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Things I Do But Should I: Post-Viral Cough

Vanessa Cardy, MD and Adrien Selim, MD
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Post-viral coughs are a common cause of visits to health care providers.  While there is little evidence to direct treatment, many recommend short acting beta agonists and inhaled corticosteroids. The study reviewed in this chapter shows the superiority of nebulized ipatropium and salbutamol in initial symptom improvement.

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Danielle K. -

possibly classify this under "things I do but should I" but I have been known to give a medrol dose pack for post viral coughs and have had decent success with this. anyone else?

Adrien Selim -

Hi Danielle,

We didn't come across any studies on systemic steroids in post-viral cough. But then again there's such little research out there on it.

James Copley -

There's actually a combined ipratropium bromide/salbutamol inhaler available in Canada, Combivent Respimat. I'll be giving it a try in the next post-viral cough I see. Anyone have any experience using this combination inhaler for post-viral cough?

Adrien Selim -

James, that's a great idea. I wonder what the cost difference is of the combined puffer vs each on their own.

James Copley -

Well, I can't tell you that, but I can tell you that the first patient I tried Combivent (ipratropium/salbutamol) on had to wait a few days for the pharmacy to get it in stock. Apparently it is used so infrequently, our pharmacies don't necessarily carry it.

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Sweat Puddled, Brains Muddled Full episode audio for MD edition 173:58 min - 82 MB - M4AHippo Primary Care RAP February 2017 Summary 316 KB - PDF