Guaifenesin is used to loosen secretions and phlegm (mucus) so as to make it easy for the patient to expectorate and clear the airways and the lungs.

Guaifenesin Uses:

• Cough (as an expectorant):

  • It is used to help thin bronchial secretions and phlegm (mucus) so as to make it easy for the patient to expectorate the secretions. It may partly act as an antitussive as well.

Guaifenesin Dose in Adults

Guaifenesin Dose in the treatment of Cough (as an expectorant):

• Granules:

  • 200 to 400 mg taken orally every four hours, as needed, up to a daily maximum of 2,400 mg.

• Extended-release tablets:

  • Up to 2,400 mg per day in doses of 600 mg to 1,200 mg taken twice daily or as needed.

• Immediate-release tablet:

  • 200 to 400 mg taken orally every four hours, as needed, up to a daily maximum of 2,400 mg.

• Liquid:

  • 200 to 400 mg taken orally every four hours as necessary, with a daily dose cap of 2,400 mg.

Guaifenesin Dose in Children

Note: OTC cough syrups should not be given to infants or children under the age of two, according to the American Association of Pediatricians. The AAP also advises using it with caution in children older than 2 years of age because to the serious and life-threatening side effects (and rarely death).

Guaifenesin Dose as an expectorant: 

Liquid:

• Children 2 years to <4 years:
  • As needed, take 50 to 100 mg orally every four hours.
  • Avoid exceeding six doses per day.
• Children 4 years to <6 years:
  • 50 to 100 mg taken orally as needed every four hours.
  • Avoid exceeding 6 doses per day.
• Children 6 years to <12 years:
  • 100 to 200 mg taken orally as needed every four hours.
  • Avoid exceeding six doses per day.
• Children ≥12 years and Adolescents:
  • 200 to 400 mg taken orally as needed every four hours.
  • Avoid exceeding 6 doses per day.

Granules:

• Children 4 years to <6 years:
  • 100 mg taken orally as needed every four hours.
  • Avoid exceeding six doses per day.
• Children 6 years to <12 years:
  • 100 to 200 mg taken orally as needed every four hours.
  • Avoid exceeding 6 doses per day.
• Children ≥12 years and Adolescents:
  • 200 to 400 mg taken orally as needed every four hours.
  • Avoid exceeding 6 doses per day.

• Immediate-release tablet:

  • Children 6 years to <12 years:
    • 200 mg orally every 4 hours as needed.
    • Avoid exceeding six doses per day.
  • Children ≥12 years and Adolescents:
    • 400 mg taken orally as needed every four hours.
    • Avoid exceeding 6 doses per day.

• Extended-release tablet:

  • Children ≥12 years and Adolescents:
    • As needed, take 600 mg to 1,200 mg twice daily orally.
    • Avoid exceeding 2 doses or 2,400 mg per day.

Pregnancy Category: B

• It is acceptable to use in normal doses as an OTC drug for cough or as an expectorant during pregnancy.
• Avoid alcohol-containing products during pregnancy. Experts recommend that alcohol be avoided in severe cases, unless there are enough symptoms to cause discomfort for the mother.

Use of Guaifenesin during breastfeeding

• It is not known whether it can be used in lactating mothers. Nursing women should avoid products containing alcohol.

Dose in Kidney disease:

There are no dosage adjustments provided in manufacturer's labeling.

Dose in Liver disease:

There are no dosage adjustments provided in manufacturer's labeling.

Side effects of Guaifenesin:

• Central Nervous System:

  • Dizziness
  • Drowsiness
  • Headache

• Dermatologic:

  • Skin Rash

• Endocrine & Metabolic:

  • Hypouricemia

• Gastrointestinal:

  • Nausea
  • Stomach Pain
  • Vomiting

Contraindications to Guaifenesin:

• OTC labeling: Avoid the use of extended-release tablets in children 12 years of age or younger.

Monitoring Parameters:

• None mentioned.
• Monitor for evidence of chest infection.
• Patients with underlying heart disease and chronic lung disease should seek expert opinion especially if there are concomitant symptoms like shortness of breath and fever.

How to administer Guaifenesin?

Oral:

• It is administered orally following meals with plenty of liquid or water.

Extended-release tablet:

• The extended-release tablets should be administered following meals without breaking, chewing, or crushing the tablets.

Granules:

• To avoid flavour, place the entire contents of the packet onto your tongue and swallow without chewing the grains.

Mechanism of action of Guaifenesin:

• It is used as a cough expectorant because it lowers the viscosity (phlegm) and increases the hydration of your respiratory tract.
• It can also be used as an antitussive to suppress the cough reflex in patients with upper respiratory tract infection (but not healthy subjects).
• It is unknown what the exact mechanism of antitussive action is. 
• It could have antitussive central effects, or suppress cough by increasing the volume of sputum.
• This acts as a barrier against tussive stimuli by covering hypersensitive respiratory epithelium.

Absorption:

• Well absorbed

Excretion:

• Urine

International Brand Names of Guaifenesin:

• Altarussin
• Bidex
• Buckleys Chest Congestion
• Diabetic Siltussin DAS-Na
• Diabetic Tussin
• Fenesin IR
• Geri-Tussin
• GoodSense Mucus Relief
• Iophen-NR
• Liquibid
• Liquituss GG
• Mucinex Chest Congestion Child
• Mucinex For Kids
• Mucinex Maximum Strength
• Mucinex
• Mucosa
• Mucus Relief Childrens
• Mucus Relief ER
• Mucus Relief
• Mucus-ER
• Organ-I NR
• Pharbinex
• Q-Tussin
• Refenesen 400
• Refenesen
• Robafen Mucus/Chest Congestion
• Robafen
• Robitussin Mucus+Chest Congest
• Scot-Tussin Expectorant
• Siltussin DAS
• Siltussin SA
• Tussin Mucus & Chest Congest
• Tussin
• Xpect
• Benylin Childrens Chesty Cough
• Borstol Linctus Orange Flavour
• Borstol Linctus Peppermint Flavour
• Breacol
• Bronchosedal Mucus
• Broncofenil
• Chamberlain`s Cough Remedy
• Codimal
• Cofen
• Coldrex Broncho
• Deflenol
• Desbly
• Dextricyl
• Excaugh
• Expelinct
• Fagusan N Losung
• Fenatussin
• Flemonex
• Formulaexpec
• Frispec
• Glyteol
• Guaiatussin
• Guajacuran
• Guajazyl
• Guaphan
• Gwajafen
• Iniston
• Kosorex
• Kosorex Strong
• Lemsip Chesty Cough
• Mucinex
• Numark Chesty Cough
• Pectal
• Pectal Expectorant
• Pharmachem
• Probat
• Relaxil-G
• Resyl
• Robitessin
• Robitussin
• Robitussin Chesty Cough
• Robitussin EX
• Robitussin Expectorant
• Robitussin Plain
• Sipla
• Suprekof
• Tintus
• Transpulmin G
• Vicks expectorant adulte
• Vicks Mucus Cough
• Vicks Vaposyrup
• Wick Formula 44 Plus L

Guaifenesin Brand Names in Pakistan: