Most sore throats in adults are caused by a viral illness and will resolve on their own without antibiotics. Signs your sore throat is likely a viral pharyngitis (sore throat) are cough, stuffy or runny nose, and diarrhea. This means many of you will be managing your throat pain at home—so what should you take for pain relief?
Here are 10 things to know:
- NSAIDS (ibuprofen, Motrin, Advil, naproxen, Aleve), Tylenol (acetaminophen) and aspirin will all help to relieve throat pain within 1 – 2 hours, and will provide relief for several hours. In general, start with one of these three choices. Using these along with sprays or lozenges may provide the most effective symptom relief—but read on.
- What works the best? Data from randomized trials suggest that NSAIDs are more effective than acetaminophen (Tylenol) for relief of throat pain.
- Pill vs. lozenge/spray to start? Remember that the pill options listed above will also help for the fever and headache you may have with your sore throat, while lozenges and sprays will not. That’s a plus.
- Ok, so which NSAID and how much? Ibuprofen 200 – 400 mg every 6 – 8 hours is the place to start. Ibuprofen decreases acute sore throat pain by 32 to 80 percent in two to four hours. To sum it up, ibuprofen produces a significantly greater reduction in sore throat pain compared with acetaminophen. Winner.
- When should I use Tylenol over ibuprofen? Though ibuprofen works slightly better, acetaminophen should be your first choice if you have a history of gastroesophageal reflux disease (GERD), ulcers, or kidney disease. Acetaminophen 1000 mg decreases acute sore throat pain by approximately 50 percent after three hours. Remember, try not to go above 4000 mg a day of acetaminophen.
- If you choose aspirin, start with 325 mg for throat pain. Aspirin is effective sore throat relief from one through six hours after taking it. Upside is that studies show headaches and muscle aches/pains are also significantly reduced if you take aspirin for sore throat. Mind the gut here though.
- Topical treatments. There is no evidence that one particular lozenge or spray is better than another. While sprays or lozenges are quicker-acting than the oral meds listed above, they have a shorter duration of pain relief. Studies show that lozenges that need to be sucked achieve higher initial concentration in the mouth and throat—and have slower rates of clearance compared with throat sprays and gargles (they last longer). That’s a win for lozenges over sprays.
- What kind of lozenge should I try? Active ingredients to look for in lozenges include menthol (Halls, Cepacol), dyclonine (Sucrets) or benzocaine (Chloraseptic lozenges).
- Throat sprays. Over the counter throat sprays can provide rapid relief of sore throat pain. Chloraseptic is a common example which contains phenol. Ultra Chloraseptic anesthetic throat sprays available over the counter contain benzocaine. Data on the effectiveness of throat sprays are limited, but they are worth a try if you don’t like lozenges.
- Throat Coat tea. Available through Amazon and some pharmacies, Throat Coat tea was shown in a small study to significantly diminish sore throat pain compared with placebo 30 minutes after drinking it. Throat Coat is an herbal tea containing licorice root, elm inner bark, marshmallow root, and licorice root aqueous dry extract. Worth a try for sure.
When should I worry about strep throat and see a doctor?
You should go see your doc If you have a sore throat AND:
- Fever over 100.4°F
- Exudate (whitish or yellowish discharge) on tonsils
- Swollen lymph nodes in your neck