Respitrol (CF)™

TCM empirical herbal formula for cough due to various causes — antitussive; expectorant; bronchodilating; antibiotic; antiallergic; releases wind from the exterior; eliminates phlegm; nourishes yin; descends Lung qi; may be used alone or combined with another formula

⚠️ Do NOT use an excessive amount of this formula — gross overdose of Ku Xing Ren (Semen Armeniacae Amarum) and Tian Zhu Zi (Fructus Nandina) may suppress respiration and cause difficulty breathing, as these herbs suppress the respiratory reflex in the brain. Other potential side effects from gross overdose include dizziness, weakness, nausea, vomiting, abdominal pain, burning sensations in the upper abdomen, increased blood pressure, and increased respiration. Use with caution for pediatric and geriatric patients. Contraindicated during pregnancy and nursing. Cough is a symptom with many causes — it is very important to identify and treat the underlying cause in addition to treating the symptom. In cases of lung infection, cough is a beneficial protective mechanism — suppressing the symptom without treating the cause may delay overall recovery; combine with additional formulas to treat the infection concurrently. ACE inhibitors (Capoten/captopril, Zestril/lisinopril, Vasotec/enalapril) may cause non-productive cough in up to 20% of patients — this drug-induced cough may begin as soon as one week after starting therapy or be delayed by up to six months; treat with Respitrol (CF) + Nourish (Fluids). Gastroesophageal reflux is a common and often overlooked cause of cough.

CLINICAL APPLICATIONS

* Cough

— with associated symptoms such as sputum, chest congestion, wheezing, and dyspnea

— from acute conditions such as common cold, influenza, and lung infection

— chronic cough induced by various conditions such as post-nasal drip, infection, drugs, and smoking

— cough in tuberculosis or lung cancer

Most effective when:

— The cause of the cough is not known or a specific treatment is not possible

— The cough performs no useful function or causes significant discomfort

— If the cause is known, this formula may be used as a useful adjunct to suppress cough

Background: Cough is an explosive expiratory maneuver intended to clear the airways. Acute cough is often caused by upper respiratory infection, post-nasal drip, pneumonia, or COPD exacerbation. Chronic cough is frequently due to postnasal drip, chronic bronchitis, airway hyper-responsiveness after resolution of an infection, or gastroesophageal reflux disease. Proper treatment requires accurate diagnosis and treatment of the cause plus management of the symptoms. Respitrol (CF) is an empirical formula designed to treat cough due to various causes — external (wind-cold or wind-heat) or internal (heat, phlegm, or yin deficiency).

Key herb-level clinical data:

— Ku Xing Ren (Semen Armeniacae Amarum / Bitter Apricot Kernel): suppresses cough via inhibitory effect on the respiratory center in the brain; descends Lung qi; marked antitussive effect

— Tian Zhu Zi (Fructus Nandina / Nandina): suppresses cough by causing Lung qi to descend; treats acute bronchitis, whooping cough, and cough in children

— Gan Cao (Radix et Rhizoma Glycyrrhizae): marked antitussive and expectorant effects via central nervous system; anti-inflammatory — reduces swelling and relieves chest congestion by stimulating production of glucocorticoids by the adrenal glands and delaying their metabolism by the liver

— Zi Su Ye (Folium Perillae / Perilla Leaf): releases wind-cold from the exterior; eliminates phlegm; stops coughing; promotes bronchodilation — relieves bronchospasm and reduces bronchial secretions; antiallergic — decreases mast cell and eosinophil infiltration, reduces histamine levels, inhibits IL-1β, IL-6, and TNF-α; treats post-nasal drip; antibacterial against Pseudomonas aeruginosa; antiviral

— Sheng Jiang (Rhizoma Zingiberis Recens / Fresh Ginger): releases wind-cold from the exterior; eliminates phlegm; stops coughing; antibacterial; antiviral

— Jie Zi (Semen Sinapis / Mustard Seed): eliminates phlegm; opens the airways; expectorant

— Mai Dong (Radix Ophiopogonis / Ophiopogon): nourishes yin; relieves chronic cough due to Lung deficiency; controls the warm dispersing and drying nature of the formula from consuming yin and fluids; antibacterial

— Wu Mei (Fructus Mume / Japanese Plum): astringes Lung qi; relieves cough; controls the warm dispersing nature of the formula; inhibits human influenza A virus in vitro

— Zi Su Zi (Fructus Perillae / Perilla Fruit): eliminates phlegm; descends Lung qi; relieves cough

WESTERN THERAPEUTIC ACTIONS

* Antitussive — Ku Xing Ren (respiratory center inhibition); Tian Zhu Zi (Lung qi descent, whooping cough, bronchitis); Gan Cao (CNS mechanism)

* Expectorant — Jie Zi (phlegm elimination, airway opening); Gan Cao (phlegm elimination, congestion relief)

* Bronchodilating — Zi Su Ye (bronchodilation, reduced bronchial secretions, bronchospasm relief)

* Antibiotic — Zi Su Ye (antibacterial, antiviral); Sheng Jiang (antibacterial, antiviral); Mai Dong (antibacterial); Wu Mei (antiviral — influenza A)

* Antiallergic / antihistamine — Zi Su Ye (mast cell↓, eosinophil↓, histamine↓, IL-1β↓, IL-6↓, TNF-α↓; dries nasal discharge; stops post-nasal drip)

CHINESE THERAPEUTIC ACTIONS

* Releases wind from the exterior (Zi Su Ye, Sheng Jiang)

* Eliminates phlegm (Zi Su Ye, Sheng Jiang, Jie Zi, Zi Su Zi)

* Descends Lung qi (Ku Xing Ren, Tian Zhu Zi, Zi Su Zi)

* Nourishes yin; astringes Lung qi (Mai Dong, Wu Mei)

* Harmonizes formula (Gan Cao)

DOSAGE

Standard: 4–6 capsules three times daily for adults. This is a potent formula — dosage must be carefully adjusted based on age, body weight, and severity of the condition, especially for pediatric and geriatric patients.

Supplementary formulas: Cough from common cold or influenza — use with Lonicera Complex. Cough from post-nasal drip — add Magnolia Clear Sinus or Pueraria Clear Sinus. Cough from lung infection (bronchitis or pneumonia) — use with Herbal ABX. Enhance antiviral function — add Herbal AVR. Cough with sore throat from sinus infection — add Herbal ENT. Cough from gastroesophageal reflux — combine with GI Care. Cough from airway hyper-responsiveness with dryness and yin deficiency — add Nourish (Fluids). Cough with chest congestion and profuse phlegm — use with Pinellia XPT. Underlying damp and phlegm with Spleen qi deficiency — add Pinellia Complex. Cough with wheezing and dyspnea from Lung heat — use with Respitrol (Heat). Cough with wheezing and dyspnea from Lung cold — use with Respitrol (Cold). Chronic cough with wheezing and dyspnea from Lung deficiency — use with Respitrol (Deficient) or Cordyceps 3. High fever — add Gardenia Complex. Cough from stress — add Calm. Immune deficiency — add Cordyceps 3 or Immune +.

Nutrition: Individuals with a poor swallowing reflex should consume food and beverages slowly — aspiration increases the risk of cough and lung infection. Pear, loquat, lemon with honey, pineapples, lotus nodes, and white radish are excellent foods to reduce frequency and severity of cough. White radish remedy: cut 1 fist-sized white radish into thin slices, mix with 1 tablespoon maltose and 1 cup water, cook 20 minutes, serve when cooled — or mix slices with honey, wait 30 minutes, and drink the secreted fluids. Fresh ginger and honey tea (1:4 ratio) relieves both acute and chronic cough. Avoid cold beverages — they may constrict the airways and induce cough. Avoid foods that are acrid, spicy, aromatic, or drying in nature; do not eat heavy, greasy, or deep-fried foods.

Tao of Nutrition (Dr. Maoshing Ni and Cathy McNease):

— Cough: Boil tea from watercress and apricot kernels (apex removed) or almonds — drink 1 cup 3x/day. Cook banana with a bit of sugar. Drink ginger tea. Mix honey with water and/or almonds. Dice carrots, mix with molasses, leave overnight — take 2 teaspoons 3x/day.

— Chronic cough: Make tea with ~20 grapefruit seeds and a bit of honey — drink 3x/day.

— Dry cough: Cook 4 grapefruit slices with pork or cabbage. Grind pine nuts and walnuts, add honey, slowly cook over low flame until thick — take 2 teaspoons with warm water. Mash strawberries with brown sugar, steam, and eat 3x/day.

— Dry cough with yellow sputum: Take warm daikon and water chestnut juice with 1 teaspoon honey.

— Productive cough: Juice raw turnip, mix with honey and warm water — drink 2–3 cups a day.

— Cough with yellow sputum: Drink apple juice.

— Cough with yellow phlegm: Core an Asian pear, fill with 3g Chuan Bei Mu (Bulbus Fritillariae Cirrhosae) and a little rock sugar or brown sugar — steam ~30 minutes and eat completely.

Lifestyle: Airway irritation from smoke, dust, and fumes is a very common cause of cough — avoid exposure to these environments as much as possible. If necessary, install an air filter to clean the air.

Related Reading

Also see: Lonicera Complex – for cough from cold/flu | Herbal ABX – for cough from lung infection | Herbal AVR – to enhance antiviral function | Herbal ENT – for cough with sore throat from sinus infection | Magnolia Clear Sinus – for cough from post-nasal drip (clear discharge) | Pueraria Clear Sinus – for cough from post-nasal drip (yellow discharge) | GI Care – for cough from acid reflux | Pinellia XPT – for cough with profuse phlegm | Pinellia Complex – for damp and phlegm with Spleen qi deficiency | Respitrol (Heat) – for cough with wheezing from Lung heat | Respitrol (Cold) – for cough with wheezing from Lung cold | Respitrol (Deficient) – for chronic cough from Lung deficiency | Cordyceps 3 – for Lung deficiency and immune support | Immune + – for immune deficiency | Gardenia Complex – for high fever | Nourish (Fluids) – for yin deficiency and ACE inhibitor cough | Respiratory Health & Lung Support Collection.