The choice of Active Ingredients is determined by the cough type: dry (non-productive) or wet (productive). Dextromethorphan (DM) is the most widely used non-opioid antitussive for dry coughs. It acts centrally on the cough center in the brainstem, dulling the cough reflex signals. While structurally similar to codeine, DM works primarily through NMDA receptor antagonism and is highly effective for temporary relief of persistent, irritating coughs.

In contrast, Guaifenesin is the standard expectorant for wet coughs and chest congestion. Its primary mechanism is to thin and loosen bronchial secretions by increasing respiratory tract fluid volume, thereby facilitating the movement and clearance of phlegm. A major trend in the space is the move away from opioid-based antitussives like codeine due to safety concerns, particularly in children, making DM the dominant choice for suppression. Understanding the specific function of these two active agents is critical for patients seeking targeted relief.

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