What is the recommended dose and frequency of benzocaine (local anesthetic)/menthol (methyl salicylate)?

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Last updated: March 16, 2025View editorial policy

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From the FDA Drug Label

When using this product avoid contact with eyes do not exceed recommended dosage do not use for more than 7 days unless directed by a dentist or doctor The FDA drug label does not answer the question.

From the Research

Benzocaine and menthol are typically used together in over-the-counter products for temporary pain relief, with a recommended dose of 10-15 mg benzocaine and 2-10 mg menthol per lozenge or spray, used every 2 hours as needed, not exceeding 10 doses in 24 hours, as supported by the most recent study 1.

Key Considerations

  • The combination of benzocaine and menthol works through different mechanisms, with benzocaine blocking nerve signals as a local anesthetic and menthol creating a cooling sensation that distracts from pain.
  • For topical applications like creams or gels, products usually contain 5-20% benzocaine and 0.5-1% menthol, applied to the affected area 3-4 times daily.
  • It's essential to use these products only for short periods (generally less than 7 days) and discontinue use if irritation develops.
  • Children under 2 years should not use benzocaine products due to rare but serious risks of methemoglobinemia, a blood disorder, as highlighted in 2.
  • Pregnant women should consult healthcare providers before use, and anyone with allergies to either ingredient should avoid these products.

Efficacy and Safety

  • A recent study 1 demonstrated the efficacy and safety of a triple active sore throat lozenge containing benzocaine, showing a significant benefit over placebo in the treatment of acute pharyngitis.
  • Another study 3 compared the efficacy of 2% lignocaine and 20% benzocaine gels in reducing pain during administration of local anesthesia, finding that 20% benzocaine showed better results than 2% lignocaine in reducing needle insertion pain.

Important Warnings

  • Benzocaine products should be used with caution, especially in children and pregnant women, due to the risk of methemoglobinemia and other potential side effects.
  • Patients should be advised to follow the recommended dosage and frequency of use, and to discontinue use if any adverse effects occur.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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