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A tasty way to tackle that tickling pain
One of the few good things about having a sore throat is cough drops. They come in lots of fun flavors and range in style from classic cherry-flavored lozenges to herbal concoctions from Switzerland. What other malady allows you to suck on yummy little sweets that actually offer some medicinal benefit?
Most cough drops are safe enough to take on a temporary basis for as long as symptoms persist. But remember to keep these medicines away from children. Medicated over-the-counter drops and lozenges may contain cough suppressants known as antitussives, which act to inhibit coughing by relaxing the throat muscles. They also contain counterirritants and anesthetics to soothe sore throat pain.
Hey, was that a cough? Oh boy! Relief is coming in your favorite flavors.
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Soothing Relief in a Pleasant Form
- Throat lozenges containing cough suppressants should not be taken for more than one week. If coughing persists, see a doctor.
- If your cough is productive, leave it alone; that phlegm you're producing is helpful and shouldn't be suppressed.
- Cough drops and lozenges may contain counterirritants and topical anesthetics that can effectively soothe inflamed throat membranes.
- Sucking even non-medicated drops produces saliva, which is beneficial in soothing the throat.
- People with diseases such as asthma or emphysema should avoid using antitussives, since they need to be able to cough to keep their airways clear.
- Drinking plenty of water can help soothe a sore throat.
- Some cough drops and lozenges may also contain an antiseptic, which appears to be completely ineffective against viral sore throats, and not very effective against bacterial sore throats either.
Medicine, Not Candy
- Throat lozenges are formulated to feel cool and taste good, but their main purpose is to relieve the minor pain of a sore throat. Do not overuse them.
- A lozenge won't cure a sore throat or kill the bacterial or viral infection that caused it, but it will offer temporary relief.
- Seniors should avoid high doses or frequent use because they can't eliminate the drug from their body as easily as younger people.
- Do not use for children under age 2 without the advice of a physician.
- Pregnant or nursing women should consult their doctor before using this or any other medication.
- Another reason not to eat them like candy is cavities. Drops and lozenges are often flavored with sugar and will promote cavities.
- If possible, use sugar-free drops and lozenges.
Bacterial or Viral
Bacteria and viruses both cause sore throats, but you should be concerned when you have a bacterial sore throat. Streptococcal bacteria that cause strep throat, if left untreated, can, in extreme cases, lead to heart damage. So if you have a sore throat accompanied by fever lasting more than five to seven days, consult your physician.
Signs of a bacterial sore throat:
- The onset of pain is rapid.
- Pain is severe.
- Lymph nodes are swollen, large, and tender.
- There is a small likelihood that the infection involves the respiratory system.
Signs of a viral sore throat:
- It takes longer for you to feel pain than bacterial infection.
- Pain is less severe compared to a bacterial infection.
- There is increased likelihood that the infection involves the respiratory system.
- Lymph nodes are slightly swollen, but not painful to the touch.
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Counterirritant/antitussive
Cough suppressants that work by relaxing the smooth muscles in the throat and bronchial passages, which leads to a reduced urge to cough. Many lozenges contain antitussives. Even the act of sucking on lozenges may provide some pain relief because the production of saliva helps soothe an irritated throat.
Topical anesthetics
Components of some throat lozenges and cough drops that temporarily reduce sensation in the throat. They work by numbing any sensation to the applied area. When anesthetic ingredients are used in combination with analgesics, which provide pain relief, they are very effective in temporarily relieving the pain of sore throats.
| Counterirritant/Antitussive | Ingredient | Description |
|---|
| Menthol | | Safe and effective when taken as lozenges. Consult a physician before using on children under age 2. | | Topical Anesthetics | Ingredient | Description |
|---|
| Benzocaine | | Extremely safe. Provides relief in 30 to 60 seconds. | | Benzyl Alcohol | | No risk of central nervous system and cardiac complications associated with this drug. Less potent than benzocaine, but effective relief all the same. Consult a physician for use on children under age 2. | | Dyclonine | | Does not have the risk of convulsions and other central nervous system side effects associated with drugs ending in "-caine" (although not benzocaine). Relief will last more than an hour. Consult a physician for children under age 2. | | Hexylresorcinol | | Less irritating than phenol, but less potent than benzocaine and shorter-acting than dyclonine. Consult a physician before using on children under age 2. | | Phenol | | Fast, safe, and effective when taken in low doses. Toxic in higher doses. Consult a physician before using on children under age 2. | | Salicyl Alcohol | | Effective but short-acting anesthetic. Consult a physician before using on children under age 2. FDA approved, but not commonly found in nonprescription products. |
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FDA-Approved Uses
Counterirritant/antitussives
- Temporarily alleviates cough due to minor throat and bronchial irritation associated with a cold.
- Suppresses your cough to help you rest.
Topical anesthetics/counterirritants
- For the temporary relief of occasional minor irritation, pain, sore mouth, and sore throat.
Antiseptics
- First aid to help decrease the risk of infection in minor cuts, minor scrapes, and minor oral irritation caused by dental procedures, dentures, orthodontic appliances, or accidental injury.
Medicine, Not Candy- Although drops and lozenges taste sweet and feel soothing, they are medications and should not be consumed like candy.
- Watch how many drops or lozenges young children use.
Menthol Drops and Lozenges- Available in doses of up to 10 mg of menthol per lozenge.
- Allow lozenges to dissolve slowly in mouth.
- Lozenges may be used up to once every three to four hours as needed.
- Children under age 2 should not use menthol drops or lozenges except under the direction of a physician.
Benzocaine Lozenges- Available in doses of up 15 mg of benzocaine per lozenge.
- Allow lozenge to dissolve slowly in mouth.
- Lozenges may be used up to once every three to four hours as needed. Do not use longer than two days.
- Children ages 2 to 12 require adult supervision when using benzocaine lozenges.
- Children under age 2 should not use benzocaine lozenges except under the direction of a physician.
Dyclonine Lozenges- Available in doses of up to 3 mg of dyclonine per lozenge.
- Allow lozenge to dissolve slowly in mouth.
- Lozenges may be used up to once every three to four hours as needed.
- Children under age 2 should not use dyclonine lozenges except under the direction of a physician.
Phenol Lozenges- Available in doses of up to 50 mg of phenol per lozenge.
- Lozenges may be taken up to once every three to four hours as needed.
- Children ages 6 to 12 require adult supervision when using phenol lozenges.
- Children under age 6 should not use phenol lozenges except under the direction of a physician.
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Warnings
Counterirritants/Antitussives
Consult a physician before using or do not use if you have:
- Chronic cough due to asthma, emphysema, or smoking
- Cough with overproduction of mucus
Or if you:
- Have a cough for more than a week accompanied by fever, headache, or rash. These may be signs of a more serious infection. Consult a physician.
- Have cough symptoms that worsen. Consult a physician.
- Have a severe sore throat for more than two days that is accompanied by fever, headache, nausea, rash, or vomiting. These may be signs of a more serious infection. Consult a physician.
- Have a sore throat for more than seven days, or symptoms worsen. Consult a physician.
Antitussive
Consult a physician before using or do not use if you have:
- Asthma
- Chronic cough due to asthma, emphysema, or smoking
- Cough with overproduction of mucus
- High fever
- Liver impairment
- Persistent headache
- Rash
- Nausea or vomiting
Or if you:
- Are pregnant or nursing
- Are a senior; you may require a lower dosage
- Drive or operate machinery requiring alertness, dexterity, or quick reflexes
- Plan to use for an extended period of time or at a higher dose
Or if you are taking:
- Monoamine oxidase inhibitors (a class of antidepressants), such as:
- Phenelzine (Nardil): may cause serious central nervous system depression or excitation
- Tranylcypromine (Parnate): may cause serious central nervous system depression or excitation
Topical Anesthetics
Consult a physician before using or do not use if you have:- Allergy to sulfites (a possible component of the medication)
- Allergy to tartrazine (a possible component of the medication)
- Heart disease
- Liver impairment
- Methemoglobinemia
- Severe shock
Or if you:
- Are pregnant or nursing
- Are administering to a child under age 12
- Plan to eat food within one hour; there is an increased risk of choking.
Common Side Effects
Counterirritant/antitussive
Topical Anesthetic
Infrequent to Rare Side Effects
Counterirritant/Antitussive
- Abdominal discomfort
- Dizziness
- Nausea
- Vomiting
Topical Anesthetic
- Allergic reaction
- Throat burning, itching, or stinging
Effects of Overdose
Counterirritant/Antitussive
- Drowsiness
- Very slow breathing
Topical Anesthetic
- Excitation
- Low blood pressure
- Seizures
- Slow heartbeat
What to Do in Case of Overdose
Counterirritant/Antitussive
- It is unlikely that an overdose of this medication will cause life-threatening symptoms. If you are still concerned, please seek the advice of your health professional.
Topical Anesthetic
- If you suspect that you or someone you know has taken an overdose of this medication, immediately STOP USING THE MEDICATION and SEEK MEDICAL HELP.
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Websites, Organizations & Manufacturers
Sources & Further Reading
Government Sources
- 1. Food & Drug Administration. Federal Register 8/12/87.
- 2. Food & Drug Administration. Federal Register 6/3/94.
- 3. Food & Drug Administration. Federal Register 9/24/91.
- 4. Food & Drug Administration. Federal Register 5/13/92.
- 5. Food & Drug Administration.Colds and Flu: Time Only Sure Cure. FDA Consumer 2/98.
Books
- 1. Covington, TR et al. Handbook of Nonprescription Drugs, Eleventh Ed. American Pharmaceutical Assoc. Washington, DC 1996.
- 2. Kastrup EK et al. Drug Facts and Comparisons. Facts and Comparisons.
- 3. Inlander, CB and Slamans, S. The Over-the-Counter Doctor. Cader Books. New York, NY 1997.
- 4. Zimmerman, DR. Zimmerman's Complete Guide to Nonprescription Drugs, Second Ed. Gale Research, Inc. 1983.
- 5. Zimmerman, DR. Zimmerman's Complete Guide to Nonprescription Drugs, Second Ed. Gale Research, Inc. 1983.
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