What over-the-counter (OTC) medications can help alleviate sore throat symptoms?

Over-the-Counter Medications for Sore Throat

Ibuprofen or paracetamol (acetaminophen) are the recommended first-line over-the-counter medications for relieving acute sore throat symptoms. 1

First-Line OTC Analgesics

• Ibuprofen (NSAIDs) and paracetamol (acetaminophen) are both effective for reducing acute sore throat symptoms, with strong evidence supporting their use 1
• Ibuprofen appears to have slightly better efficacy than paracetamol for pain relief in sore throat, making it potentially the preferred option when not contraindicated 1, 2
• Both medications are considered safe when used according to directions, with ibuprofen being as well tolerated as paracetamol for short-term treatment of sore throat pain 1
• For optimal relief, these medications should be taken at regular intervals rather than as needed, which many patients don't realize 3

Dosing Recommendations

• For adults:
  • Ibuprofen: 400mg every 6-8 hours (not exceeding 1200mg in 24 hours) 4, 2
  • Paracetamol (acetaminophen): 650-1000mg every 4-6 hours (not exceeding 4000mg in 24 hours) 5, 2

Topical OTC Options

• Phenol-containing throat sprays (1.4%) act as local anesthetics/analgesics and can provide temporary relief of sore throat pain 6
• Benzocaine (8mg), lidocaine (8mg), and ambroxol (20mg) lozenges have demonstrated efficacy in clinical trials as local anesthetics 4
• Menthol-containing products may provide some analgesic effect through topical application 7
• Ibuprofen lozenges (25mg) have shown efficacy for sore throat pain relief with effects beginning within 15 minutes and can be used as an alternative to systemic medication 8

Treatment Algorithm

1. First step: Try systemic analgesics

   • Ibuprofen (preferred if no contraindications) 1, 2
   • Paracetamol (acetaminophen) as alternative 1

2. Adjunctive therapy: Consider adding topical treatments

   • Local anesthetic sprays or lozenges for additional symptom relief 6, 4
   • Can be used alongside systemic medications for enhanced effect 4

3. Duration of treatment:

   • Most sore throats are self-limiting with 82% of untreated patients becoming symptom-free within one week 9
   • Continue analgesics as needed for symptom control, typically 3-7 days 1, 9

Important Considerations and Pitfalls

• Common pitfall: Many patients do not use analgesics optimally before seeking medical care - they either don't take them at all or use inadequate dosing schedules 3
• Avoid local antibiotics or antiseptics: Due to the mainly viral origin of sore throats and lack of efficacy data, these should not be recommended for self-medication 4
• Corticosteroids: Not routinely recommended for sore throat treatment in self-care settings. Only consider in conjunction with antibiotic therapy for adults with severe presentations (3-4 Centor criteria) under medical supervision 1
• Alternative treatments: Zinc gluconate is not recommended for sore throat treatment due to conflicting efficacy results and increased adverse effects 1
• Herbal treatments: There are no reliable data supporting the efficacy of alternative treatments such as herbal remedies or acupuncture for sore throat 1

Special Populations

• Children: Both ibuprofen and paracetamol are effective for sore throat symptoms in children, with no significant difference in analgesic efficacy or safety between the two 1
• Pregnant women: Paracetamol is generally preferred over NSAIDs during pregnancy, especially in the third trimester 4
• Patients with comorbidities: Consider individual contraindications to NSAIDs (e.g., renal impairment, gastric ulcers, certain cardiovascular conditions) 4