do you have to cough. The coughing stimulus is practically a kind of self-help mechanism of the body.

When you cough, you breathe in deeply. The larynx closes and the respiratory muscle contracts. The air escapes with high pressure and the larynx opens again.

If you have ever been tormented by a coughing fit, you know how much effort is involved.

There are many muscles involved in coughing and you can easily get sore muscles.

What causes a cough?

A distinction must be made between a cough that is spontaneously triggered and a cough that is caused by illness.

Type of cough Causes
Spontaneous cough Dust, gases, chemicals, ingestion
Cough caused by illness Cold, bronchitis, allergy, asthma, pneumonia, tuberculosis, whooping cough

Most of the time, a cough is relatively harmless. The most common causes of coughing are colds and swallowing food and drink.

In Germany, about 1.7 million euros are spent annually on remedies for colds.

It is estimated that every German buys cough syrup and cold remedies for 20 euros a year. Statistically, Germans catch a cold three times a year.

What is cough syrup?

The term cough syrup is used to describe medicines that are intended to either relieve or suppress the urge to cough. Cough syrups usually consist of a syrup made from water, sugar or alcohol.

On this basis, synthetic ingredients or herbal active substances are added to the juices.

Many herbal cough syrups are available without a prescription. Medicines with synthetic ingredients usually require a prescription.

Do I really need cough syrup?

You can only answer this question for yourself. According to the German Society for General and Family Medicine, it is not necessary to take medication for a cough.

A cough is a side effect of a cold and usually disappears with the other symptoms after eight to ten days.

In quite a few cases, however, a persistent cough sets in, which does not simply go away and can develop into chronic bronchitis or even pneumonia.

There is nothing wrong with having a cough syrup in the house to be able to react quickly. Even when there is a scratchy throat, the use of herbal cough remedies can be recommended. Studies have confirmed that herbal cough remedies help very well and can also loosen stuck mucus. For dry irritating coughs, cough suppressants have been shown to be effective. The active ingredient dextromethorphan has been shown to be particularly effective.

How does a cough develop?

The cough is subject to development. That is why different cough syrups have been developed. Most of the time, you first suffer from an irritating cough.

This can mean two to three days of pure stress, because you have to cough constantly without being able to do anything about it.

A cough syrup can be used here to calm the irritation. With increased coughing, the number of cilia decreases and the bronchial tubes are less well protected.

Cough syrup promotes coughing up and loosens the mucus.

When the cough enters its second phase, the mucus comes into play. This helps to get the viruses out of the lungs.

However, the mucus is still stuck at first and coughing becomes an effort. Now it is important to take a cough syrup that promotes expectoration and loosens the mucus.

Once the mucus has been loosened and the cold symptoms have subsided, an irritating cough may remain for a few days.

In this case, cough syrup can soothe the irritated mucous membranes and be taken until the cough subsides completely.

Does cough syrup have side effects?

Herbal cough syrups do not cause any side effects. Allergic reactions can only occur if certain ingredients are not tolerated.

Synthetic cough suppressants and cough expectorants can have different side effects.

Cough syrup Type possible side effects
Cough suppressants tiredness, drowsiness, dizziness, nausea, vomiting, itching
Cough expectorants headaches, digestive complaints, fever, skin rashes, shortness of breath, dry mouth

In rare cases, cardiac arrhythmias and hallucinations have also been observed with cough suppressants.

In the case of cough expectorants, the side effects mentioned are often triggered by the active ingredients ambroxol and acetylcysteine.

When buying cough syrup, always read the package leaflet. Taking other medicines can lead to interactions under certain circumstances.

Individual active substances are also strengthened or weakened by the consumption of coffee, milk or grapefruit juice.

If you have an intolerance to certain sugars, this should also be taken into account.

If the cough syrup contains paracetamol, make sure that the active substance is not overdosed. Otherwise there is a risk of severe liver damage.

Furthermore, you should not take cough suppressants and expectorants at the same time. If in doubt, always ask a doctor or pharmacist for advice.

When should cough syrup be taken?

Cough expectorants should be taken during the day. The purpose of this medicine is to loosen mucus.

Cough suppressants allow you to have a good night's sleep without coughing.

Frequent coughing might prevent you from falling asleep and sleeping through the night.

Cough suppressants are given before bedtime. They have a calming effect and allow you to sleep peacefully.

For prescription medicines, the package leaflet is authoritative. Avoid overdosing.

To loosen mucus and make it easier to cough up, drink plenty of fluids.

What is the difference between herbal and synthetic cough syrups?

Herbal cough syrups are considered safe and well-tolerated medicines. Especially when treating children, these remedies should be used.

The effect of herbal cough syrups is based on the following active ingredients:

Plant substance Effect
Thyme relaxes the bronchial tubes, loosens phlegm, soothes pain
Ivy leaves soothes cough irritation, loosens phlegm
Eucalyptus loosens phlegm, also helps against the common cold

On the other hand, there are synthetic active ingredients that have a broader spectrum of effects and can also relieve pain or reduce fever. One of the best-known active substances of this kind is paracetamol.

The advantages and disadvantages of herbal and synthetic cough syrups:

Cough syrup Type Advantages Disadvantages
Herbal cough syrup Well tolerated, also suitable for children, no risk of addiction Slow effectiveness, no broad spectrum of effect
Synthetic cough syrup Fast effect, also effective for severe coughs Side effects, interactions, risk of addiction

Is cough syrup available over-the-counter?

In Germany, there are generally three types of medicines:

  • Over-the-counter medicines
  • Pharmacy-only medicines
  • Prescription medicines
Most cough syrups do not require a prescription.

Cough syrups are available in all three categories. You can find over-the-counter products in drugstores or health food shops. These include, for example, fennel syrup and various herbal preparations.

You can get pharmacy-only medicines at the pharmacy, but you do not need a prescription for them.

These are cough syrups with a stronger formula of active ingredients, which are bound to a certain dosage and make it necessary for them to be sold by professional staff.

If you go to the doctor because your cough is particularly persistent, he or she will probably give you a prescription for a prescription cough syrup and at the same time specify the appropriate dose.

These are preparations with synthetic additives that are effective for severe coughs and bronchitis.

What are the alternatives to cough syrup?

As an alternative to cough syrup, warm herbal tea with honey is a proven home remedy.

Throat lozenges and lozenges also have a soothing effect on the throat. Cough sprays and cough drops can also be used as an alternative.

Often, a cold bath can also help to loosen mucus from the bronchial tubes and make it easier to cough up.

Decision: What types of cough syrup are there and which is the right one for you?

Basically, you can distinguish between two different types of cough syrup:

  • Cough suppressants
  • Cough expectorants

In the following, we will explain the different types and their respective advantages and disadvantages. In this way, we want to help you find the cough syrup that is best for you.

What are the advantages and disadvantages of cough suppressants?

Cough suppressants fight a dry, irritating cough. It reduces the urge to cough and makes it easier to get to sleep in the evening. However, cough suppressants can also be used incorrectly.

If the preparation is used for a mucous cough, the removal of secretions from the bronchial tubes is prevented and mucus can accumulate at night, hindering breathing.

  • Effective for dry irritating cough
  • Enable calm sleep
  • Dampen coughing stimulus
  • Not suitable for mucous cough
  • Can be addictive

Cough suppressants are available over-the-counter and by prescription. Prescription preparations use hydrocon, codeine or noscapine, substances that are not unlike opiates.

There is a certain risk of dependence. For this reason, these medicines may not be sold freely.

What are the characteristics of cough expectorants and what are their advantages and disadvantages?

The purpose of cough expectorants is to make it easier to cough up stubborn mucus. Herbal active ingredients such as fennel, thyme and eucalyptus are very effective.

  • Frees the airways from mucus
  • Facilitates coughing up
  • Helps with stubborn cough with sputum
  • Side effects with synthetic preparations
  • Mucus formation can also be increased

Synthetic preparations contain the active ingredients ambroxol, acetylcysteine or bromhexil. With chemical preparations, there is often a risk that mucus formation is stimulated and the actual problem is thereby exacerbated.

Buying criteria: Use these factors to compare and evaluate cough syrups

In the following, we will show you which criteria you can use to compare and evaluate cough syrups. This will make it easier for you to get an overview and decide on a suitable and effective product.

In summary, these are:

  • Symptoms
  • Ingredients
  • Additives
  • Efficacy
  • Tolerability

In the following, you can read about the respective criteria and find out why it makes sense for you to purchase a product based on the criteria or not.


As we have already heard, there are different preparations for the different phases of cough.

So you should first look at the symptoms. If the cough is dry and keeps you awake at night, you will need a cough suppressant.

If your cough disturbs your sleep, you should use a cough suppressant. (Picture source: / 87211311)

If you have a mucous cough, you need a cough suppressant to help you cough it up. Experience has shown that it is advisable to have both products in the house.

The initial irritating cough usually turns into a phlegmy cough after three days at the latest.

The market knows the habits of the cough and also offers so-called combination preparations.

These products contain several active substances that are supposed to combat the different symptoms.

These preparations also increase the risk of side effects. It is therefore advisable to treat the different symptoms individually and to rely on cough suppressants and cough expectorants.


Before buying, look at the list of ingredients. Herbal preparations will probably have the following ingredients:

  • Thyme
  • Eucalyptus
  • Primrose root
  • Ribwort
  • Ivy leaves

Herbal ingredients are safe and do not cause side effects. However, if you are allergic to any of the ingredients, you should choose a different product.


Cough syrup may contain a number of additives that may be harmful to health and should not be given to children.

In synthetic products, ambroxol and acetylcysteine are among the active ingredients. However, the effect of both substances has not been sufficiently confirmed.

Other additives that could be dangerous, especially for small children, are sodium benzoate, benzoic acid or propylparaben. The body can only break down these additives with difficulty.Hardly any cough syrup does without sugar. The tricky thing is that the package insert often does not show this at first glance.

As a critical consumer, you should pay particular attention to the following substances:

Synonyms for sugar

  • Sorbitol
  • Dextrin
  • Glucose
  • Maltose
  • Maltitol
  • Fructose
  • Sucrose


  • Citric acid
  • Ascorbic acid
  • Potassium sorbate
  • Benzoic acid


You know your body best and you know how badly you've got it. For a mild cough, a herbal cough syrup is a good choice. You can use it to relieve the discomfort and help cough up the mucus.

However, if you have a full-blown flu, there is a risk that the cough could turn into bronchitis or you could get pneumonia. Quick action is needed here.

Products with synthetic active ingredients work much faster than herbal preparations. In any case, you should seek advice at the pharmacy or consult a doctor.


Here, too, it is essential to consult the manufacturer's instructions. If you have allergies or intolerances, you should switch to another medicine.

Children should only be given herbal preparations for mild coughs. Medicines containing acetylsalicylic acid should not be used for children under 12 years of age. Pregnant women should only take cough syrup after consulting their doctor.

Especially for children, you should use herbal cough expectorants. (Picture source: / 51904595)

Facts worth knowing about cough syrup

How should I cough properly?

Frequent coughing irritates your mucous membrane.

Coughing is not a disease, quite the opposite. You cough because your body helps itself and wants to get rid of the pathogens as quickly as possible.

Frequent and vigorous coughing can not only lead to sore muscles, but also irritate the mucous membrane unnecessarily.

Therefore, try not to give in immediately to every scratchy throat. It can often help to swallow hard several times instead of coughing. A warm tea with honey can also soothe the mucous membranes.

Try to avoid violent coughing and soothe it with tea.

If you stress your mucous membranes during a cold by talking loudly or coughing violently, you delay the chances of recovery.

Try not to cough too hard. This prevents the mucous membrane from cracking and promotes the healing process.

If you have coughed into your hands, you should wash them thoroughly with soap. If you have a severe cough, coughing into the crook of your arm has proven to be effective.

Can I make my own cough syrup?

Onions are a tried and tested household remedy and can actually be used to make a quite effective cough syrup.

Proceed as follows:

  • Peel onion
  • Cut onion into small pieces
  • Put onion pieces into a drinking vessel
  • pour two tablespoons of honey over it
  • Leave onion pieces and honey to infuse overnight
  • Pour off the liquid

You can take a teaspoon of this cough syrup several times a day. This syrup is a good alternative when the shops are closed and you have not yet been able to get any cough syrup.

Does cough syrup also help with smokers' coughs?

Conventional cough syrups are not suitable for treating smokers' coughs.

Most cough syrups are not effective against this particularly persistent cough. Moreover, they are not suitable for long-term use.

For smoker's cough, it can help to inhale regularly with essential oils. The doctor can prescribe cortisone spray.

A simple and guaranteed effective method is to become a non-smoker.

Can cough syrup replace a visit to the doctor?

It is impossible to say for sure, and you should not take any risks.

If a cold runs its course without complications, you feel fit and have no serious concomitant illnesses, a visit to the doctor is not absolutely necessary.

Coughs can be controlled quite quickly with the targeted use of cough suppressants and cough expectorants.

However, if you have any of the following symptoms, you should not hesitate and consult a doctor immediately:

  • High fever
  • Persistent feeling of illness
  • Severe aching limbs
  • Sore throat
  • Earache

If the symptoms do not subside after eight to ten days at the latest, a doctor should be consulted.

The cough syrup you have chosen is probably too weak and a prescription medicine must be used.

Cough syrup can relieve cold symptoms. However, you should not expect miracles.

Above all, your body needs rest to defend itself against the more than 200 known pathogens that can cause a cold.

(Image source: / Original_Frank)