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. Bruce
    Richmond, VA
    Reply

    I have been hunting for a source for Terpin Hydrate (non codeine) for a few years now. That stuff always worked for me for years as a great expectorant. I can’t even find a compounding pharmacy that has it! Any recommendations where to get it?? Possibly import it???
    Thanks.

  2. Scotty
    Winston-Salem, NC
    Reply

    I have been on a quest to get Terpin Hydrate back in my medicine chest for years. I have even tried unsuccessfully to “import” it from Canada. Thought I hit a home run when my compounding Phamacist discovered he could get the ingredients to make it. However, unlike the Pharmacist at the beginning the above article, he “did the math” and figured out that it would cost him a major amount to buy the ingredients and he would have to charge me way more than anyone could afford to pay for a couple of bottles.

  3. Mrsb62
    Eloy, AZ
    Reply

    I understand when used properly Terpin hydrate with codeine did stop the cough and chest congestion. Let me tell you the other side of Terp. I hand the unfortunate task of having heroin addicts for parents. Although most of my childhood was in foster care, the time with my parents was spent every Saturday going from drug store to drug store from county to county in southern California loking for the cough syrup to replace the heroin. They both took a half a bottle several times a day so the need was great. They allowed my appendix to rupture when I was twelve rather than take me to the hospital. This was because the drug stores in the fifties and sixties were closed on Sundays. Not trying to bore you but there was a good reason to take it off the market. My mother died in 1965 at the age of 42

  4. joyce
    IL
    Reply

    In the early 70’s, I ordered drugs for an outpatient pharmacy and sometimes helped cashiering. I remembee this drug and hadn’t noticed that it disappeared from the shelves as I moved to an inpatient pharmacy.

    I thought that terpin hydrate with codeine was very helpful vs. guiafenesin with DM. Now in 2015 I was prescribed promethazine DM which had an ill effect that didn’t help serious coughing and sore abdominal muscles.

  5. Evelyn S
    North Carolina
    Reply

    Thank you for writing about terpin hydrate – made from oil of turpentine. It brought back memories of PineX along with a smile. It always tasted so terrible that just the threat of having to take it made us get over a cough within a day! Back in the mid-1960’s was when we had it and thru the years we occasionally have recalled it & wished it was still available.

  6. Sheila
    Reply

    I remember using this cough syrup up until the 1970’s, maybe the 80’s. Worked great.

    I want to ask about a treatment similar to Terpin hydrate: in the 1970’s, I had a serious case of walking pneumonia/pneumonia. My old timey doctor gave me a very painful injection of what I called a miracle. It reminded me of Terpin hydrate.

    The injection used a huge needle and big syringe. The injection was thick. It smelled, but I loved the scent. Right before he gave me my injection, he asked me to tell him, immediately, of what I tasted or smelled.

    Within seconds, I could taste, and smell, what tasted like a telephone pole that was freshly coated in creosote! It worked amazingly! It was like pulling a stopper from a bath tub drain. All that gunk seemed to drain from my sinuses and lungs. Doc said the med did have creosote or some thing like it! Years later, an osteopath gave me a shot that seemed similar. Wow.

  7. Bruce
    NC
    Reply

    I used Terpin Hydrate for many years when all you had to do was sign for it at the local pharmacy. When I was a medic in the 60’s we used it as well in our ER. During my many many years as a Physician Assistant I wish I had availability of that medication as it did work very well. Why the FDA chose to stop it makes one wonder. It would be nice to have it available again as you didn’t need a lot of it to have a reasonable effect.

  8. Brent
    NW IL
    Reply

    I definitely remember the old Creo-Turpin cough medicine, especially since my late grandpa had emphysema. There’s a wise man in Canada named Tony Pantalleresco, a veteran of the health food industry and he sometimes recommends turpentine. I would also recommend N-acetylcysteine to break up mucus, and I do use guaifenesin sometimes too. Will have to try the thyme and sage and oregano is also useful. Also you might want to check out the Smallflower site — it is a Chicago emporium which sells a lot of imported remedies. I would highly recommend it and they also have fun video reviews of products!

  9. Judy
    Eugene, Or
    Reply

    I have to laugh about the lady who says she still has some “dregs” left of terpin hydrate as I still have a half bottle of it on my kitchen shelf. It was the ” best ” for coughs and colds. I am glad to hear that you can still get it at a compounding pharmacy.

  10. Jackie
    Lake Geneva, Wi.
    Reply

    For a hacking dry cough I have used mullein tea. I picked the leaves from nature or my yard, using 3 or 4 leaves about 4 inches long. Boil or steep them in 2 cups hot water about 10 minutes and drink hot. Tastes a little like camomile and “green bean” water, sunny yellow.

    In a very short time the coughing subsides and the phlegm gets loose. It will let you finally get sleep. When I had a bookstore, I sometimes gave it to someone who was going to “cough up a lung”, If you have a hard painful cough this will calm it down fast. I even had customers knock on my door after closing, asking for little more so they could sleep.

    Mullein is a soft fuzzy leaf that grows wild in a lot of the U.S. I’m in Southeast Wisconsin. I have dug it out of the snow or even picked and dried in the Summer, keeping it in a ziploc. I’m told it was a Native American remedy, but it grows wild in Germany too. Mullein oil is used for earaches and that is available in health food stores.

  11. Andie W.
    W. Bloomfield, MI
    Reply

    I have a Question. Is Elixir Terpin Hydrate an NSAID?

  12. neva
    Texas
    Reply

    My memory of terpin hydrate was that it was nearly 100% alcohol…you could sip on all day and stay drunk!

  13. Stanley C Parks
    Washington
    Reply

    As a boy I worked in a compounding pharmacy back in 1939. It was by far the best and most effective cough syrup and each doctor wrote for a favorite. As a dentist 1950 to 1983 I used it personally and in my practice when a patient arrived coughing. I would give them a teaspoon of Elixir Terpin Hydrate with codeine, wait 20 minutes and proceed doing dental work with a patient that was not coughing in my face. Stanley c Parks DDS

  14. John
    Florida
    Reply

    Ask anyone who served in the armed forces in the 50’s or 60’s if GI Gin (Terpin Hydrate) was good to kill a cold. I couldn’t count the times I went to work with a bottle in my pocket.

  15. Victor K
    West Palm Beach, Fl.
    Reply

    Turpin hydrate was given to me when I was in the military service pneumonia ward and Japan surrendered in WW11. It was our toasting cocktail.

  16. ladyliza
    Los Angeles
    Reply

    My family uses mullein for a cough. But neither my husband nor I get sick anymore since we watch our vitamin D levels. My children however are another matter. Since they both work and go to grad school, they say they don’t have time to take pills. So they get colds and flu like anyone else. My son swears by mullein..56 drops in a couple of tablespoons of anything warm. We buy it on Amazon. My son came down with the flu last week. So he put 5 peeled cloves of garlic on a piece of bread and ate it. Then I gave him 4 drops of oil of oregano and the next morning his fever and aches and pains were gone. Both of those items are natural antibiotics. His flu is gone so now we treat the cold left behind.

  17. Robert
    Tarboro, NC
    Reply

    I remember a college fad of mixing it with gin. It was considered an excellent substitute for a “Tom Collins.”

  18. Jane O
    McKinney,Tx
    Reply

    I was prescribed Terpin-hydrate in the middle 60s when I was pregnant and had an uncontrollable cough. It worked.

  19. Betty
    Missouri City Tx
    Reply

    I remember my mother and grandmother preparing hot toddies from hot water, lemon juice, honey and a “splash” of whiskey. Sipping on the mixture seemed to relieve the cough and help with other cold symptoms.

  20. Ginny g.
    Raleigh
    Reply

    In the 60s we had a cough syrup called Brown’s Mixture and it tasted wonderful! Is this the same thing?

  21. Bella
    Reply

    I would buy it

  22. Rosie LaLonde
    Illinois
    Reply

    I have a clear memory of my mother using terpin hydrate for years. I always wondered why it had disappeared—-if it was determined to be dangerous or addicting. Unfortunately I have an asthma cough that comes and goes for various reasons even when not sick. I might need to try that or your thyme tea suggestion. I appreciate the information about it and all the information you provide each week!

  23. Stephanie
    Colorado
    Reply

    I do remember Terpin hydrate and codeine from my childhood, it was very effective and had a pleasant taste. Fast forward many years I came down with a terrible cough where I could not get any sleep and a friend suggested Mucinex. It was very effective for me as long as you drank all of the water they suggest. I was amazed. I am sure that if more folks asked their physicians for Turpin hydrate more pharmacies would carry it. Sometimes the old stuff is still the best stuff.

  24. Jack
    Florida
    Reply

    Regarding Terpin Hydrate & codeine – as a kid, and young man, I used it liberally & regularly for severe coughs, and found it helpful. A psychiatrist friend with whom I was working at the time noticed me adding a big dollop of it to my coffee one morning and opined that he was glad I was not his patient. Never used it when not pretty sick.

  25. Stan
    NC
    Reply

    As a youngster (1950’s & 60’s) we were always given Elixir Terpin Hydrate And Codeine for a bad cough. I always heard that they took it off the market because it had codeine in it.

  26. Jim
    Reply

    Many folks felt it was the high alcohol content of terpin hydrate that makes it a good expectroant , brandy and water works too.

  27. David, RPh
    Texas
    Reply

    Terpin Hydrate with Codeine was the victim of Big Brother. If it does no harm why not let those that think it works have it. Would any company study such a product for efficacy? Of course not. It is not economically feasible. As a pharmacist practicing in the early ’60s when there are repeated request for a product would you not have a clue that the patient was satisfied with that product. Oh, I see. Some non practicing gad fly like Sidney Wolfe (Ralph Nader’s hatch man under the guise of Public Citizen) decides what is best. Absolutely ridiculous. Terpin Hydrate with Codeine worked. Another example would be the demise of propoxyphene (Darvon) products. Sidney said they didn’t work so off the market they go only to be replaced by hydrocodone addictive products. A tremendous number of people certainly were prescribed and took those propoxyphene products. Were they really duped?

  28. Sara H
    Lackawanna, NY
    Reply

    I like sage leaf tea for cough. Learned of it from a docent at Mumford, NY who was talking about the Shaker herb garden.

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