Ibuprofen (generic Advil or Motrin)
Results from clinical trials suggest that non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are more effective than acetaminophen (Tylenol) at relieving throat pain. Start with 200-400 mg of ibuprofen every 6-8 hours. In studies, ibuprofen was found to reduce acute sore throat pain by 32% to 80% in as quickly as 2-4 hours.
Acetaminophen (generic Tylenol)
When should you choose acetaminophen (Tylenol) over ibuprofen? Acetaminophen rather than ibuprofen should be your first choice if you have a history of gastroesophageal reflux disease (GERD), ulcers, or kidney disease. In studies, 1000 mg of acetaminophen reduced acute sore throat pain by approximately 50% after 3 hours. Remember: Try not to go above 4000 mg a day as too much acetaminophen can be toxic to the liver.
If you choose aspirin, start with 325 mg for throat pain. Aspirin will start to provide pain relief from a sore throat within 1-6 hours after taking it. Studies show that aspirin not only helps with sore throat pain but significantly reduces headaches and muscle aches at the same time, too. Mind the gut here though; too much aspirin can be harmful to the stomach and esophagus.
About lozenges and sprays
Using a topical treatment (like a throat lozenge or spray) along with one of the over-the-counter medications above may be your best bet for throat pain relief. Topical treatments like lozenges and sprays can provide faster relief from throat pain compared to Advil, Tylenol, or aspirin, but these medications provide longer-lasting pain relief and will help for the fever and headache that often accompany a sore throat.
Lozenges may be better than sprays since the active ingredients in lozenges start out more concentrated in the mouth and throat compared to those in sprays—and lozenges last longer. When choosing a lozenge, look for menthol (which soothes the throat) and dyclonine or benzocaine (which numb the throat) in the active ingredients.
Research on the effectiveness of throat sprays is limited, but they may be worth a try if you really don’t like lozenges. Chloraseptic is a common recommendation; it contains phenol, which soothes pain and irritation. Ultra Chloraseptic Anesthetic Throat Spray is another option; it contains benzocaine (a numbing ingredient) and is available over the counter.
Tea can help soothe a sore throat—depending on which one you choose. Caffeine can dehydrate your body and make your sore throat worse, so you’ll want to stay away from caffeinated varieties. Instead, opt for a caffeine-free, herbal tea like Throat Coat tea (available online and in some pharmacies). Throat Coat tea contains licorice root, elm inner bark, marshmallow root, and licorice root aqueous dry extract, and was shown in a small study to relieve sore throat pain better than placebo. Worth a try for sure.
When should I see a doctor?
Most sore throats in adults are caused by viruses (not bacteria), which means they will likely resolve on their own without antibiotics. Signs your sore throat is viral include cough, stuffy or runny nose, and diarrhea. However, rarely, sore throats may be a sign of a more serious infection.
You should go see your doc if you have a sore throat and experience any of these symptoms:
- Fever over 100.4°F
- Exudate (whitish or yellowish discharge) on tonsils
- Swollen lymph nodes in your neck
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