Siltussin SA Syrup
It is used to thin mucus so it can be taken from the body by coughing.
Drug Class
Expectorant
Pharmacologic Class
Expectorant
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Guaifenesin is a medicine that helps to thin and loosen mucus in your lungs and airways, making it easier to cough up. It's used to relieve chest congestion caused by colds, infections, or allergies.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, take it exactly as directed by your doctor. Carefully read all the information provided with your prescription, and follow the instructions closely. You can take this medication with or without food. If it causes stomach upset, taking it with food may help. Drink plenty of non-caffeinated liquids, unless your doctor advises you to limit your fluid intake.
When taking the liquid form of this medication, measure your dose accurately using the measuring device that comes with the medication. If one is not provided, ask your pharmacist for a suitable measuring device.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, avoiding the bathroom. Keep all medications in a safe location, out of the reach of children and pets. Dispose of any unused or expired medication. Do not flush it down the toilet or pour it down the drain unless instructed to do so by your doctor or pharmacist. If you have questions about the proper disposal of your medication, consult with your pharmacist. You may also want to check if there are any drug take-back programs in your area.
What to Do If You Miss a Dose
If you take this medication on a regular schedule, take the missed dose as soon as you remember. However, if it's almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take two doses at the same time or take extra doses. If you take this medication as needed, do not take it more frequently than directed by your doctor.
To get the most benefit from your medication, take it exactly as directed by your doctor. Carefully read all the information provided with your prescription, and follow the instructions closely. You can take this medication with or without food. If it causes stomach upset, taking it with food may help. Drink plenty of non-caffeinated liquids, unless your doctor advises you to limit your fluid intake.
When taking the liquid form of this medication, measure your dose accurately using the measuring device that comes with the medication. If one is not provided, ask your pharmacist for a suitable measuring device.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, avoiding the bathroom. Keep all medications in a safe location, out of the reach of children and pets. Dispose of any unused or expired medication. Do not flush it down the toilet or pour it down the drain unless instructed to do so by your doctor or pharmacist. If you have questions about the proper disposal of your medication, consult with your pharmacist. You may also want to check if there are any drug take-back programs in your area.
What to Do If You Miss a Dose
If you take this medication on a regular schedule, take the missed dose as soon as you remember. However, if it's almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take two doses at the same time or take extra doses. If you take this medication as needed, do not take it more frequently than directed by your doctor.
Lifestyle & Tips
- Drink plenty of fluids (water, juice) to help thin mucus.
- Avoid irritants like smoke, dust, and pollutants.
- Use a humidifier to moisten the air.
- Do not use for persistent or chronic cough (e.g., with smoking, asthma, emphysema) or if cough is accompanied by excessive phlegm, unless directed by a doctor.
- Do not exceed recommended dose.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
200-400 mg every 4 hours as needed
Dose Range:
200 - 400 mg
Condition-Specific Dosing:
maximumDailyDose:
2400 mg/day
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established (generally not recommended under 2 years)
Child:
6 to under 12 years: 100-200 mg every 4 hours as needed (max 1200 mg/day); 2 to under 6 years: 50-100 mg every 4 hours as needed (max 600 mg/day). Not recommended for children under 2 years unless directed by a doctor.
Adolescent:
12 years and older: 200-400 mg every 4 hours as needed (max 2400 mg/day)
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed
Moderate:
No adjustment needed
Severe:
No adjustment needed
Dialysis:
No specific considerations; not significantly dialyzable
Hepatic Impairment:
Mild:
No adjustment
Moderate:
No adjustment
Severe:
No adjustment
Pharmacology
Mechanism of Action
Guaifenesin is an expectorant that works by increasing the volume and decreasing the viscosity of secretions in the trachea and bronchi. This facilitates the removal of tenacious mucus by ciliary action and coughing. It is thought to act by irritating the gastric vagal receptors, which then stimulate respiratory tract fluid secretion.
Pharmacokinetics
Absorption:
Bioavailability:
Not available (rapid and well absorbed)
Tmax:
Approximately 1-2 hours
FoodEffect:
Food may slightly delay absorption but does not significantly affect bioavailability.
Distribution:
Vd:
Not available
ProteinBinding:
Not available (low)
CnssPenetration:
Limited
Elimination:
HalfLife:
Approximately 1 hour
Clearance:
Not available
ExcretionRoute:
Renal (primarily as inactive metabolites)
Unchanged:
<1%
Pharmacodynamics
OnsetOfAction:
Within 30 minutes
PeakEffect:
Approximately 1-2 hours
DurationOfAction:
Approximately 4-6 hours
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor immediately or seek emergency medical attention:
* Signs of an allergic reaction, including:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Other Possible Side Effects
Like all medications, this drug can cause side effects. However, many people do not experience any side effects or only have mild ones. If you have any side effects that bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
This list does not include all possible side effects. If you have questions or concerns about side effects, discuss them with your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch. Your doctor can provide medical advice on managing side effects.
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor immediately or seek emergency medical attention:
* Signs of an allergic reaction, including:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Other Possible Side Effects
Like all medications, this drug can cause side effects. However, many people do not experience any side effects or only have mild ones. If you have any side effects that bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
This list does not include all possible side effects. If you have questions or concerns about side effects, discuss them with your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch. Your doctor can provide medical advice on managing side effects.
Seek Immediate Medical Attention If You Experience:
- Cough lasting more than 7 days or recurring
- Cough accompanied by fever, rash, or persistent headache
- Worsening symptoms
- Signs of allergic reaction (hives, difficulty breathing, swelling of face/lips/tongue/throat)
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
If you have a cough that produces a significant amount of mucus, a chronic cough caused by smoking or exposure to smoke, or lung conditions like asthma or emphysema.
This list is not exhaustive, and it is crucial to discuss all potential interactions with your doctor. To ensure your safety, tell your doctor and pharmacist about:
All medications you are taking, including prescription and over-the-counter drugs, natural products, and vitamins.
Any health problems you have, as they may affect the safety of taking this medication.
Before starting, stopping, or changing the dose of any medication, including this one, consult with your doctor to confirm it is safe to do so.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
If you have a cough that produces a significant amount of mucus, a chronic cough caused by smoking or exposure to smoke, or lung conditions like asthma or emphysema.
This list is not exhaustive, and it is crucial to discuss all potential interactions with your doctor. To ensure your safety, tell your doctor and pharmacist about:
All medications you are taking, including prescription and over-the-counter drugs, natural products, and vitamins.
Any health problems you have, as they may affect the safety of taking this medication.
Before starting, stopping, or changing the dose of any medication, including this one, consult with your doctor to confirm it is safe to do so.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
If you are following a low-sodium or sodium-free diet, consult your doctor before taking this drug, as some formulations may contain sodium.
Additionally, if you have phenylketonuria (PKU), discuss this with your doctor, as certain products may contain phenylalanine.
When considering administration to children, note that different brands of this medication may be approved for use in various age groups. Therefore, consult your doctor before giving this drug to a child to ensure the appropriate formulation and dosage are used.
If you are pregnant, planning to become pregnant, or are breastfeeding, inform your doctor. It is crucial to discuss the potential benefits and risks of this medication to both you and your baby to make an informed decision.
If you are following a low-sodium or sodium-free diet, consult your doctor before taking this drug, as some formulations may contain sodium.
Additionally, if you have phenylketonuria (PKU), discuss this with your doctor, as certain products may contain phenylalanine.
When considering administration to children, note that different brands of this medication may be approved for use in various age groups. Therefore, consult your doctor before giving this drug to a child to ensure the appropriate formulation and dosage are used.
If you are pregnant, planning to become pregnant, or are breastfeeding, inform your doctor. It is crucial to discuss the potential benefits and risks of this medication to both you and your baby to make an informed decision.
Overdose Information
Overdose Symptoms:
- Nausea
- Vomiting
- Dizziness
- Diarrhea
- Abdominal pain
- Kidney stones (with very high, prolonged doses)
What to Do:
Call 1-800-222-1222 (Poison Control Center) immediately or seek emergency medical attention.
Drug Interactions
Monitoring
Symptom Monitoring
- Cough frequency and intensity
- Sputum production and consistency
- Ease of breathing
- Signs of allergic reaction (rash, itching, swelling)
- Gastrointestinal upset (nausea, vomiting)
Special Patient Groups
Pregnancy
Guaifenesin is generally considered low risk for short-term use during pregnancy, but it is classified as Pregnancy Category C. Use only if clearly needed and the benefit outweighs the potential risk. Consult a healthcare provider.
Trimester-Specific Risks:
First Trimester:
Limited data, but generally considered low risk for malformations. Use with caution.
Second Trimester:
Generally considered low risk.
Third Trimester:
Generally considered low risk.
Lactation
Guaifenesin is considered L3 (moderately safe) during lactation. It is excreted into breast milk in small amounts. Monitor the infant for potential side effects like drowsiness or gastrointestinal upset. Use with caution and consult a healthcare provider.
Infant Risk:
Low to moderate risk; monitor for drowsiness or GI upset.
Pediatric Use
Not recommended for children under 2 years of age unless directed by a doctor. Dosing for children 2-12 years is weight/age-dependent and lower than adult doses. Always use pediatric formulations and measuring devices.
Geriatric Use
No specific dose adjustment is typically needed for elderly patients. However, elderly patients may be more sensitive to side effects or have underlying conditions that warrant caution. Advise caution with comorbidities and polypharmacy.
Clinical Information
Clinical Pearls
- Guaifenesin is most effective when taken with plenty of fluids to maximize its expectorant effect.
- It is an expectorant, not a cough suppressant. It helps you cough more productively, not less.
- Often combined with other ingredients (e.g., dextromethorphan for cough suppression, pseudoephedrine for decongestion) in OTC products; be aware of all active ingredients.
- Advise patients that if their cough persists for more than 7 days, worsens, or is accompanied by high fever, rash, or persistent headache, they should consult a healthcare provider.
Alternative Therapies
- Hydration (primary non-pharmacological intervention)
- Humidifiers/vaporizers
- Saline nasal sprays/washes
- Cough suppressants (e.g., dextromethorphan, codeine - for dry cough)
- Mucolytics (e.g., N-acetylcysteine - prescription, different mechanism)
Cost & Coverage
Average Cost:
Varies widely per bottle (e.g., 4 oz, 8 oz)
Generic Available:
Yes
Insurance Coverage:
OTC (Over-the-Counter) - generally not covered by prescription plans unless specifically prescribed or part of an FSA/HSA plan.
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.