Mucinex vs. Bromelain

We have all seen the commercials for Mucinex: Mr. Mucus losing the battle to Mucinex, resulting in his eviction from the nose. Yes, this stuff really works, if used as directed, which is 2 pills, twice a day, with plenty of water.

Guaifenesin works by increasing the water content of your mucus, making it thin and easier to clear out. Mucinex contains time-released guaifenesin, so it only has to be taken every 12 hours. The generics also work, but not when taken twice a day. Walgreen's Mucus Relief contains immediate-release guaifenesin, and should be taken 1 pill every 4 hours. There's a big difference between remembering to take something twice a day vs. remembering to take something four times a day. Even though Mucinex is more expensive than the generic, it may be worth it if you can only remember to take a pill twice a day. Guaifenesin's main side effect is stomach upset.

For people who get stomach upset with guaifenesin, I often recommend bromelain. Bromelain is basically pineapple enzyme. You know how they say you can mix jell-o with fruit, as long as that fruit isn't pineapple? That's because the bromelain prevents the protein in the jell-o from setting, or clotting. Same thing with your mucus, which is partially made of protein. Bromelain prevents the mucus from getting thick and stuck.

The German Commission E, which is roughly Germany's Food & Drug Administration, has approved bromelain for "treatment of sinus and nasal swelling". The trick with bromelain is to take it an hour before you eat; otherwise it will simply digest the protein in the meal you just ate. Rather than milligrams, the potency of bromelain is measured in "GDU's", or gelatin-dissolving units. That makes sense, right, because bromelain works by digesting protein. Many of my patients have gotten some good quality bromelain at Whole Food's that worked well. Each capsule contains 2400 GDU's, and I recommended one capsule, one hour before breakfast, lunch, and dinner.

What's not worth the price? Mucinex Full Force nose spray, which contains the exact same oxymetazoline as Afrin or 4-Way nasal spray. But Afrin costs about 5 bucks, and Mucinex Full Force Nasal Spray is more than twice that. Meanwhile, generic Afrin can be had at Sam's Club, 3 double-size bottles for less than $5.00.

Note: Information contained in this article should not be considered a substitute for consultation with a board-certified allergist to address individual medical needs.