What medications are used to treat throat pain?

Medications for Throat Pain

Non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol are the first-line treatments for throat pain, with ibuprofen showing slightly better efficacy than paracetamol for pain relief. 1, 2

First-Line Analgesics

• Ibuprofen (400mg) is the preferred first-line treatment for throat pain in adults, providing superior pain relief compared to paracetamol after 2 hours of administration 1, 3, 4
• Paracetamol (1000mg) is an effective alternative when NSAIDs are contraindicated 1, 2
• Both medications are considered safe when used according to directions for short-term treatment of sore throat pain 1, 2
• For children, both ibuprofen and paracetamol are effective with no significant difference in analgesic efficacy or safety between the two 1, 2

Topical Treatments

• Local anesthetics can be used as adjunctive therapy for additional symptom relief 2, 5
• Effective local anesthetics with confirmed efficacy include:
  • Lidocaine (8mg) lozenges/sprays 5
  • Benzocaine (8mg) lozenges/sprays 5
  • Ambroxol (20mg) lozenges/sprays (best documented benefit-risk profile among local anesthetics) 5
• Flurbiprofen lozenges (8.75mg) have shown efficacy in clinical trials for sore throat pain relief 1, 6
• Low-dose ibuprofen lozenges (25mg) provide rapid relief of sore throat pain and are well tolerated 6

Treatment Algorithm

1. Start with systemic analgesics:

   • First choice: Ibuprofen 400mg (adults) if no contraindications 1, 7
   • Alternative: Paracetamol 1000mg if NSAIDs are contraindicated 1, 2

2. Consider adding topical treatments for additional relief:

   • Local anesthetic lozenges/sprays (lidocaine, benzocaine, or ambroxol) 2, 5
   • Anti-inflammatory lozenges (flurbiprofen or ibuprofen) 1, 6

Important Considerations and Pitfalls

• Local antibiotics or antiseptics should not be recommended for sore throat treatment due to the mainly viral origin of sore throats and lack of efficacy data 2, 5
• Zinc gluconate is not recommended for sore throat treatment due to conflicting efficacy results and increased adverse effects 2, 3
• There is a lack of reliable data supporting the efficacy of alternative treatments such as herbal remedies or acupuncture for sore throat 2, 3
• In comparative studies, ibuprofen consistently shows better pain relief than paracetamol for sore throat, particularly after 2 hours of administration 4, 8
• For severe presentations of sore throat in adults, corticosteroids may be considered in conjunction with antibiotic therapy under medical supervision, but should not be routinely used for self-care 2, 3

Special Populations

• For children, both ibuprofen and paracetamol are effective for sore throat symptoms with no significant difference in analgesic efficacy or safety 1, 2
• In patients with contraindications to NSAIDs (such as gastric ulcers, renal impairment, or aspirin-sensitive asthma), paracetamol should be used as the first-line treatment 2, 3