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Sore throat: paracetamol is the best option

Nonsteroidal anti-inflammatory drugs (NSAIDs) appear to be somewhat more effective than paracetamol, but they expose patients to more serious side effects.

Throat infections and pharyngitis are frequent; most often they are of viral origin and non-serious. These include sore throats that make swallowing difficult, which are soothed by sucking on hard candy, with or without sugar, and having hot or iced drinks. Paracetamol is often used to relieve sore throats, especially for self-medication.

According to available randomised clinical trials, oral paracetamol is more effective than placebo in reducing sore throats associated with common pharyngeal infections.

When sore throats are painful enough to warrant the use of an analgesic, paracetamol is the one with the fewest adverse effects in children and adults, including pregnant women, provided that overdoses are avoided. Doses should not exceed those recommended, even if efficacy is considered insufficient.

Ibuprofen appears to be a little more effective than paracetamol in adults, but it can cause the harms associated with nonsteroidal anti-inflammatory drugs, ranging from tonsil phlegmon to serious infectious complications. Nonsteroidal anti-inflammatory drugs must never be used in pregnant or potentially pregnant women.

©Prescrire 1 December 2019

"Sore throat due to infection. Choose paracetamol" Prescrire Int 2019; 28 (210): 300-301. (Pdf, subscribers only).

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See also:

Pharyngitis and NSAID:
peritonsillar abscess
Prescrire Int 2019;
28 (200): 18.
Pdf, subscribers only