Cough drops are a common over-the-counter remedy widely used for temporary relief from a cough and sore throat. They soothe irritated throat tissues and often suppress the cough reflex. Despite their widespread availability and candy-like appearance, cough drops contain active ingredients that can lead to adverse effects if consumed excessively.
Common Active Ingredients and Their Potential Risks
Cough drops contain active ingredients that provide therapeutic benefits but can pose risks in high doses. Dextromethorphan (DXM) is a common cough suppressant found in some varieties, with typical cough drops containing around 5.8 milligrams per piece. While generally safe at recommended levels, exceeding the maximum adult dose of 120 milligrams per day can lead to an overdose. Ingesting 1500 milligrams or more of DXM can result in central nervous system effects, including hallucinations, confusion, and agitation.
Menthol, derived from peppermint and eucalyptus oils, is another frequent active ingredient, providing a cooling sensation and soothing effect. A typical cough drop usually contains between 5 and 10 milligrams of menthol. While a lethal dose of menthol is highly improbable from cough drops alone, consuming excessive amounts can still cause symptoms like nausea, abdominal pain, headaches, and rapid heart rate.
Benzocaine, a local anesthetic, is included in some cough drops to numb the throat and reduce pain. Overconsumption of benzocaine can lead to a rare but serious condition called methemoglobinemia. This condition affects the blood’s ability to carry oxygen and can be particularly concerning for young children.
Recognizing Symptoms of Overdose
Recognizing the signs of consuming too many cough drops is important, as symptoms can range from mild discomfort to severe medical concerns depending on the amount and type of active ingredient. Initial signs of overconsumption often involve digestive upset, such as nausea, vomiting, abdominal pain, or diarrhea. Dizziness, drowsiness, and headaches may also occur.
More severe symptoms, particularly with high doses of dextromethorphan, can include hallucinations, agitation, confusion, or psychosis. Rapid heartbeat, shallow breathing, seizures, or loss of consciousness are also possible. For cough drops containing benzocaine, a bluish tint to the skin, lips, or fingernails, alongside shortness of breath and fatigue, may indicate methemoglobinemia.
Factors Influencing Overdose Risk and Safe Use
Several factors can influence an individual’s risk of experiencing adverse effects from cough drops. Body weight plays a role, with children being more susceptible to the effects of active ingredients due to their smaller size. Pre-existing medical conditions, such as liver or kidney issues, respiratory problems like asthma or chronic obstructive pulmonary disease, or heart disease, can also increase vulnerability to complications. Individuals with diabetes should consider the sugar content in many cough drops, as it can affect blood glucose levels.
Interactions with other medications present another important consideration. Dextromethorphan, for example, can interact with certain antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs). This combination can lead to serotonin syndrome, a condition characterized by restlessness, agitation, confusion, rapid heart rate, and muscle tremors. To ensure safe use, it is important to strictly follow the recommended dosages on the product label, typically advising against exceeding 8-12 drops per day for adults or one drop every two hours. Cough drops should always be stored out of the reach of children, as their appearance can be mistaken for candy, posing both an overdose and choking hazard.
When to Seek Medical Help
Knowing when to seek medical attention is important if there is concern about cough drop overconsumption. Contacting a poison control center, such as the national Poison Help Line at 1-800-222-1222, is advisable for expert guidance, even if the situation does not seem like an immediate emergency. Immediate emergency services (like 911) should be called if severe symptoms are observed, such as difficulty breathing, seizures, loss of consciousness, or signs of an allergic reaction like swelling of the face, lips, or tongue.
Seeking prompt medical help is important if a large quantity of cough drops has been consumed, or if there is any doubt about the severity of the situation. It is also advisable to consult a healthcare professional if a sore throat persists for more than two days, a cough lasts longer than seven days, or if symptoms worsen or are accompanied by a fever, headache, or rash. When contacting medical personnel, be prepared to provide details such as the person’s age, weight, the specific cough drop product, the amount consumed, and the time of ingestion.