Guaifenesin, also known as glyceryl guaiacolate, sold under the brand name Mucinex, among others,[ by making airway secretions more liquid.
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Side effects may include dizziness, sleepiness, skin rash, and nausea.[ While it has not been properly studied in pregnancy, it appears to be safe.]
Guaifenesin has been used medically since at least 1933.[ In 2022, it was the 295th most commonly prescribed medication in the United States, with more than 400,000 prescriptions.]
Medical uses
Guaifenesin is used to try to help with coughing up thick mucus. It is sometimes combined with the antitussive (cough suppressant) dextromethorphan, such as in Mucinex DM or Robitussin DM.
A Cochrane review identified three assessing guaifenesin for the treatment of acute cough, with one finding significant benefit and the other two trials finding that it was not effective.
Side effects
Although generally well-tolerated, side effects of guaifenesin may include an allergic reaction (rare), nausea, vomiting, dizziness, or headache.
Pharmacology
Mechanism of action
Guaifenesin might act as an expectorant by increasing the volume and reducing the viscosity of secretions in the trachea and Bronchus via stimulation of the gastric mucosa. This stimulation leads to an increased parasympathetic activity in the respiratory tract via the so-called gastro-pulmonary reflex, although some in vitro studies suggested that it might also act directly on the respiratory epithelium.
History
Similar medicines derived from the guaiacum were used 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 Hispaniola; 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."
In the US, 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 received approval on 12 July 2002.
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, ketamine, since guaifenesin does not provide analgesia or produce unconsciousness.
Society and culture
Brand names
Guaifenesin is taken by mouth,[ and is supplied as a tablet, a capsule, an extended-release (long-acting) tablet, dissolving granules, and a syrup.][ It is available under many brand names, as either the sole active ingredient or part of a combination drug.][ Drugs combined with guaifenesin in over-the-counter preparations include the cough-suppressant dextromethorphan, analgesics such as paracetamol/acetaminophen, and decongestants such as ephedrine, pseudoephedrine, or phenylephrine.][
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Economics
In 2014, sales of guaifenesin were estimated to be approximately $135 million per year in the United States.
See also
External links
