II. Indications

  1. Infectious cough (may speed recovery)
  2. Chronic Bronchitis (clear airway mucus)
  3. Acute Sinusitis (assists with sinus drainage)

III. Guaifenesin

  1. Short acting agents (e.g. Robitussin)
    1. Ages 2 to 5 years old: 2.5 ml PO q4h
    2. Ages 6 to 12 years old: 5 ml PO q4h
    3. Adults: 10 ml PO q4h
  2. Long acting agents
    1. Mucinex (Over-the-counter)
    2. Humabid LA with new, unproven formulation
      1. Contains guiacolsulfonate (old expectorant)
  3. Discontinued agents
    1. Prior Humibid LA, Liquibid, Guaifenex LA
  4. Effect
    1. The only effective expectorant medication per FDA
    2. Paradoxically also reduces cough in URI
      1. Due to altered cough receptor sensitivity in URI
      2. Dicpinigaitis (2003) Chest 124:2178-81 [PubMed]

IV. Other Expectorant Preparations (use with caution)

  1. Nebulized Hypertonic Saline
    1. Used to induce Sputum for Sputum exam and culture
  2. Terbutaline (Brethine)
    1. Beta adrenergic agonist (Tachycardia risk)
    2. Dose (age >12): 2.5 to 5 mg PO q6 hours while awake
  3. Amiloride (Midamor)
    1. Potassium sparing Diuretic

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Cost: Medications

guaifenesin (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
GUAIFENESIN 100 MG/5 ML LIQUID Generic OTC $0.01 per ml
GUAIFENESIN 100 MG/5 ML SYRUP Generic OTC $0.01 per ml
GUAIFENESIN 200 MG TABLET Generic OTC $0.04 each
GUAIFENESIN AC COUGH SYRUP Generic OTC $0.03 per ml
GUAIFENESIN DM SYRUP Generic OTC $0.01 per ml
GUAIFENESIN ER 1,200 MG TABLET Generic OTC $0.53 each
GUAIFENESIN ER 600 MG TABLET Generic OTC $0.26 each
GUAIFENESIN-CODEINE SYRUP Generic OTC $0.03 per ml
GUAIFENESIN-PSE ER 600-60 MG Generic OTC $0.40 each

Ontology: Guaifenesin (C0018305)

Definition (CHV) An expectorant
Definition (CHV) An expectorant
Definition (CHV) An expectorant
Definition (CHV) An expectorant
Definition (NCI) A glyceryl guaiacolate with expectorant effects. Guaifenesin increases respiratory tract mucus secretions, acts as an irritant to gastric vagal receptors and recruits efferent parasympathetic reflexes that cause glandular exocytosis. This agent reduces the viscosity of mucus secretion by reducing adhesiveness and surface tension as well as increasing hydration of mucus. Guaifenesin promotes the efficiency of the mucociliary mechanism important in removing accumulated secretions from the upper and lower airway.
Definition (MSH) An expectorant that also has some muscle relaxing action. It is used in many cough preparations.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D006140
SnomedCT 363737009, 87174009, 386184000
LNC LP18968-5, MTHU007063
English Ether, Guaiacol Glyceryl, Glycerol Guaiacolate, Glyceryl Ether, Guaiacol, Guaiacolate, Glycerol, Guaifenesin, Guaiphenesin, Guaiphenezine, 1,2-Propanediol, 3-(2-methoxyphenoxy)-, 3-(o-Methoxyphenoxy)-1,2-propanediol, Glyceryl Guaiacolate, guaifenesin (medication), GUAIFENESIN, Guaifenesin [Chemical/Ingredient], guaiacol glyceryl ether, guaiphenesin, glyceryl guaiacolate, guaifenesin, guaiFENesin, GuaiFENesin, Guaifenesin - chemical, Guaifenesin - chemical (substance), Guaiacol Glyceryl Ether, Glyceryl guaiacolate, Guaianesin, alpha-Glyceryl guaiacol ether, Guaifenesin (product), Guaifenesin (substance)
Swedish Guaifenesin
Czech guaifenesin, guajakol glycerylether
Finnish Guaifenesiini
Russian GVAIFENEZIN, GVAIAKOLGLITSERINOVYI EFIR, ГВАЙФЕНЕЗИН, ГВАЯКОЛГЛИЦЕРИНОВЫЙ ЭФИР
Japanese グアイフェネシン, グアヤコールグリセリンエーテル, グアイアコールグリセリルエーテル, フストジル
Polish Eter glicerynowy gwajakolu, Guaifenezyna
Spanish guaifenesina - sustancia química (sustancia), guaifenesina - sustancia química, gliceril guayacolato, guaifenesina (producto), guaifenesina (sustancia), guaifenesina, guayanesina, éter de alfagliceril guayacolato, Guaifenesina, Éter Guayacol Glicerilo
French Éther glycérique du gaïacol, Éther glycérogaïacolique, Éther monoglycérique du gaïacol, Gaïacolate de glycérol, Gaïacolate de glycéryle, Glycéryl gaïacolate, Glycérylgaïacol, Glycéryl guaïacolate, Guaïanésine, Guaïfénésine, Guaïphénésine
German Guaifenesin, Guaiphenesin, Guajakolglycerinether
Italian Guaifenesina
Portuguese Éter Glicerílico do Guaiacol, Guaifenesina

Ontology: Guaifenex (C0720747)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
English Guaifenex, guaifenex

Ontology: Liquibid (C0721382)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
English Liquibid, liquibid

Ontology: Robitussin (C0723110)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
English Robitussin, robitussin

Ontology: Humibid (C0729017)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D006140
English humibid, Humibid