From Ancient Remedy to Modern Medicine Cabinet
The history of using sweetened tablets to soothe throats dates back to ancient Egypt around 1000 BC, where honey was combined with herbs, spices, and citrus [1.10.1]. The modern cough drop has evolved significantly. In the 19th century, manufacturers like the Smith Brothers (1852) and Luden's (1879) created popular cough drop formulations [1.10.1]. William Luden, in collaboration with a pharmacist, invented the first menthol cough drop in 1881 [1.10.4]. Early versions sometimes included opioids like heroin and morphine to suppress the cough reflex, but concerns over dependency led to the development of safer, alternative medications [1.10.1, 1.10.4].
What's in a Name? Cough Drop, Lozenge, Troche, and Pastille
While often used interchangeably, there are subtle distinctions between the common names for these soothing tablets [1.2.2, 1.2.3]:
- Cough Drop: The most common term, generally referring to a hard, candy-like tablet intended to be dissolved slowly in the mouth.
- Lozenge: A broader term that encompasses cough drops. Medically, a lozenge is a small, medicated tablet designed for slow oral dissolution to treat throat or mouth conditions [1.3.2].
- Troche: This is a more technical, pharmaceutical term for a medicated lozenge [1.2.2].
- Pastille: Sometimes known as jujubes, pastilles are traditionally softer, jelly-like preparations made from glycerin and gelatin, though the term is often used for hard lozenges as well [1.2.4].
How Do Cough Drops Work?
The primary mechanism of a cough drop is to increase saliva production as it dissolves in the mouth. This saliva helps lubricate and coat irritated throat tissues, reducing dryness and the scratchy sensation that triggers coughing [1.3.2]. Beyond this basic function, many cough drops contain active ingredients designed for specific effects.
Medicated vs. Non-Medicated
Cough drops can be divided into two main categories:
- Non-Medicated: These lozenges, such as those containing pectin or honey, act as demulcents. They form a protective, soothing film over the throat's mucous membranes without providing a specific medicinal effect [1.6.4, 1.7.2]. Sucking on any hard candy can produce a similar soothing effect by boosting saliva [1.3.1].
- Medicated: These contain active pharmaceutical ingredients to provide targeted relief. They are further classified by their function, such as oral anesthetics, cough suppressants, or expectorants [1.4.5, 1.6.5].
Common Active Ingredients and Their Functions
Different medicated cough drops use various active ingredients to achieve their effects. Understanding these can help you choose the right product for your symptoms.
- Menthol: An organic compound derived from mint oils, menthol is the most common active ingredient [1.3.4]. It acts as both a cough suppressant and a local anesthetic. It triggers a cooling sensation that makes nerves in the throat less sensitive to pain and irritation, helping to reduce the urge to cough [1.3.3, 1.3.5, 1.7.1].
- Pectin: Often found in fruit, pectin is a demulcent. It doesn't have a medicinal effect but works by creating a soothing, protective layer over the irritated throat tissues [1.7.2].
- Benzocaine: This is a local anesthetic, or numbing agent [1.3.4]. It temporarily blocks nerve signals in the mouth and throat to relieve pain but is not a cough suppressant on its own [1.7.2]. The FDA has issued warnings about risks associated with benzocaine, particularly in products for teething pain [1.3.1].
- Dextromethorphan (DXM): This is a cough suppressant that works by acting on the part of the brain that controls the cough reflex [1.7.1]. It is effective for a dry, persistent cough but does not relieve throat pain [1.7.4].
Comparison of Active Ingredients
| Ingredient | Primary Function | Mechanism of Action | Best For... |
|---|---|---|---|
| Menthol | Oral Anesthetic & Suppressant | Creates a cooling sensation, desensitizing nerves to reduce pain and cough urge [1.3.5]. | Mild sore throat and cough. |
| Pectin | Demulcent (Soothing) | Forms a protective film over irritated throat tissues [1.7.2]. | Dry, scratchy throat. |
| Benzocaine | Oral Anesthetic (Numbing) | Blocks nerve pathways to numb throat pain [1.7.2]. | Moderate to severe throat pain. |
| Dextromethorphan | Cough Suppressant | Acts on the brain's cough center to reduce the cough reflex [1.7.1]. | Persistent, dry cough. |
Potential Side Effects and Precautions
While generally safe when used as directed, excessive consumption of cough drops can lead to adverse effects. Consuming too many menthol-containing drops can cause nausea, abdominal pain, headaches, and dizziness [1.8.2]. In extremely high doses, some active ingredients can be toxic [1.8.2]. It is crucial to follow the package's dosage instructions and not treat them like regular candy [1.3.1]. Furthermore, falling asleep with a cough drop poses a significant choking hazard [1.3.1].
When to Consult a Doctor
A cough drop provides temporary symptomatic relief; it does not cure the underlying infection or condition [1.3.2]. You should consult a healthcare professional if your cough lasts for more than a week, recurs, or is accompanied by other serious symptoms [1.9.2, 1.9.4].
Seek medical care if you experience:
- A fever that lasts for a few days [1.9.1]
- Difficulty breathing or swallowing [1.9.3]
- Coughing up thick, green/yellow, or bloody phlegm [1.9.3]
- Wheezing or chest pain [1.9.3]
Conclusion
So, what do you call a cough drop? Whether you call it a lozenge, troche, or pastille, this small tablet serves the important function of soothing a sore, irritated throat and quieting a cough. From simple, non-medicated pectin drops to powerful anesthetic and suppressant formulas containing menthol, benzocaine, or dextromethorphan, there is a wide variety available over-the-counter. By understanding the different types and their active ingredients, you can make an informed choice to find the best temporary relief for your symptoms while recognizing when it's time to seek professional medical advice. Always use as directed and keep them out of reach of young children [1.11.2].
For official guidelines on over-the-counter medications, consult the U.S. Food and Drug Administration.
