How Do Cough Drops Work?

Cough drops might not be as effective at stopping coughs as once thought. While they can help soothe throat irritation, they’re not much better than hard candy when it comes to cough relief. Although cough drop ingredients like menthol are meant to ease discomfort, some research suggests ingesting too much menthol in cough drops might actually make coughing worse.

If you find cough drops helpful, there’s no need to stop using them altogether. Just keep in mind that they’re designed to be sucked on, not chewed or swallowed, which allows the ingredients to dissolve slowly for extended relief. Chewing or swallowing cough drops reduces their effectiveness and poses a choking hazard.

How Do Cough Drops Stop Coughing?

Cough drops are meant to:

• Soothe the throat: Cough drops contain ingredients like menthol, honey, and glycerin that moisturize the throat and provide a soothing, protective layer.
• Loosen mucus: Some cough drops contain expectorants like guaifenesin, which help thin and loosen mucus, making it easier to expel from the airways.
• Reduce cough reflex: By reducing irritation, cough drops are supposed to reduce the cough reflex, which helps expel irritants from the airways. Ingredients like menthol and eucalyptus also provide cooling and numbing effects to ease this reflex.

Do Cough Drops Really Help?

Research shows that most cough drops have no effect on the cough reflex, and are likely no better than hard candy for relieving cough. Furthermore, there is increasing evidence that cough drops—particularly menthol cough drops—might do more harm than good.

A 2018 review of 548 surveys found that cough drop use was significantly associated with longer cough duration. Interestingly, nearly 90% of the people who used cough drops were taking ones that contained menthol.

The review also found that the severity of coughing was closely related to the amount of menthol in the cough drop. Overall, cough severity and duration appeared to be negatively influenced by the use of menthol cough drops.

Menthol may provide a cooling and mild numbing sensation that eases pain. But these effects are temporary, and won't help your cough in the long term.

If you have a sore, dry throat, cough drops may help alleviate dryness and discomfort. Common ingredients like honey, aloe vera, and glycerin can help moisturize dry throat tissues. While medicated cough drops, like those containing guaifenesin, may help loosen mucus in the throat so that your body can expel it by coughing.

Keep in mind that coughing is your body's way of expelling irritants. So, if the cough appears to be getting better on its own and isn't causing you pain, it may be more beneficial to let your body carry out this natural process.

Do Cough Drops Work If You Chew Them?

Cough drops are specially designed to be sucked on. This allows the cough drop to gradually dissolve in the mouth, allowing its ingredients to coat the throat over an extended period of time.

Chewing a cough drop causes it to break apart faster, and its ingredients to bypass the throat tissues faster as well. This doesn't mean it will work faster; it means it won't be as effective.

Swallowing a cough drop whole is not recommended, either. Cough drops and hard candies are among the top causes of choking emergencies. Swallowing a cough drop gives it no time to coat and soothe your throat.

If you accidentally swallowed a cough, don't fret. The quick release of active ingredients from one cough drop in your stomach won't put you at risk for overdose. You would need to consume much more than that for this to happen.

Can Too Many Cough Drops Be Harmful?

Too many cough drops can be harmful. Although it's exceptionally rare, certain active ingredients in cough drops, including menthol and the anesthetic drug benzocaine, can cause overdose when eaten in excessive or highly concentrated amounts.

The lethal dose of menthol is said to be about 50 to 150 milligrams (mg) of menthol per kilogram (kg) of body weight. A single cough drop contains between five to 10 mg of menthol. That means a person who weighs 175 pounds (79.5 kg) would need to ingest 397 to 7,950 cough drops containing 10 mg each to overdose.

Ingesting excessive amounts of benzocaine can also lead to serious health issues, including a life-threatening blood disorder called methemoglobinemia, in which the blood can't carry oxygen effectively. According to the FDA, oral products containing benzocaine "carry serious risks and provide little to no benefits for treating oral pain."

Most cases of benzocaine-induced methemoglobinemia occur in children younger than 18. However, benzocaine-induced methemoglobinemia has been reported in adults as well.

Symptoms of methemoglobinemia can occur with doses as low as five grams of benzocaine, but most cough drops contain less than 15 mg per drop. You'd likely need to consume several hundred drops to experience symptoms, though individual sensitivity can vary.

Which Cough Drops Are Most Effective?

Some of the most popular cough drops include:

• Halls Relief with 5.4 mg of menthol per drop
• Cepacol InstaMax with 15 mg of benzocaine and 20 mg of menthol per drop
• Ricola Swiss Alpine Herb with 4.8 mg of menthol per drop
• Fisherman's Friend with 5.2 mg of menthol per drop
• Wedderspoon with Manuka honey, lemon oil, eucalyptus oil, and propolis

The most effective cough drop for you depends on your individual taste and preferences. When shopping for cough drops, look for products that contain ingredients like honey, which have proven benefits for reducing cough duration and severity.

Summary

Unlike candy, cough drops are formulated with active ingredients like menthol and benzocaine. These ingredients are meant to numb throat pain and ease the cough reflex. However, research shows that cough drops are no more effective at reducing cough than hard candy, and eating them in excess might do more harm than good.

If cough drops make you feel better, it's okay to use them in moderation. Just take care to let them dissolve in your mouth rather than chewing or swallowing, and only eat the amount recommended on the product's packaging.