What Medicine to Take for a Sore Throat

A sore throat can range from a mild tickle to severe pain that makes swallowing difficult. Most cases improve on their own in 5–7 days. The goal of treatment is to ease pain, reduce inflammation, and address any underlying cause. Below is a guide to common “sore throat medicine,” precautions, and when to seek medical help.

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1. General Self-Care Measures

Before turning to medications, try these simple steps:

• Stay hydrated: Drink plenty of water, herbal teas, or warm broths.
• Rest your voice: Avoid yelling or talking loudly when possible.
• Humidify the air: Use a cool-mist humidifier or inhale steam from a hot shower.
• Warm saltwater gargle: Mix ½ teaspoon of salt in 8 ounces of warm water; gargle 2–3 times daily.
• Soothe with honey: A teaspoon of honey (in tea or alone) can coat the throat.
• Avoid irritants: Tobacco smoke, strong fragrances, or dry, cold air can worsen symptoms.

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2. Over-the-Counter Pain Relievers

Acetaminophen (Paracetamol)

• Dose (Adults): 500–1,000 mg every 6 hours, not to exceed 3,000 mg in 24 hours.
• Pros: Relieves pain and fever.
• Cautions:
  • People with liver disease or heavy alcohol use should limit total dose to 2,000 mg/day or consult a doctor first (see EASL guidelines on liver disease management).
  • Check labels for combination products to avoid accidental overdose.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

• Examples: Ibuprofen, naproxen.
• Dose (Ibuprofen, Adults): 200–400 mg every 6–8 hours, not to exceed 1,200 mg/day without medical advice.
• Pros: Reduces inflammation, pain, and fever.
• Cautions:
  • May irritate the stomach lining—take with food.
  • Use with care if you have kidney problems, ulcers, or cardiovascular disease.
  • People with decompensated cirrhosis should get personalized advice (see EASL clinical practice guidelines).

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3. Local (Topical) Treatments

Throat Lozenges and Hard Candies

• Common active ingredients: Benzocaine, menthol, eucalyptus oil, dextromethorphan.
• How they help: Coat and numb the throat.
• Use: Suck one lozenge every 2–4 hours as needed.

Throat Sprays

• Ingredients: Phenol, benzocaine or lidocaine.
• Application: Spray directly onto the back of the throat 2–4 times/day.
• Note: Don’t exceed recommended sprays to avoid numbing your gag reflex.

Throat Gels and Pastilles

• Similar to sprays but in gel form (e.g., lidocaine gel).
• Pros: Longer-lasting relief in some patients.

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4. Corticosteroids for Severe Pain

A single dose of oral corticosteroid can speed pain relief for moderate–severe sore throat in adults.

• Evidence: Hayward et al. (BMJ 2009) found that one dose of dexamethasone reduced pain and improved swallowing by 24 hours.
• Typical dose: One 10 mg tablet of dexamethasone or equivalent.
• Use: Usually prescribed when pain is so intense you can’t swallow fluids or medications.
• Precautions:
  • Not for routine use—speak to your doctor first.
  • May raise blood sugar; avoid if you have uncontrolled diabetes.

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5. Antibiotics (Only If Bacterial)

Most sore throats are viral. Antibiotics help only if you have confirmed bacterial infection (e.g., strep throat).

• First-line agents:
  • Penicillin V or amoxicillin for 10 days.
  • If penicillin-allergic: a macrolide (e.g., azithromycin).
• When to test/treat:
  • Sudden onset of severe sore throat, fever >38 °C (100.4 °F), swollen lymph nodes, white patches on tonsils.
  • Positive rapid antigen detection or throat culture.
• Benefits: Prevent complications like rheumatic fever.
• Risks: Antibiotic resistance, side effects (diarrhea, rash).

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6. Special Considerations

• Children under 16:
  • Avoid aspirin—risk of Reye’s syndrome.
  • Doses of acetaminophen/ibuprofen must be weight-based.
• Pregnant or breastfeeding:
  • Acetaminophen is generally preferred.
  • NSAIDs are usually avoided in the third trimester.
• Chronic liver disease (cirrhosis, hepatitis):
  • Limit acetaminophen to 2,000 mg/day or consult a hepatologist (see Ziol et al. on noninvasive fibrosis assessment and EASL guidelines).
  • Use NSAIDs with caution—risk of kidney injury and gastrointestinal bleeding.
• Immune-compromised or severe illness:
  • Seek medical advice early; you may need prescription antiviral or antibiotic therapy.

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7. When to Seek Medical Attention

Most sore throats improve at home. However, contact a healthcare provider or go to urgent care if you experience:

• Difficulty breathing or noisy breathing (stridor).
• Drooling or inability to swallow any fluids.
• Severe neck stiffness or headache.
• High fever (>39 °C/102.2 °F) that doesn’t respond to acetaminophen/NSAIDs.
• Symptoms lasting more than 1 week without improvement.
• Signs of dehydration: dizzy light-headedness, very dry mouth, little/no urine.

Consider doing a free, online symptom check for sore throat to help guide your next steps.

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8. Summary of Sore Throat Medicines

Type	Examples	Pros	Key Caution
Acetaminophen	Tylenol (paracetamol)	Pain relief, fever control	Limit to 2–3 g/day; liver disease risks
NSAIDs	Ibuprofen, naproxen	Anti-inflammatory & analgesic	GI upset, kidney effects, heart disease
Throat lozenges/sprays	Benzocaine, menthol, phenol	Local numbing	Overuse can numb gag reflex or cause irritation
Corticosteroid (single-dose)	Dexamethasone	Fast relief for severe pain	Prescription only; blood sugar elevation
Antibiotics (if strep)	Penicillin, amoxicillin	Treats bacterial infection	Only with confirmed strep; risk of resistance

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9. Final Advice

• Always read and follow the label directions.
• Keep track of total daily doses to avoid overdose.
• If you have underlying health issues (liver disease, cirrhosis, diabetes, heart or kidney problems), consult a healthcare professional before starting new medications.
• Remember to speak to a doctor about anything that could be life threatening or serious.

By combining self-care with the right medicine, most sore throats will resolve quickly. If in doubt, seek professional advice to ensure safe and effective treatment.