Usage
- Medical Conditions: Amylmetacresol combined with Dichlorobenzyl alcohol is prescribed for the symptomatic relief of mouth and throat infections, including sore throat (pharyngitis), and minor mouth infections. It is often used for the relief of discomfort associated with these conditions.
- Pharmacological Classification: Oral antiseptic, local anesthetic (when combined with Lidocaine).
- Mechanism of Action: Both Amylmetacresol and Dichlorobenzyl alcohol are mild antiseptics with antibacterial, antifungal, and limited antiviral properties. They work by killing bacteria, fungi, and some viruses associated with mouth and throat infections. The combination often exhibits synergistic antibacterial action. The lozenge format promotes localized action in the oropharynx and increases saliva production, which lubricates and soothes the throat.
Alternate Names
- No widely recognized alternate generic names.
- Brand Names: Strepsils (various formulations), Cepacol (some formulations), Difflam (some formulations), Trosoothe Plus (with Lidocaine), Neo-angin, Coldangin, Vocasept.
How It Works
- Pharmacodynamics: Amylmetacresol and Dichlorobenzyl alcohol exert a local antiseptic effect in the oropharynx. The combined action reduces throat soreness, provides pain relief, and eases swallowing difficulties within minutes of administration, with effects lasting up to two hours. This relief may be attributed to antiseptic activity and a potential interaction with sodium channels involved in pain signaling. When combined with lidocaine, the anesthetic effect is enhanced.
- Pharmacokinetics: Limited information is available on the pharmacokinetics of this combination. Administered as a lozenge, the drugs primarily exert their effects locally in the oral cavity and throat. Absorption into the systemic circulation is expected to be minimal. Metabolism and elimination pathways for Amylmetacresol are not well-characterized. Dichlorobenzyl alcohol is metabolized in the liver to hippuric acid and excreted in urine. Lidocaine, when present, is absorbed through mucous membranes, metabolized in the liver, and excreted in urine.
Dosage
Standard Dosage
Adults:
- One lozenge dissolved slowly in the mouth every 2-3 hours as needed.
- Maximum of 8-12 lozenges in 24 hours (depending on specific product formulation and local guidelines).
Children:
- Generally not recommended for children under 6 years old due to choking hazard.
- Children over 6: Follow adult dosage guidelines, but some formulations recommend a lower maximum daily dose (e.g., 4 lozenges in 24 hours). Always refer to product-specific information.
Special Cases:
- Elderly Patients: No specific dosage adjustments are typically required.
- Patients with Renal Impairment: No specific dosage adjustments are typically required, but caution is advised in severe impairment.
- Patients with Hepatic Dysfunction: No specific dosage adjustments are typically required, but caution is advised in severe impairment.
- Patients with Comorbid Conditions: Use with caution in patients with asthma, bronchospasm, or methemoglobinemia (especially when combined with lidocaine). For diabetic patients, consider sugar content of lozenges.
Clinical Use Cases
The provided sources do not mention dosage recommendations for these clinical settings. The primary use is for symptomatic relief of throat discomfort.
Dosage Adjustments
Dose modifications are not generally required based on renal or hepatic function but should be considered in cases of severe impairment.
Side Effects
Common Side Effects
- Mild burning or stinging sensation in the mouth or throat.
- Numbness of the tongue (especially with lidocaine-containing formulations).
- Allergic reactions (rash, itching, hives, swelling).
- Gastrointestinal discomfort (nausea, vomiting, diarrhea).
Rare but Serious Side Effects
- Difficulty breathing or swallowing.
- Severe allergic reactions (angioedema).
- Methemoglobinemia (rare, particularly with formulations containing lidocaine or prilocaine).
Long-Term Effects
No significant long-term adverse effects are known for short-term usage as directed. Prolonged use might lead to changes in oral flora or increase the risk of fungal infections.
Adverse Drug Reactions (ADR)
Severe allergic reactions (angioedema, anaphylaxis) require immediate medical attention. Methemoglobinemia, though rare, is a serious ADR associated with certain anesthetic combinations.
Contraindications
- Hypersensitivity to any of the ingredients.
- Age under 6 years (due to choking risk, some formulations may have higher age limits).
- Open sores or wounds in the mouth.
- Methemoglobinemia (for lidocaine-containing formulations).
Drug Interactions
- No clinically significant drug interactions are typically reported with Amylmetacresol and Dichlorobenzyl alcohol alone.
- Lidocaine, when present in formulations, may interact with beta-blockers, cimetidine, other local anesthetics, antiarrhythmic drugs (mexiletine, procainamide), certain antibiotics (erythromycin), and antifungals (itraconazole).
Pregnancy and Breastfeeding
- Pregnancy: Use with caution. Consult a doctor before use. Limited data available, potential risk to the fetus cannot be excluded.
- Breastfeeding: Consult a doctor before use. It is unknown whether these drugs are excreted in breast milk.
Drug Profile Summary
- Mechanism of Action: Local antiseptic and analgesic (if lidocaine is present).
- Side Effects: Burning sensation, numbness, allergic reactions.
- Contraindications: Hypersensitivity, age under 6, open mouth sores.
- Drug Interactions: Limited interactions reported, Lidocaine interactions possible.
- Pregnancy & Breastfeeding: Use with caution, consult a doctor.
- Dosage: One lozenge every 2-3 hours, max 8-12/24 hours.
- Monitoring Parameters: Observe for allergic reactions, resolution of symptoms, and (for lidocaine formulations) methemoglobinemia.
Popular Combinations
- Amylmetacresol + Dichlorobenzyl Alcohol + Menthol (for cooling effect)
- Amylmetacresol + Dichlorobenzyl Alcohol + Lidocaine (for enhanced pain relief)
Precautions
- Discontinue use and consult a doctor if symptoms worsen or persist after 3 days.
- Not recommended for continuous or prolonged use.
- Diabetic patients should consider sugar content of some formulations.
- May cause temporary numbness, affecting eating/drinking.
FAQs (Frequently Asked Questions)
A: One lozenge every 2-3 hours, as needed, not exceeding 8-12 lozenges in 24 hours for adults. Children over 6 may generally follow adult dosage, but some formulations recommend lower maximum daily doses. Not suitable for children under 6.
Q2: How does this combination work to relieve a sore throat?
A: It acts locally as an antiseptic, killing bacteria and some viruses responsible for throat infections. It also has a soothing effect on the throat lining and promotes saliva production for lubrication.
Q3: Can I use this while pregnant or breastfeeding?
A: Consult a doctor before use during pregnancy or breastfeeding, as safety has not been fully established.
Q4: Are there any drug interactions I should be aware of?
A: Amylmetacresol and Dichlorobenzyl Alcohol have limited known drug interactions. However, formulations containing lidocaine can interact with other medications. Consult your doctor or pharmacist if you are taking other medications.
Q5: What should I do if my sore throat doesn’t improve?
A: If symptoms persist or worsen after 3 days, consult a doctor. This combination is intended for short-term symptomatic relief.
Q6: Can children use these lozenges?
A: Generally not recommended for children under 6 due to choking risk. Some formulations may have higher age limits. Follow product-specific instructions and consult a doctor if needed.
Q7: What are the common side effects?
A: Common side effects include mild burning or stinging in the mouth, numbness of the tongue (especially with lidocaine), and allergic reactions.
Q8: Are there sugar-free options available?
A: Yes, several sugar-free formulations are available. Check the product packaging.
Q9: Can I use these lozenges for other mouth infections?
A: While primarily indicated for sore throat, they can also be used for other minor mouth infections, providing symptomatic relief. However, it is always best to consult a doctor for persistent or severe infections.
Q10: Is it safe to take more lozenges than the recommended dose for faster relief?
A: No, exceeding the recommended dosage can lead to overdose symptoms, potentially affecting the heart and nervous system. Follow the instructions carefully and do not exceed the recommended daily limit.
