Usage
Dichlorobenzyl alcohol is primarily prescribed for the symptomatic relief of mouth and throat infections, including sore throat. It is classified as an antiseptic. Its mechanism of action involves disrupting the cell walls of bacteria and fungi, leading to their destruction. It is often combined with amylmetacresol, which also possesses antiseptic properties, in lozenge formulations. Lidocaine, a local anesthetic, is sometimes added to these formulations to provide additional pain relief.
Alternate Names
The common alternate name for Dichlorobenzyl alcohol is 2,4-Dichlorobenzyl alcohol. It is often found in combination products, so the name alone may not be prominently featured. Brand names containing this ingredient may include Strepsils, Trosoothe Plus, Bactidol, and THROATSIL, though formulations vary by region and brand.
How It Works
Pharmacodynamics: Dichlorobenzyl alcohol exerts its antiseptic effects by disrupting the cell walls of bacteria and fungi. This leads to leakage of cellular contents and ultimately the death of the microorganisms. When combined with amylmetacresol, the two agents exhibit synergistic antiseptic activity. Lidocaine, when present in formulations, provides local anesthetic action by blocking sodium channels and inhibiting nerve impulse transmission.
Pharmacokinetics: Dichlorobenzyl alcohol is absorbed from the mucous membranes of the mouth and throat. It is metabolized by the liver to hippuric acid and excreted in the urine. Specific pharmacokinetic parameters such as half-life and bioavailability are not readily available. Lidocaine, if present, is also readily absorbed through mucous membranes, metabolized in the liver, and excreted in urine. The pharmacokinetics of amylmetacresol are less well-studied.
Mode of Action: Dichlorobenzyl alcohol disrupts cell wall integrity in bacteria and fungi, similar to other phenolic antiseptics. It does not appear to have specific receptor binding or enzyme inhibition properties. Lidocaine’s mode of action involves blocking voltage-gated sodium channels, preventing neuronal depolarization and thus blocking pain signal transmission.
Elimination Pathways: Dichlorobenzyl alcohol is primarily metabolized in the liver and subsequently excreted in the urine as hippuric acid.
Dosage
Standard Dosage
Special Cases:
- Elderly Patients: No dose adjustment is typically required.
- Patients with Renal Impairment: Dose adjustments may be needed. Consult current clinical guidelines and consider the patient’s glomerular filtration rate (GFR).
- Patients with Hepatic Dysfunction: Dose adjustments may be necessary. Monitor liver function tests and adjust dosing as needed.
- Patients with Comorbid Conditions: Use with caution in diabetic patients due to the sugar content of some lozenges. Consider sugar-free options.
Clinical Use Cases
The primary clinical use case for Dichlorobenzyl alcohol lozenges is symptomatic relief of mild mouth and throat infections. They are not indicated for intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations.
Dosage Adjustments
Dosage adjustments may be necessary in patients with renal or hepatic impairment. Consult clinical practice guidelines for appropriate adjustments based on specific organ function parameters.
Side Effects
Common Side Effects
Sore tongue or mouth, mild burning sensation, numbness in the mouth.
Rare but Serious Side Effects
Allergic reactions including rash, hives, and angioedema (swelling of the face, tongue, or throat). Difficulty breathing, bronchospasm.
Long-Term Effects
No specific long-term effects are associated with short-term use for throat infections. Prolonged use may increase the risk of oral thrush.
Adverse Drug Reactions (ADR)
Severe allergic reactions. Methemoglobinemia (though rare) has been reported with certain lozenge formulations containing other ingredients.
Contraindications
Hypersensitivity to dichlorobenzyl alcohol or any other components of the formulation. Age under 6 years. History of methemoglobinemia for some formulations containing additional ingredients.
Drug Interactions
Clinically significant drug interactions are not well-documented. However, inform patients to report all concurrent medications, including over-the-counter drugs and supplements, to their healthcare provider.
Pregnancy and Breastfeeding
Limited data are available on the use of dichlorobenzyl alcohol during pregnancy and breastfeeding. Consult clinical guidelines for the latest recommendations. If the benefits outweigh the risks, use with caution under medical supervision. Choose sugar-free lozenges if necessary during pregnancy.
Drug Profile Summary
- Mechanism of Action: Antiseptic, disrupts bacterial and fungal cell walls.
- Side Effects: Sore tongue/mouth, allergic reactions, numbness.
- Contraindications: Hypersensitivity, age under 6, certain formulations are contraindicated in methemoglobinemia.
- Drug Interactions: Limited data available, always inquire about other medications.
- Pregnancy & Breastfeeding: Limited data; use with caution if benefits outweigh risks.
- Dosage: One lozenge every 2-3 hours, maximum 8-12 lozenges/24 hours.
- Monitoring Parameters: Observe for improvement of symptoms, signs of allergic reaction.
Popular Combinations
Dichlorobenzyl alcohol is frequently combined with amylmetacresol for synergistic antiseptic action. Formulations may also include lidocaine hydrochloride for local anesthetic effect.
Precautions
- General Precautions: Screen for allergies, check for open sores in the mouth. If symptoms persist for more than 2-3 days, consult a physician.
- Specific Populations: Use with caution in pregnant or breastfeeding women. Not recommended for children under 6.
- Lifestyle Considerations: Excessive use can lead to gastrointestinal discomfort. Diabetic patients should consider sugar-free options.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Dichlorobenzyl Alcohol?
A: For adults and children over 6 years, dissolve one lozenge slowly in the mouth every 2-3 hours, not exceeding 8-12 lozenges in 24 hours. Not recommended for children under 6.
Q2: How does Dichlorobenzyl Alcohol work?
A: It acts as an antiseptic, disrupting the cell walls of bacteria and fungi.
Q3: What are the common side effects?
A: Common side effects include sore tongue/mouth and mild burning or numbness.
Q4: Is Dichlorobenzyl Alcohol safe during pregnancy?
A: Limited data are available. Consult clinical guidelines and use with caution if benefits outweigh risks.
Q5: Can Dichlorobenzyl Alcohol be used for children?
A: It is generally not recommended for children under 6 years old due to the choking risk of lozenges.
Q6: What should I do if my symptoms don’t improve?
A: If symptoms persist for more than 2-3 days, consult a doctor.
Q7: Are there any drug interactions I should be aware of?
A: Clinically significant interactions are not well-documented, but inform patients to always disclose all concurrent medications to their doctor.
Q8: Are there sugar-free options available?
A: Yes, some brands offer sugar-free formulations.
Q9: Can I chew the lozenge instead of dissolving it?
A: No, the lozenge should be dissolved slowly in the mouth for optimal effect.
Q10: How long should I use Dichlorobenzyl Alcohol lozenges?
A: Use for the shortest duration necessary to relieve symptoms. If symptoms persist beyond 2-3 days, consult a physician.
