angioedema, choking, man sticks out his tongue while coughing

One of the most popular cough medicines in pharmacies for over 100 years was terpin hydrate. It was an expectorant, meaning that it was prescribed by physicians to loosen mucus and ease congestion. It was derived from compounds found in plants like oregano, thyme and eucalyptus. It was also manufactured from oil of turpentine. This was obtained from the resin of pine trees and used to be applied topically to joints and muscles to ease pain and inflammation. Many readers who remember terpin hydrate want to know what happened to it and how to obtain it. One reader offered this:

What Happened to Terpin Hydrate?

Q. Most people think that the old-fashioned cough medicine terpin hydrate has been banned. That’s not true. Although it’s no longer kept in stock at pharmacies, it can be special ordered from a compounding pharmacy.

Four years ago I came down with a bad cold and wicked cough. I asked my doctor if he could write a prescription for terpin hydrate and was surprised that he was willing to do so. I contacted my local compounding pharmacy and they said they don’t carry it in stock but they would place a special order. They filled my prescription.

Last week I came down with another bad cold and was coughing constantly. I went back to my doctor, who asked if the terpin hydrate had worked. When I said yes, he rewrote the prescription and the pharmacy filled it. Within 48 hours it made a HUGE difference, instead of taking three weeks for the cough to run its course.

A. Terpin hydrate was a popular cough medicine in the early 1900s. By the late 1980s, however, the FDA found inadequate evidence to support continued sales.

Update from the FDA:

On April 1, 2016 the FDA stated:

“A number of active ingredients have been present in OTC drug products for various uses, as described below. However, based on evidence currently available, there are inadequate data to establish general recognition of the safety and effectiveness of these ingredients.”

Under the category of “Expectorant drug products” is “Terpin hydrate preparations.”

As a result of an FDA ruling terpin hydrate pretty much disappeared from pharmacy shelves in the 1980s. An FDA staffer confided to me decades ago that he personally used terpin hydrate and found it helpful. Nevertheless, the agency decided it was inappropriate for OTC cough and cold remedies. There just wasn’t adequate data demonstrating effectiveness. Apparently no drug company was willing to invest in new research.

We’re Left with Guaifenesin:

Pretty much the only expectorant left on pharmacy shelves was guaifenesin. It can be found in lots of cough and cold remedies. The independent Cochrane Collaboration reviews the evidence behind many drugs. In its analysis of OTC cough medicine (Cochrane Database of Systematic Reviews, Nov. 24, 2014) it reported:

“Three trials compared the expectorant guaifenesin with placebo; one indicated significant benefit, whereas the other two did not…There is no good evidence for or against the effectiveness of OTC medicines in acute cough.”

That’s hardly a ringing endorsement. One might go so far as to wonder how the FDA gave guaifenesin the green light if the data were equivocal.

Another article in the journal Respiratory Care (July, 2007) noted:

“Although expectorants, such as guaifenesin (eg, Robatussin or Mucinex), are sold over the counter, there is no evidence that they are effective for the therapy of any form of lung disease, and when administered in combination with a cough suppressant such as dextromethorphan (the “DM” in some medication names) there is a potential risk of increased airway obstruction.”

What About Terpin Hydrate?

As the reader reported, terpin hydrate disappeared from pharmacy shelves but compounding pharmacies may still make and dispense it. Many readers remember it to be quite helpful for calming a hard-to-treat cough.

Other comments from readers:

Emily shared this story:

“I used to carry Terpin Hydrate Elixir in my music bag and found it very helpful before voice lessons and singing engagements. It was available at the time at pharmacies w/o Rx (non-codeine), and 1 tsp in a glass of water, or even undiluted tasted like Cointreau (orange liqueur)! I hoarded the last bit when it became unavailable — I may even still have a bottle with dregs in it!”

Brian from the UK offers this:

“Terpin Hydrate and Codeine is still available from chemists [pharmacists] without prescription over here in England. Having had a deep chesty cough for the last fortnight, I found the terpin & codeine mixture was far more soothing, especially at night, than just codeine on its own. Apart from the physical sensation of cooling my throat and lungs I couldn’t really say if it was overly effective in producing anything more than short-term relief.

“The authorities must think that terpin does something, as the daily dosage for terpin & codeine is three eighths of the dosage of codeine on its own. So, effective or otherwise, I’m grateful that they haven’t yet banned it on this side of the water!”

What Else Can you Do for a Cough?

We are not big defenders of terpin hydrate. We agree with the folks at Cochrane that data are lacking to prove effectiveness. What we do like is thyme tea. We brew up a cup with half a teaspoon of dried thyme leaves from our kitchen spice rack. We let the thyme leaves steep for several minutes, remove and add a bit of honey. We find this old-fashioned cough remedy to be quite helpful.

If you would like to learn more about other ways to calm a cough we recommend our Guide to Colds, Coughs & the Flu. You will find other suggestions for kicking a cough.

Share your own experience with terpin hydrate, thyme or other remedies below in the comment section.

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  1. Patty
    Boise, ID
    Reply

    I was given terpin hydrate years ago and it worked amazingly well. I had had a horrid, hard cough that felt like a rock in my chest, and it broke it up right away. After that, I kept it in my med cabinet, but the last time I tried to find it, the pharmacist said he’d never heard of it.

  2. Danny J
    Indiana
    Reply

    As of 2018-NOT ONE Compound Pharmacy could get or Order the TH wC…the VA will NOT give anything with Codene anymore. I have had a Tickle with Congestion going on 5 Months now and my Doctor at the VA will give me Nothing to help- I am in the Process of changing Doctors-mine at the VA is a Woman and I cant understand most of what she says- a looser to me! Seems the VA is NOT giving the best Meds to the Vets YET- civilians can get another w/Codeine at most Hospitals- WHY ? The VA now has NOTHING with Codeine and IF you check the Definition of Turpin Hydrate w/Codeine it says- Stops the Tickle and breaks up Congestion and I, at 72 -know very well- it was the BEST one could get to STOP Congestion and that Nagging Tickle!

  3. Alice
    OR
    Reply

    I remember when you could purchase terpin hydrate with codeine, over the counter. I was really surprised the time I looked for it and had to ask the pharmacist. He said it was by prescription only. It’s all I remember ever having when growing up. I knew it worked and wanted it for my family. I think it was late 60’s or early 70’s. I have found the DM cough syurp works better than most available now.
    OH for the good old days.

    • Rainbo
      Indiana
      Reply

      I took Terpin hydrate from the mid 50’s thru he 80’s..I though my Parents were trying to kill me…couldn’t catch my breath…but it’s the BEST cough suppressant in the world! My 2 Sons (48 & 44 yrs old) swear by it also and wish they still had it at times now. If you can find some…guard it with your life!

  4. Tammy M
    RI
    Reply

    I grew up with my grandmother giving it to me every year when I got bronchitis or a cold. It cleared up in a day or two. As a am fighting these year’s bout and nothing works, i would love a dose of good old terpin hydrate w/ codeine.

  5. Mike
    Kentucky
    Reply

    Back in the eighties, I used to get bronchitis so badly that I was literally down on my hands and knees from coughing so hard. Terpin hydrate is the only thing I have ever found that is effective against bronchitis. I always held my nose while taking it because it tastes like week-old roadkill. If I could find it again, I would gladly pay a premium for it.

  6. JOAN
    NJ
    Reply

    Used terpin hydrate back in the 80’s. One teaspon at night calmed your cough. Always assumed it was banned due to it being so effective.

  7. Dean
    Tx
    Reply

    I ordered 1 kilo of Terpin Hydrate Powder from India a couple of weeks ago. It took 6 days to arrive. Just yesterday I mixed up 1000ml of Terpin Hydrate Cough Syrup without codeine. I used only 17gm of the powder, plus 95% Alcohol, Orasweet Simple Syrup, Orange Peel tincture, water & glycerin. I have been coughing since October…tried all guaifenesin products…young doctors today don’t know what ETH is (Elixir of Terpin Hydrate)….also known as “G.I. Gin” in the military.

    Happy to say my cough is subsiding rather quickly since I started taking my homemade ETH. If you want me to post more on this let me know…it took a month or more to find a reputable supplier of TH powder from India.

    • Kristy
      Peoria, Illinois
      Reply

      YES! Please share! I have been up and down sick since I received a flu shot in 11/2011 as advised by my Dr.

  8. Vickie
    Kentucky
    Reply

    In 1977 my daughter and I contracted tuberculosis. Both of us became active TB, the remainder of family were just listed as contacts. The only thing that helped the TB cough was Turpin Hydrate. I sure hated to see it go away, because I do have bronchitis now and I am sure it would help and not cause more damage like broken ribs from coughing

  9. yzoldowl
    Ohio
    Reply

    When I was a child, my grandfather gave me terpin hydrate for cough and cold. I continued to use it through my mid-30s. Now I miss it terribly! Guiafenisin does not work at all well and nauseates me. Yes, I know codeine is addictive. I was never addicted. I used it as necessary and no more. Now because young people are abusing drugs like these for some sort of silly “high” I can’t get it any more? Canada, maybe?

  10. Ralph
    Claymont, DE
    Reply

    I used terpin hydrate when I was a kid, and it worked GREAT.
    Now, I am a middle aged adult, and still have the phlegm/mucus issues, and nothing I use works as good.
    I think the brand was called ”Terpex”, and I remember a blue cross in the bottle….
    I will look for this , either here or overseas…….

  11. Maggie
    Thousand Oaks, Ca
    Reply

    Can anyone refer me to a compounding pharmacy that will make up a bottle of terpin hydrate? My local pharmacy can’t get hold of the ingredients. Any place in US or Canada or Mexico? I need it so badly. It is the only thing that works for me. I think I gave myself a hiatal hernia from coughing for 17 days. I’m on the mend now, but what about the next time? Help!

  12. Sandy
    Maine
    Reply

    Terpin hydrate was what my dad used in the Navy and he always had it on hand for me and my sibs when we had coughs. I was able to buy it from Michigan pharmacies until approximately 20 years ago. The last time I asked a pharmacist he told me that it was no longer available. Looking at the comments on this page I see that if I am persistent I can find it again. It always worked well and I actually got to like the taste!!

    • Bill
      Tucson
      Reply

      I, too, used Elixer of Terpin Hydrate when I was a Navy Hospital Corpsman in the early ‘60’s. It was very effective for cough.

  13. Adrienne
    Akron, OH
    Reply

    Started using turpin hydrate in the 60’s. I am a nurse. I have never found anything as effective for harsh coughs than turpin hydrate with codeine except for tessalon perles. Both are available with a prescription. You might have to use a compound pharmacy for the turpin hydrate with codeine though.

  14. Monica
    Michigan
    Reply

    I used terminal hydrate many years ago and it was the only medicine that worked to break up mucus in my chest. . Mucinex and Robitusson DM are no where near as effective. I have been unable to find terpin hydrate anywhere. I would love to have some

  15. Salty Doc
    California
    Reply

    SSKI (Saturated Solution of Potassium [chemical symbol”K”] Iodide is an ancient but effective expectorant. Its use was curtailed in past because it interfered with assays of thyroid function, but I suspect modern tests would obviate that objection.

  16. Rich
    New Mexico
    Reply

    I have found Terpin Hydrate to be extremely effective in knocking out a bad cough, additionally a beneficial side effect of easing the twitches and spasms of my Tourettes Syndrome

  17. Tony
    Victoria BC Canada
    Reply

    Used to be my favourite – partly because it was flavoured with orange essence instead of the nauseating artificial strawberry used in most mixtures these days. It tasted almost like Cointreau. Boots-UK and amazon.co.uk do not list it. I have found sites in India but somewhere closer to home (Canada) would be preferable. Buckley’s plus a couple of T1s (acetaminophen/paracetamol with codeine) makes an effective substitute but tastes AWFUL. Anyone had any luck ordering online recently (2017)?

  18. Jim K
    Brockton, MA
    Reply

    Terpin Hydrate with Codeine had a long history in my family. My grandparents kept a bottle pretty much as a tonic for any and all uses for us kids. They called it “Dr. Burack’s Medicine” and had a prescription written by said Dr. Burack….dated in the year 1925 !! I can remember at age 15 in 1960 bringing the now tattered piece of paper to the drug store more than once to refill it. I guess the medicine kept us kids cough-free, and more importantly quiet, when they needed us to be quiet.

  19. Marcie
    California
    Reply

    Turpin Hydrate is a wonder medicine for coughs. Guaifenesin in the other hand does not work!

  20. Sean
    Reply

    Super saturated potassium iodide (SSKI) is an expectorant. I asked my PCP at the VA for a prescription for my cough. She had to look it up. It was in the VA’s formulary and I was able to walk out with it that day.

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