Issue 505 – Sore Throat Relief? Try an Oral Spray!

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When faced with a sore throat due to a cold or painful mouth ulcers caused by enterovirus in children, oral sprays can help relieve pain and discomfort. But how do you choose the right product and use it properly? To address these questions, the Taiwan Food and Drug Administration (TFDA) has invited pharmacist Chien-Hung Kuo to explain in detail how to safely and effectively use oral sprays to relieve throat discomfort.

Choosing the Right Oral Spray: Look for a Valid Drug License Number First

According to pharmacist Kuo, oral sprays designed to relieve throat discomfort can be categorized into western medicines, traditional Chinese medicines, and health supplements.

• Western medicine-based oral sprays will carry a license number such as "衛署藥輸", "衛署藥製", "衛部藥製", or "衛部藥輸" (indicating import or domestic manufacture approved by the Ministry of Health and Welfare).
• Traditional Chinese medicine-based oral sprays will be labeled with "衛署成字".
• Health supplements are typically marked with the word “食品” (food) on the box.

Two Types of Western Oral Sprays

Western oral sprays can be further divided into two main types:

1. Non-steroidal anti-inflammatory and analgesic sprays – These usually contain Benzydamine, which provides pain relief and anti-inflammatory effects.
2. Antiseptic sprays – These contain Povidone-iodine, which kills bacteria, viruses, and other microorganisms.

Both types are used similarly: spray directly onto the inflamed area in the mouth for localized treatment. However, neither type should be used for more than 7 days.

⚠️Oral Sprays with Benzydamine: Not Recommended for Children Under 6

Pharmacist Kuo explains that Benzydamine provides anti-inflammatory, pain-relieving, and anesthetic effects, making it especially useful for children over 6 years old who have painful sore throats caused by conditions such as enterovirus and are unwilling to eat.

Benzydamine sprays commonly come in concentrations of 3mg/mL and 1.5mg/mL.

• For adults using the 3mg/mL spray: 2–3 sprays per dose, every 3–4 hours.
• For children aged 6–12: 1–2 sprays per dose.
• For the 1.5mg/mL spray: dosage may be increased based on advice from a doctor or pharmacist.

⚠️ Important: Oral sprays with Benzydamine should not be used in children under 6 years old due to insufficient safety data. Additionally, people with liver or kidney disease should consult a physician before use.

Povidone-Iodine Oral Sprays: Antiseptic but No Pain Relief

Povidone-iodine oral sprays are primarily used to kill bacteria and viruses, and can be used as supportive treatment for common colds, COVID-19, and other respiratory infections. However, they do not have anesthetic effects and cannot provide immediate pain relief.

Recommended dosage: 2–3 sprays per dose, every 3–4 hours.

⚠️ Not suitable for:

• Individuals with hyperthyroidism or thyroid disorders
• Children under 6 years old
• Pregnant and breastfeeding women, as povidone-iodine can pass through the placenta or breast milk and may cause temporary hypothyroidism in the fetus or infant.

Use One Spray Per Person to Prevent Infection Spread

Traditional Chinese medicine-based oral sprays are often derived from classic formulas like “Pu Ji Xiao Du San” and are commonly in powdered form. These may have fewer usage restrictions but should still be used only after consulting a physician or pharmacist, especially to determine suitability and correct usage.

Health supplement oral sprays, while not medicinal, can be used for daily care. However, users should not expect immediate therapeutic effects. Always read the label carefully to confirm suitability.

⚠️ Propolis-based products should not be used by:

• Children under 1 year old
• Individuals with impaired liver/kidney function
• Pregnant or breastfeeding women
• People allergic to honey or pollen

Replace Oral Spray 3 Months After Opening

Pharmacist Kuo advises that oral sprays should not be shared among family members, as sharing may lead to cross-infection of different viruses or pathogens. Store sprays in a cool, shaded place—refrigeration is unnecessary.

Discard oral sprays 3 months after opening. If the originally clear solution becomes cloudy, discontinue use. Keep the nozzle and spray tip clean to prevent blockage.

TFDA Reminder: Western and Chinese Oral Sprays Are Regulated Medicines

Both western and traditional Chinese medicine oral sprays are classified as prescription or over-the-counter drugs in Taiwan. They must be used according to physician or pharmacist guidance. Always read the product instructions thoroughly before use to ensure maximum safety and effectiveness.

Source: TFDA “Drug and Food Information Net” – https://article-consumer.fda.gov.tw/subject.aspx?subjectid=2&id=3710