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12.3 Drugs acting on the oropharynx

12.3.1 Drugs for oral ulceration and inflammation

Benzydamine spray, oral rinse
Carbenoxolone oral gel
Carmellose sodium oral paste (Orabase)
Choline Salicylate dental gel (Bonjela) - see note
Hydrocortisone pellets (Corlan)
Lidocaine gel (Dentinox)
Tranexamic Acid Mouthwash


1. Benzydamine oral rinse ('Difflam') may be used where there is painful inflammation of the mouth and throat. Use 10-15mL for rinsing/gargling. May cause stinging or numbness; dilute with an equal volume of water if this occurs.

2. Choline Salicylate dental gel (Bonjela) is unsuitable for use in patients younger than 16 years.


12.3.2 Oropharyngeal anti-infective drugs

Miconazole oral gel - see note
Nystatin suspension


Oral candidosis: treatment should be given as long before eating or drinking as possible, to increase contact time between lesions and drug. Treatment should be continued for two days after symptoms clear.

Miconazole increases the anticoagulant effect of warfarin. Monitor patients carefully, and adjust the dose of warfarin accordingly – see MHRA DSU


12.3.3 Lozenges and sprays


1. Antiseptic throat lozenges are not recommended for routine use as most infections are viral and there is little evidence of their benefit.



12.3.4 Mouthwashes, gargles and dentrifices

Chlorhexidine mouthwash, dental gel
Mouthwash solution tablets
Povidone-iodine (Betadine) mouthwash/gargle
Hydrogen peroxide mouthwash 6% (20 Volumes) Use diluted as in the BNF.


1. Mouthwash solution tablets, one dissolved in a tumblerful of warm water and used at frequent intervals may help relieve traumatic ulceration.

2. Chlorhexidine 0.2% mouthwash can be used for oral hygiene where patients are particularly at risk (e.g. neutropenia). Rinse the mouth with about 10ml for 1 minute twice daily.


12.3.5 Treatment of dry mouth

Saliva Orthana spray
Oralbalance saliva replacement gel
Pilocarpine tablets ( for palliative care use )


For link to BNF section: 12.3 Drugs acting on the oropharynx