From the Guidelines
To use lozenges effectively, place one lozenge in your mouth and allow it to dissolve slowly without chewing or swallowing it whole, as recommended by various studies including 1. When using lozenges, it is essential to follow the specific instructions on the package or from your healthcare provider.
- For sore throat lozenges like benzocaine (Cepacol) or menthol-based products (Halls, Ricola), let them dissolve completely to maximize contact time with irritated tissues.
- Zinc lozenges for cold symptoms should be started within 24 hours of symptom onset and taken every 2-4 hours while awake, as supported by studies such as [@98@] and [@99@].
- Nicotine lozenges for smoking cessation come in different strengths (typically 2mg or 4mg) and should be used according to a tapering schedule over 12 weeks. Lozenges work by slowly releasing active ingredients that coat the throat or are absorbed through the mouth's mucous membranes, providing targeted relief or medication delivery.
- Avoid drinking or eating for 15 minutes after using a lozenge to prevent washing away the active ingredients before they can work effectively, as suggested by various guidelines including 1. It is also important to note that lozenges may represent a choking hazard for young children, as mentioned in 1, and therefore should be used with caution in this population.
From the Research
Using Lozenges
To use lozenges effectively, consider the following points:
- Lozenges are a preferred oral dosage form due to their palatable means of drug administration and pharmaceutical applications 2
- They offer benefits to pediatric and geriatric patients, as well as people with gastro-intestinal tract problems, by providing a means to bypass the first-pass effect and increasing bioavailability for buccal or upper gastro-intestinal disorders 2
- Lozenges can be used to prevent postoperative sore throat in surgeries done under laryngeal mask airway insertion, with turmeric-based lozenges showing efficacy in reducing the incidence of postoperative sore throat 3
- Different types of lozenges are available, including lidocaine 8 mg sore throat lozenges, which have been shown to be superior to placebo in treating acute sore throat 4
- AMC/DCBA lozenges, containing Amylmetacresol and 2,4-Dichlorobenzylalcohol, have also been found to be effective in relieving pain associated with acute uncomplicated sore throat 5
- A triple active sore throat lozenge, containing tyrothricin, benzalkonium chloride, and benzocaine, has been shown to be effective in treating acute pharyngitis, providing rapid analgesic effect and relieving severe throat pain and difficulty in swallowing 6
Administration
When using lozenges, consider the following:
- Lozenges can be administered preoperatively to prevent postoperative sore throat 3
- They can be taken as needed, with a maximum number of lozenges per day, depending on the specific product and instructions 4, 5
- It is essential to follow the recommended dosage and administration instructions for each type of lozenge to ensure safe and effective use
Efficacy and Safety
The efficacy and safety of lozenges have been evaluated in various studies, including:
- A systematic review and meta-analysis of AMC/DCBA lozenges, which found them to be a safe treatment option for relieving pain in patients with uncomplicated sore throat 5
- A multi-centre, randomised, placebo-controlled trial of a triple active sore throat lozenge, which showed significant benefit over placebo in treating acute pharyngitis 6
- A study on lidocaine 8 mg sore throat lozenges, which found them to be superior to placebo in treating acute sore throat 4