Is Difflam (benzydamine) spray effective for relieving sore throat and mouth ulcer symptoms?

Effectiveness of Difflam (Benzydamine) Spray for Sore Throat and Mouth Ulcers

Yes, Difflam spray (benzydamine hydrochloride) is effective for relieving sore throat and mouth ulcer symptoms, with strong evidence supporting its use as an anti-inflammatory oral rinse or spray for pain relief in these conditions.

Mechanism of Action and Properties

Benzydamine hydrochloride (Difflam) works through multiple mechanisms:

• It is a topical non-steroidal anti-inflammatory drug (NSAID) with combined local anesthetic and analgesic properties 1
• Unlike other NSAIDs, it is a weak inhibitor of cyclooxygenase and works primarily through:
  • Membrane stabilization (providing local anesthesia)
  • Inhibition of pro-inflammatory cytokines
  • Anti-inflammatory effects 1
• It also possesses antimicrobial and antifungal properties that help reduce secondary infections 1

Evidence for Effectiveness in Sore Throat

The British Journal of Dermatology guidelines specifically recommend:

• Using an anti-inflammatory oral rinse or spray containing benzydamine hydrochloride every 3 hours, particularly before eating, for oral pain management 2
• This recommendation is made with level D evidence (good practice point) based on clinical experience

For general sore throat management, benzydamine is recognized as:

• The most suitable agent for topical treatment of sore throat symptoms according to surveys of healthcare professionals across multiple European countries 3
• Recommended by approximately 90% of pharmacists and prescribed by 80% of general practitioners for sore throat relief 3

Evidence for Effectiveness in Oral Mucositis

For oral mucositis (including mouth ulcers):

• The ESMO Clinical Practice Guidelines specifically recommend benzydamine mouthwash to prevent oral mucositis in patients with head and neck cancer receiving moderate dose radiation therapy (up to 50 Gy) 2
• This recommendation carries the highest level of evidence (Level I)
• NCCN guidelines note that "benzydamine also has some data supporting its use in an oral rinse for the prevention and treatment of mucositis" 2
• Research shows benzydamine is effective in delaying the development of severe mucositis and reducing pain intensity in patients undergoing radiotherapy 4

Dosage and Administration

According to the drug label:

• Adults and children: 5 to 10 drops orally, 3 times daily or as directed by a healthcare professional
• For children under 12 years, physician consultation is recommended 5

For optimal effectiveness in sore throat:

• Use every 3 hours, particularly before eating 2
• Can be used as a rinse or spray depending on the formulation

Advantages Over Other Treatments

Benzydamine offers several advantages over other topical treatments:

• Combined anti-inflammatory, analgesic, and local anesthetic effects in a single product
• Additional antimicrobial properties that help prevent secondary infections
• Well-tolerated with minimal side effects when used as directed 6
• Can be used as an alternative when pain is inadequately controlled with other measures 2

Limitations and Precautions

• Should not be used for more than 2 days without physician consultation
• Not recommended for children under 3 years unless directed by a physician
• May cause local numbness, burning, or stinging sensation in some patients 7
• If symptoms persist for more than 2 days, medical advice should be sought 5

Conclusion for Clinical Practice

When treating sore throat or mouth ulcers, benzydamine hydrochloride spray (Difflam) should be considered an effective first-line topical treatment, especially when pain relief is a priority. Its multiple mechanisms of action provide both symptom relief and potential reduction in inflammation, making it particularly valuable for managing these conditions.