A cough is not usually serious and will generally go away within a few weeks. There are things you can do to make life easier while you’ve got a cough. It’s also good to know when you should seek medical advice.
This page is about cough in adults. Find out about cough in children.
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A cough, with or without other respiratory symptoms such as fever or runny nose, could also be a COVID infection. Test for COVID-19 and stay home until well or sure this isn’t COVID.
How to look after yourself when you have a cough
In most cases, treatment for cough is not necessary. Mild, short-term coughs are likely to be due to a viral infection that will get better on its own within a few weeks. Antibiotics are only prescribed if your cough is caused by a bacterial infection.
You can care for yourself by:
- drinking plenty of fluids, including lemon and honey drinks
- sleeping with your head propped up on pillows
- avoiding smoke, and if you smoke quitting smoking
- using cough medicine – it doesn’t cure a cough but may give you some relief from it (see below)
- using your inhaler if you have asthma
- taking antihistamines if you have hayfever.
There are a number of cough medicines available on the market. They may be sold in combination with other medicines in cold and cough products, or as cough mixtures or cough lozenges. There is little evidence to suggest that cough medicine is any more effective than simple home remedies, (eg, honey, saltwater gargles and warm drinks) and they're not suitable for everyone. If you're not sure, talk to your pharmacist. Examples of cough medicines include:
- cough suppressants – used for dry coughs and may control the urge to cough such as dextromethorphan, pholcodine and codeine.
- expectorants – used for productive coughs. They loosen mucus making it easier to cough up.
When to get help
Contact a healthcare provider or call Healthline 0800 611 116 for advice:
- If you a have a cough and you're short of breath.
- If you cough up blood.
- If you have unexplained problems like weight loss or a high temperature (fever).
What causes a cough?
The most common cause of a cough is a viral infection such as a cold or the flu. Other common causes include:
Rarely, a cough may be caused by:
How can I stop passing my cough on?
Remember to cover your cough and wear a mask when you are out of the home, or around others so you don’t spread your bugs. You can reduce your chances of getting a cough by following these winter tips for staying well.
Cough Ministry of Health, NZ
Cough, colds and sore throats – manage symptoms without antibiotics Choosing Wisely, NZ
Cough Health Direct, Australia
Cough NHS Choices, UK
- Cough caused by a virus Patient Info, UK, 2016
- Cough Patient Info, UK, 2015
- Cough Ministry of Health, NZ, 2014
- Cold season – managing without antibiotics BPAC, NZ, 2018
Information for healthcare providers on cough in adults
The content on this page will be of most use to clinicians, such as nurses, doctors, pharmacists, specialists and other healthcare providers.
The following information on chronic cough in adults is taken from Auckland Regional HealthPathways, accessed January 2020:
About chronic cough in adults
95% of adult patients with non-productive cough and a normal chest x-ray will have:
- post-nasal drip due to rhinorrhoea or sinus disease
- chronic bronchitis due to eosinophils (asthma) or neutrophils (usually low grade infection)
- gastro-oesophageal reflux
- side-effects from medication
- a combination of these.
- Suspected malignancy or tuberculosis.
- Take a history of cough.
- Check for lung cancer risk factors.
- Explore previous cough treatments and if there is evidence of:
• insufficient dose or duration.
• inadequate technique.
• poor compliance (most patients require 6 to 8 week trial to assess efficiency).
- Consider common differentials:
• Chronic bronchitis due to eosinophils (asthma) or neutrophils (usually low-grade infection)
• Gastro-oesophageal reflux
• ACE inhibitors
• Snoring and sleep apnoea
• Microaspiration from tooth and gum disease – poor dental hygiene and tooth disease is a major risk factor for aspiration pneumonia and chronic cough, particularly in older adults who may also have swallowing or feeding difficulties.
• Blood tests:
◊ FBC, including eosinophils
◊ Total IgE.
◊ Brain natriuretic peptide (BNP) if the possibility of heart failure.
• Chest X-ray, if the patient is not responsive to treatment and has lung cancer risk factors. POAC does not fund chest X-ray for chronic cough.
• Sputum culture for productive cough. Occasionally Aspergillus and non-tuberculous mycobacteria are reported on sputum culture. In the absence of a clinical picture, (i.e. bronchiectasis) of Aspergillus lung disease, they are likely to be a contaminant.
• Mycobacterial culture for tuberculosis if chest X-ray is suggestive.
Read more: Chronic cough in adults Auckland Regional HealthPathways, NZ
Other clinical resources
Chronic persistent cough in adults Patient Info Professional, UK, 2017
Gibson P, Wang G, McGarvey L, Vertigan AE, Altman KW, Birring SS. Treatment of unexplained chronic cough: CHEST guideline and expert panel report Chest. 2016; 149 (1); 27–44.
Continuing professional development
Management of chronic refractory cough BMJ online learning module. (The Royal New Zealand College of General Practitioners (RNZCGP) provides free access to BMJ Learning for its members.)
Chronic cough – Fiona Horwood
Dr Fiona Horwood talks about the management of chronic cough in primary care. Fiona is clinical head of general medicine and a respiratory physician at Counties Manukau DHB. Fiona overviews the basics of the cough mechanism and its various causes as well as when to seek further tests/interventions.
(Goodfellow podcast, NZ, 2017)
Regional HealthPathways NZ
Access to the following regional pathways is localised for each region and access is limited to health providers. If you do not know the login details, contact your DHB or PHO for more information: