Over-the-Counter Medications for Sore Throat

First-Line OTC Analgesics

• Ibuprofen and paracetamol are both effective for reducing acute sore throat symptoms, with strong evidence supporting their use 2, 3
• The American College of Physicians recommends ibuprofen and paracetamol as first-line treatments for sore throat, with ibuprofen appearing to have slightly better efficacy than paracetamol for pain relief 2
• Both medications are considered safe when used according to directions, with ibuprofen being as well tolerated as paracetamol for short-term treatment of sore throat pain 2

Treatment Algorithm

• The European Society of Clinical Microbiology and Infectious Diseases recommends trying systemic analgesics, such as ibuprofen (preferred if no contraindications) or paracetamol, as the first step in treating sore throat 2
• The American Academy of Family Physicians suggests considering adjunctive therapy with topical treatments, such as local anesthetic sprays or lozenges, for additional symptom relief 1

Important Considerations and Pitfalls

• The Centers for Disease Control and Prevention advise against using local antibiotics or antiseptics for sore throat treatment due to the mainly viral origin of sore throats and lack of efficacy data 1
• The American College of Physicians recommends that corticosteroids not be routinely used for sore throat treatment in self-care settings, but may be considered in conjunction with antibiotic therapy for adults with severe presentations under medical supervision 1
• The National Institute of Allergy and Infectious Diseases states that zinc gluconate is not recommended for sore throat treatment due to conflicting efficacy results and increased adverse effects 1
• The American Academy of Family Physicians notes that there are no reliable data supporting the efficacy of alternative treatments, such as herbal remedies or acupuncture, for sore throat 1

Special Populations

• The American Academy of Pediatrics recommends that both ibuprofen and paracetamol are effective for sore throat symptoms in children, with no significant difference in analgesic efficacy or safety between the two 2