4 Best throat numbing lozenges that work

For many customers, throat numbing lozenges are the first choice in the management of sore and irritated throat. Throat numbing lozenges contain a local anaesthetic which numbs the area and hence helps with pain and irritation. This post list all sore throat lozenges containing a local anaesthetic available in the UK. You may also be interested in a related post listing a variety of sore throat lozenges.

Can you buy throat numbing lozenges over the counter?

Sore throat lozenges, which contain a local anaesthetic as an active ingredient, are classified as pharmacy-only products (P). P products can only be purchased from the pharmacy counter and online chemists.   

What active ingredients can you find in throat numbing lozenges? 

Local anaesthetics are included in a few over the counter products, mainly to manage local conditions associated with pain. Lozenges and local anaesthetic mouth sprays are primarily used to reduce pain associated with sore throats. Other popular applications for local anaesthetics are skin numbing creams, normally used to numb the skin before injections, and oral gels to manage toothache pain, ulcers and teething in children.

Two local anaesthetics used in sore throat lozenges are:

• Lidocaine
• Benzocaine

Over the counter local anaesthetic lozenges usually come in combination with antiseptic agents to ‘fight the infection’ (a slightly over-advertised claim for antiseptics). The National Institute for Health and Care Excellence (NICE) states that it is not clear if products containing antiseptic and local anaesthetic help with the management of sore throats (NICE, 2018). However, I provided some evidence which proves otherwise.

Can anyone use throat numbing lozenges?

As with all pharmacy-only products, certain restrictions on supply may be in place. The main restriction on the use of local anaesthetic throat lozenges is minimum age and hypersensitivity to active ingredients (‘bad’ reaction to local anaesthetics like lidocaine or benzocaine) or other excipients present in the formulation. Details on age restriction are reviewed with each product in this post. For more information, please refer to the product information leaflet or speak to your pharmacist.

Popular throat numbing lozenges

1. Chloralieve sore throat lozenges

Dual-action Chloralieve lozenges ‘fight infection’ and numb the pain. Main active ingredients found in Chloralieve lozenges:

• amylmetacresol and 2, 4-dichlorobenzyl alcohol (AMC/DCBA) – antiseptic agents
• lidocaine, a local anaesthetic

Are Chloralieve lozenges effective in the management of sore throat?

Both amylmetacresol and 2, 4-dichlorobenzyl alcohol throat lozenges demonstrated effectiveness in relieving symptoms of a sore throat in a safe and fast manner (McNally et al., 2009). Additionally, both antiseptic agents showed to have local anaesthetic properties (NICE, 2009 ). When studied in laboratory experiments, AMC/DCBA reduced the total number of viruses (viral load) caused by the common cold (Del Mar et al., 2006).

Several clinical trials showed that lozenges containing AMC/DCBA provide pain relief and help with other symptoms associated with sore throats caused by upper respiratory infections, such as difficulty swallowing and throat numbness (McNally et al., 2009).

Additionally, lidocaine has also been proven to reduce pain caused by sore throats (Wonnemann et al., 2007).

Chloralieve lozenges are one of the best numbing lozenges supported with solid evidence supporting amylmetacresol and 2, 4-dichlorobenzyl alcohol and lidocaine effectiveness.  

Chloralieve lozenges – age restrictions

Children under 12 years of age should not use Chloralieve sore throat lozenges.

2. Covonia Medicated Sore Throat lozenges  

Covonia Medicated Sore Throat lozenges are pharmacy-only product containing a local anaesthetic – lidocaine and an antiseptic – chlorhexidine. Covonia sore throat lozenges come in a sugar-free formulation and are suitable for diabetic patients.

Described as dual-action medicated sore throat lozenges, Covonia sweets help with the pain (lidocaine) and help to ‘fight the infection’ with the addition of chlorhexidine – a disinfectant and antiseptic agent.

Are Covonia lozenges effective?

There is no specific research that demonstrates the effectiveness of chlorhexidine in the management of sore throats, although chlorhexidine is a well-known antiseptic agent. The benefits of a local anaesthetic and its effectiveness in pain control were previously discussed.

Covonia Lozenges – age restriction

Covonia Medicated can be used by children and adults over 12 years of age.

3. Difflam sore throat lozenges

So far, the Difflam brand has been primarily known for two of its main products, mouth spray (Difflam spray) and Difflam oral rinse, both of which contain benzydamine hydrochloride as an active ingredient.

Difflam lozenges are a pharmacy-only product that contains benzydamine hydrochloride. Difflam sore throat lozenges can be used to manage the pain and irritation of the throat and mouth.

Although benzydamine hydrochloride is classified as a Non-Steroidal Anti-Inflammatory Drug (NSAID, like ibuprofen or naproxen) which reduces inflammation (swelling), it also acts as a local anaesthetic to numb the throat and also helps with the pain.  

Treatment with Difflam lozenge should be limited to a maximum of 7 days.

Difflam lozenges – age restrictions

The minimum recommended age for use is 6 years of age.

Who should not use Difflam lozenges?

Some patients are asked to take caution when using Difflam lozenges, for example, people who were advised not to use NSAIDs due to underlying conditions, for example:

• Patients who are sensitive to NSAIDs or salicylic acid (use of Difflam lozenges is not advisable)
• Asthmatic patients due to possible increased risk of narrowing of the airways
• people with phenylketonuria
• patients with rare problems of fructose intolerance
• pregnant and breastfeeding women

Difflam lozenges come in different flavours:

• Lemon flavour
• Orange and honey
• Eucalyptus Flavour
• Mint flavour

Difflam lozenges are the only product (lozenges) used for throat and mouth irritation which contain benzydamine hydrochloride. Benzydamine hydrochloride is an effective agent which reduces inflammation and pain.

4. Dorithricin sore throat lozenges

Dorithricin numbing lozenges are not available in the UK; however, they can be purchased online from EU pharmacies. Dorithricin contains tyrothricin (the same antibiotic found in Tyrozets) alongside a combination of benzalkonium chloride (antiseptic) and benzocaine (local anaesthetic).

Dorithricin lozenges have an interesting combination of the active ingredient, the best when compared to throat numbing lozenges available in the UK.

A small study investigating Dorithricin lozenges in treating pharyngitis (inflammation of the pharynx and sore throat) showed significant benefits in patients who used Dorithricin. Dorithricin provides a fast pain relief effect, helping with severe throat pain and difficulty in swallowing (Palm et al., 2018).

What happened to Tyrozets?

Tyrozets used to be one of the most popular sore throat lozenges available from the pharmacy. Tyrozets contained benzocaine (a local anaesthetic) and tyrothricin (an antibiotic), a unique combination offered over the counter. Tyrozets were the only over the counter medicine in the UK, which contained active ingredient with antibiotic properties.

Tyrozets were discontinued due to the ‘overuse’ of antibiotics by the public to treat sore throat, which is mainly caused by viruses rather than bacteria. Read more about Tyrozets alternative sore throat lozenges. 

Other medicines for managing sore throat

• Local anaesthetic throat sprays, for example, Covonia throat spray, Ultra Chloraseptic and Difflam spray. Covonia and Ultra Chloraseptic spray combine local anaesthetic and antiseptic active ingredients.

• A local anaesthetic mouth rinse, for example, Difflam sore throat rinse, contains the same active ingredient as Difflam lozenges to relieve pain and inflammation.
• Use of simple anaelgesics such as paracetamol or ibuprofen.

Conclusion

Customers in the UK have the choice of a few local anaesthetic products for the symptomatic management of sore throats. It seems that Chloralieve lozenges have the most evidence behind the effectiveness of the active ingredients and potentially could be named the best throat numbing lozenges.

References

Del Mar CB, Glasziou PP, Spinks AB (2006). Antibiotics for sore throat. Cochrane Database Syst Rev 2006; 18 4:CD000023. Available at: https://doi.org/10.1002/14651858.CD000023.pub2 Accessed on 16/01/2023

McNally D, Simpson M, Morris C, Shephard A, Goulder M (2009). Rapid relief of acute sore throat with AMC/DCBA throat lozenges: randomised controlled trial. Int J Clin Pract. 2010 Jan;64(2):194-207. doi: 10.1111/j.1742-1241.2009.02230.x. Epub 2009 Oct 22. PMID: 19849767; PMCID: PMC7202229 Available at: https://doi.org/10.1111/j.1742-1241.2009.02230.x Accessed on 15/01/2023

NICE (2009). NICE guideline: respiratory tract infections? Antibiotic prescribing: prescribing antibiotics for self-limiting respiratory tract infections in adults and children in primary care. 2008; London, UK: NICE. Available at: http://www.nice.org.uk/nicemedia/pdf/CG69FullGuideline.pdf Accessed on 15/01/2023

Palm J, Fuchs K, Stammer H, Schumacher-Stimpfl A, Milde J; DoriPha investigators (2018). Efficacy and safety of a triple active sore throat lozenge in the treatment of patients with acute pharyngitis: Results of a multi-centre, randomised, placebo-controlled, double-blind, parallel-group trial (DoriPha). Int J Clin Pract. 2018;72(12):e13272. doi:10.1111/ijcp.13272 Available at: https://dx.doi.org/10.1111%2Fijcp.13272 Accessed on 15/01/2023

Wonnemann M, Helm I, Stauss-Grabo M, Röttger-Luer P, Tran CT, Canenbley R, Donath F, Nowak H, Schug BS, Blume HH (2007). Lidocaine 8 mg sore throat lozenges in the treatment of acute pharyngitis. A new therapeutic option investigated in comparison to placebo treatment. Arzneimittelforschung. 2007;57(11):689-97. doi: 10.1055/s-0031-1296669. PMID: 18193690. Available at: https://doi.org/10.1055/s-0031-1296669 Accessed on 16/01/2023