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Cepacol

Ingredient: Benzocaine, menthol, dextromethorphan.

Dosage Form:

Sore Throat Lozenges: 15 mg benzocaine with menthol (3.6 mg in cherry, 2.5 mg in honey lemon, and 3.6 mg in sugar-free).

Sore Throat + Cough Lozenges: 7.5 mg benzocaine and 5 mg dextromethorphan HBr.

*Also available in an antibacterial mouth wash.

FDA Indication/Dosages:

To temporarily relieve sore throat pain, sore mouth, minor mouth irritation, and pain associated with canker sores: Slowly dissolve one lozenge in mouth. May repeat every 2 hours or as directed by a doctor or dentist.

To temporarily relieve occasional minor irritation, pain, sore mouth, and sore throat while controlling cough due to minor throat and bronchial irritation associated with a cold (Sore Throat + Cough Lozenges): For adults, dissolve 2 lozenges in mouth, one after the other, and repeat every 4 hours. Do not exceed 12 lozenges in any 24-hour period. For children 6-12, dissolve one lozenge in mouth every 4 hours, not to exceed 6 per 24 hours.

Pharmacology: Benzocaine is a local anesthetic structurally similar to procaine. It increases the threshold for electrical excitation in the nerve cell by decreasing the permeability of the cell membrane to sodium ions during depolarization. Prolonged use will decrease effectiveness. Menthol is a counterirritant at concentrations above 1%. When applied topically, it produces a sensation of coolness while depressing pain receptors. The coolness sensation may be followed by a feeling of warmth. Dextromethorphan is structurally similar to codeine and has equal antitussive properties without CNS effects or addiction. It depresses the cough reflex center in the medulla oblongota without depressing ciliary function. Its effects last for 5 or more hours.

Evaluation: A sore throat can be caused by bacterial or viral infection or by direct irritation such as dryness or cough. Sprays and lozenges are used to treat the symptoms and may mask the underlying cause. The patient should be advised to see a doctor promptly if the sore throat is accompanied by a fever, swelling, headache, nausea, or vomiting. There are three important factors to consider when treating coughs: the frequency of the cough; the congestion of the lower respiratory tract; and the ability to expectorate. Cough suppressants are used to decrease the frequency of coughing. They are not indicated in congested/productive coughs of low frequency. In fact, the productive cough is useful in removing debris and excess phlegm from the lower respiratory tract. Suppressants are indicated in coughs of high frequency, especially dry/hacking coughs.

Contraindications/Precautions: The presence of a sore throat may be an indication of a more severe condition. If accompanied or followed by a fever, difficulty in breathing, headache, nausea, or vomiting, stop use and consult a physician or dentist promptly. Do not use for more than 7 days unless directed to by a physician or dentist. Do not use in children under the age of 5 years unless directed to do so by a physician or dentist.

Adverse Effects: Rare beyond symptoms being treated.

Patient Consultation:

Ask the patient if they have a fever, headache, nausea, vomiting, or trouble breathing.

Do not exceed 18 lozenges per day for adults and 10 lozenges per day for children ages 6-12 years.

Do not use for more than 7 days or if condition worsens.

Allow lozenges to dissolve in mouth.

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