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Different Types of Guaifenesin and its Recently Changed Status with the FDA

Single-ingredient guaifenesin refers to a product where guaifenesin is the only active ingredient. This is the only guaifenesin recommend for the nonplus conditions. Guaifenesin that is combined with other ingredients whether in cough syrups or in pill form is not generally considered appropriate for our purposes.

Guaifenesin comes in two types, both of which are non-prescription, immediate-release, IR, and extended-release, ER guaifenesin. Immediate-release guaifenesin is also called QA, meaning quick acting and FA, fast acting. Immediate-release guaifenesin is also available as a liquid and is found in most grocery and drug stores. The liquid form frequently contains food coloring and sweeteners and is not recommended due to these additives. Guaifenesin contained in liquid cough and cold medications is not considered appropriate for treating the nonplus conditions due to the other ingredients. Extended-release guaifenesin is sometimes known by several other names: long-acting, LA, sustained-release, SR, and bi-layered.

The two different types of guaifenesin currently sold both work well when used for treating the nonplus conditions. However, if a person changes the type of guaifenesin they are using (from immediate release to extended release or vice versa) an adjustment in dose may be necessary to achieve the same level of symptomatic change. It is not unusual to require a slightly lower daily dose if one is using immediate-release when compared to extended-release. This means that if a person switches from extended-release to immediate-release the dose may need to be lowered. Conversely, an increased dose may be necessary if switching from immediate-release to extended-release. The difference in dose between the two often ranges from 20 % to 70%. However, a change in dose is not always required. If you change from one type to another, pay attention to your symptom changes and be prepared to alter your dose to achieve the ideal amount of symptomatic change as discussed in The Guaifenesin Guide, Chapter 8, Finding Your Dose.

Because of problems with the release rate of many brands of extended-release guaifenesin, the FDA has stopped all companies except one from selling extended-release guaifenesin. As of December 2003 the only single-ingredient extended-release guaifenesin available is a bi-layered guaifenesin that contains some immediate release guaifenesin also. This product is labeled as an extended-release guaifenesin and the above suggestions for extended-release still apply.

Even though all brands of guaifenesin currently available work consistently well, whether extended-release or immediate-release, you should be aware that many brands of extended-release guaifenesin sold prior to December of 2003 may not be effective. (1) This unfortunate problem has no doubt resulted in many people and physicians failing to get results when using it as a treatment for the nonplus conditions. If you were one of the people who used ER, SR or LA guaifenesin before December of 2003 and did not get the results you expected, I encourage you to give guaifenesin another try.

All legally manufactured single-ingredient guaifenesin now sold, whether immediate-release or extended-release is FDA approved. No approval has a higher status than another with regards to guaifenesin.(2)

  1. U. S. Food and Drug Administration News, 10-17-2003, ‘FDA Proposes Steps to Assure the Safety and Efficacy of Certain Currently Unapproved Medicines.’ Accessed 2004 July 20.
  2. Food and Drug Administration Center for Drug Evaluation and Research, Letter to Author, 8-27-04.

GET THE BOOK!  "Fibromyalgia, Chronic Fatigue & Irritable Bowel:  
Treating Symptoms Treating Cause
By Dr. Greg Penniston - Only $14.95

Dr. Penniston explains the different treatments that are commonly used and how the little known medication, guaifenesin, appears to treat the underlying cause in many people.  

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For international orders please call (520)745-8101 or email us.   © 2007 Dr. Gregory Penniston. All rights reserved. Statements on have not been evaluated by the Food and Drug Administration. This product and information is not intended to diagnosis, treat, prevent or cure any disease.

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