Usage
Benzydamine is a non-steroidal anti-inflammatory drug (NSAID) with local anesthetic and analgesic properties. It’s prescribed for the relief of pain and inflammation in the mouth and throat. This includes conditions such as:
- Sore throat (pharyngitis)
- Mouth ulcers (aphthous ulcers)
- Oral mucositis (inflammation of the mucous membranes lining the mouth) caused by radiation therapy
- Pain following dental surgery or tonsillectomy
- Trauma from nasogastric tubes
- Gingivitis
Its pharmacological classifications include: NSAID, analgesic, local anesthetic, anti-inflammatory.
Benzydamine works by stabilizing cell membranes and inhibiting prostaglandin synthesis, thus reducing inflammation and pain. It also has some local anesthetic action, further contributing to pain relief.
Alternate Names
Benzydamine Hydrochloride is also known as benzydamine HCl.
Brand names: Tantum, Difflam, Oroeze.
How It Works
Pharmacodynamics: Benzydamine acts locally to reduce inflammation and pain. It stabilizes cell membranes, reducing the release of inflammatory mediators. It inhibits prostaglandin synthesis, which plays a key role in inflammation and pain. It also exerts a local anesthetic effect.
Pharmacokinetics:
- Absorption: Benzydamine is absorbed through the oral mucosa when used as a mouthwash, spray, or lozenge. Systemic absorption is low after topical administration. Following oral administration, it is well-absorbed.
- Metabolism: Metabolized primarily in the liver.
- Elimination: Excreted primarily in the urine, with some elimination in the feces.
Mode of Action: Benzydamine’s primary mode of action involves the stabilization of cell membranes and the inhibition of prostaglandin synthesis. More specifically:
- It inhibits the enzyme cyclooxygenase (COX), which is involved in prostaglandin production.
- It may also interact with other inflammatory mediators.
- It has a local anesthetic effect, though the exact mechanism is not fully elucidated.
Elimination pathways: Benzydamine is primarily metabolized in the liver and excreted via the kidneys. Small amounts are excreted via feces.
Dosage
Standard Dosage
Adults:
- Mouthwash/Gargle: 15ml every 1.5 to 3 hours, as needed. Do not swallow.
- Spray (0.15%): 4-8 sprays every 1.5 to 3 hours, directed at the affected area.
- Spray (0.30%): 2-4 sprays every 1.5 to 3 hours, directed at the affected area.
- Lozenges: 1 lozenge dissolved slowly in the mouth every 1-2 hours as needed (maximum 12 lozenges/day) or 1 lozenge three times per day.
Children:
- Mouthwash/Gargle: Not recommended for children 12 years and under.
- Spray (0.15%):
- 6-12 years: 4 sprays every 1.5 to 3 hours.
- Under 6 years: 1 spray per 4kg body weight (max 4 sprays) every 1.5 to 3 hours.
- Spray (0.30%):
- 6-12 years: 2 sprays every 1.5-3 hours.
- Under 6 years (over 8kg): 1 spray per 8kg body weight (max 2 sprays) every 1.5 to 3 hours.
- Lozenges: Recommended for children over 6 years: 1 lozenge three times per day.
Special Cases:
- Elderly Patients: Generally, the standard adult dose is appropriate. However, careful monitoring is recommended.
- Patients with Renal Impairment: Caution is advised, and dose adjustments may be necessary.
- Patients with Hepatic Dysfunction: Caution is advised, and dose adjustments may be necessary.
- Patients with Comorbid Conditions: Consider individual patient factors and adjust dosage as needed.
Clinical Use Cases
Dosing for specific clinical situations follows the standard recommendations provided above. There are no special dose recommendations for intubation, surgical procedures, mechanical ventilation, intensive care unit (ICU) use, or emergency situations.
Dosage Adjustments
Dose adjustments may be necessary for patients with renal or hepatic impairment. Consult current guidelines and consider individual patient factors.
Side Effects
Common Side Effects
- Numbness or stinging sensation in the mouth or throat
- Dry mouth
- Nausea
- Vomiting
Rare but Serious Side Effects
- Allergic reactions (e.g., bronchospasm, skin rash, swelling)
Long-Term Effects
No specific long-term side effects have been identified.
Adverse Drug Reactions (ADR)
Clinically significant ADRs are rare but include allergic reactions and bronchospasm. These require immediate medical attention.
Contraindications
- Hypersensitivity to benzydamine or any of its components.
- Hypersensitivity to aspirin or other NSAIDs.
Drug Interactions
No clinically significant drug interactions have been definitively established. However, it’s always prudent to consider potential interactions, particularly with other NSAIDs or medications metabolized by the liver. Always check for potential interactions before co-prescribing.
Pregnancy and Breastfeeding
The safety of benzydamine during pregnancy has not been fully established. It is recommended to avoid use during pregnancy unless the potential benefit outweighs the risk.
While benzydamine may be excreted in breast milk, it is generally considered safe to use during breastfeeding. Use for the shortest duration necessary.
Drug Profile Summary
- Mechanism of Action: Local anesthetic and anti-inflammatory; reduces pain and inflammation by stabilizing cell membranes and inhibiting prostaglandin synthesis.
- Side Effects: Numbness, stinging/burning sensation, nausea, vomiting, dry mouth.
- Contraindications: Hypersensitivity to benzydamine or other NSAIDs.
- Drug Interactions: No clinically significant interactions identified.
- Pregnancy & Breastfeeding: Avoid during pregnancy unless clearly needed. Generally safe during breastfeeding.
- Dosage: See detailed dosage guidelines above.
- Monitoring Parameters: Observe for allergic reactions and local irritation.
Popular Combinations
Benzydamine is not typically used in combination with other drugs for its primary indications.
Precautions
- General Precautions: Screen patients for hypersensitivity to benzydamine or NSAIDs.
- Pregnant Women: Avoid use unless the benefit outweighs the risk.
- Breastfeeding Mothers: Use with caution and for the shortest duration necessary.
- Children & Elderly: Use age-appropriate formulations and dosages.
- Lifestyle Considerations: No specific lifestyle restrictions are associated with benzydamine use.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Benzydamine?
A: See the detailed dosage section above for specific dosages for adults, children, and various formulations.
Q2: How does Benzydamine work?
A: Benzydamine works by stabilizing cell membranes and inhibiting prostaglandin synthesis, reducing inflammation and pain. It also has local anesthetic properties.
Q3: What are the common side effects of Benzydamine?
A: Common side effects include numbness or stinging in the mouth or throat, dry mouth, nausea, and vomiting.
Q4: Is Benzydamine safe to use during pregnancy?
A: Benzydamine’s safety during pregnancy hasn’t been fully established. Use only if the potential benefit outweighs the risk.
Q5: Can I use Benzydamine while breastfeeding?
A: Generally considered safe to use while breastfeeding, but use for the shortest period necessary.
Q6: Are there any drug interactions with Benzydamine?
A: No clinically significant interactions have been definitively established. However, always check for potential interactions.
Q7: What should I do if a patient experiences an allergic reaction to Benzydamine?
A: Discontinue use immediately and provide appropriate medical care, which may include antihistamines, corticosteroids, or other supportive measures.
Q8: Can Benzydamine be used for long-term treatment?
A: Generally, Benzydamine is used for short-term treatment. Consult a healthcare professional for guidance on prolonged use.
Q9: What are the contraindications for Benzydamine use?
A: Known hypersensitivity to Benzydamine or other NSAIDs is a contraindication.
Q10: Is Benzydamine addictive?
A: No, Benzydamine is not considered addictive.
