What Medications Cause a Sore Throat? Identifying Drug-Induced Irritation

October 13, 2025 •

5 min read

According to Poison Control, over 100 different medications have been reported to cause pill esophagitis, a leading cause of throat irritation. Understanding what medications cause a sore throat is crucial for distinguishing between common illness and adverse drug effects, helping you and your healthcare provider find the root cause of your discomfort.

Quick Summary

This article explores common drug classes and specific medications known to cause throat irritation, pain, and soreness. It covers causes such as pill esophagitis, dry mouth, and medication-induced acid reflux. Strategies for prevention and management are discussed.

Key Points

Pill Esophagitis: Certain medications, including specific antibiotics and osteoporosis drugs, can cause ulcers and pain if they get stuck in the esophagus.
Dry Mouth (Xerostomia): Many common drugs like antidepressants, antihistamines, and diuretics reduce saliva, leading to a dry and sore throat.
Inhaler Technique: Improper use of corticosteroid inhalers can cause direct throat irritation and increase the risk of oral thrush.
ACE Inhibitors: A persistent cough and throat tickle are known side effects of some blood pressure medications like lisinopril.
Exacerbated GERD: Medications such as calcium channel blockers can relax the esophageal muscles, worsening acid reflux and throat pain.
Always Consult a Doctor: Do not stop taking any medication without first speaking with a healthcare provider, who can help diagnose the issue and find a safe solution.
Symptom Tracking: Keeping a log of when your symptoms occur relative to taking your medication can help your doctor diagnose the issue.

While a sore throat is often associated with viruses like the common cold or flu, it can also be a surprising side effect of certain medications. This type of irritation is typically a result of direct tissue damage, reduced saliva production, or exacerbation of underlying conditions like acid reflux. Recognizing if your medication could be the cause is the first step toward effective management and relief.

Common Medication-Related Causes of a Sore Throat

Pill Esophagitis: When Medication Gets Stuck

Pill esophagitis, also known as medication-induced esophagitis, occurs when a tablet or capsule lodges in the esophagus instead of passing into the stomach. As the pill dissolves, the concentrated medication can damage the mucosal lining, causing inflammation, ulcerations, and significant pain.

Common culprits for pill esophagitis include:

Antibiotics: Certain antibiotics, such as doxycycline, tetracycline, and clindamycin, are notorious for their acidic or corrosive properties. They are especially implicated in younger adults who may rush taking their medication.
Bisphosphonates: Used to treat osteoporosis, drugs like alendronate can irritate the esophagus and cause severe mucosal injury.
NSAIDs: Nonsteroidal anti-inflammatory drugs like ibuprofen, naproxen, and aspirin can cause esophageal ulcers if they get stuck.
Supplements: Certain acidic or irritant supplements, including iron and potassium chloride, can cause direct mucosal damage.
Vitamin C: High doses of vitamin C can create an acidic solution when dissolved, leading to irritation.

To prevent pill esophagitis, always take medications with a full glass (4–8 ounces) of water while sitting or standing upright. Do not lie down for at least 10 minutes after swallowing.

Dry Mouth (Xerostomia): The Parched Throat

Many medications can reduce saliva production, a condition known as xerostomia. Saliva plays a crucial role in lubricating the throat and neutralizing acids. A lack of saliva can lead to a dry, scratchy, or sore throat.

Medications that commonly cause dry mouth include:

Antidepressants: Many types, including SSRIs like sertraline (Zoloft) and fluoxetine (Prozac), can cause significant dry mouth.
Antihistamines and Decongestants: Commonly used to treat allergies and cold symptoms, these medications have anticholinergic effects that reduce moisture.
Antipsychotics: Several antipsychotic medications, such as clozapine and olanzapine, can cause dry mouth.
Diuretics: These medications, which increase urine output, can lead to overall dehydration and dry mouth.
ACE Inhibitors: While known for causing a persistent cough, some ACE inhibitors can also cause dry mouth.

Inhalers: Addressing Asthma and Respiratory Issues

Inhaled corticosteroids, a cornerstone of asthma and COPD management, are often associated with throat irritation.

Potential causes include:

Direct Irritation: The medication itself can cause a scratchy or sore sensation in the throat.
Oral Thrush: The use of steroid inhalers can suppress the local immune response, leading to a fungal infection in the mouth and throat called oral candidiasis, or thrush.
Poor Technique: Inhaling incorrectly can cause more medication to settle in the throat instead of reaching the lungs.

To prevent this, rinse your mouth with water (and spit) after each use of a corticosteroid inhaler. A spacer device can also help improve delivery to the lungs.

ACE Inhibitor-Induced Cough and Throat Tickle

Angiotensin-converting enzyme (ACE) inhibitors, a class of blood pressure medications including lisinopril and enalapril, are well-known for causing a persistent, dry cough. This cough is often accompanied by a throat tickle or irritation, which can feel like a sore throat. If you develop this symptom, your doctor may consider switching you to a different class of blood pressure medication.

Exacerbated GERD: Acid Reflux and Throat Irritation

Some medications can relax the lower esophageal sphincter, the muscle that prevents stomach acid from flowing back into the esophagus. This can worsen gastroesophageal reflux disease (GERD), leading to symptoms like heartburn and a sore throat from acid irritation.

Medications that can exacerbate GERD include:

Calcium Channel Blockers: Used for high blood pressure and angina, these drugs can relax smooth muscles, including the esophageal sphincter.
Nitrates: Used to treat chest pain, nitrates have a similar muscle-relaxing effect.
Other Drugs: Certain sedatives, antidepressants, and antihistamines can also worsen reflux symptoms.

Comparison Table: Medications and Their Throat-Related Side Effects


Medication Class	Example Medications	Mechanism of Action	Common Symptoms
Pill Esophagitis Culprits	Doxycycline, Alendronate, Ibuprofen, Iron, Vitamin C	Pill gets stuck in esophagus, causing direct corrosive injury to the lining.	Painful swallowing, chest pain, discomfort.
Anticholinergics	Antihistamines, Antidepressants, Antipsychotics	Reduce saliva production, leading to dry mouth (xerostomia).	Dry, scratchy, and sore throat.
Inhaled Corticosteroids	Fluticasone, Budesonide	Direct irritation to the throat or promotion of fungal growth (thrush).	Throat irritation, soreness, white patches (thrush).
ACE Inhibitors	Lisinopril, Enalapril	Interference with the breakdown of bradykinin, leading to a persistent cough.	Chronic, dry cough and throat tickle.
GERD-Exacerbating Drugs	Calcium Channel Blockers, Nitrates	Relax the lower esophageal sphincter, allowing stomach acid to reflux.	Sore throat, heartburn, and sour taste.

What to Do If Your Medication Causes a Sore Throat

If you suspect a medication is causing your sore throat, follow these steps in consultation with your healthcare provider:

Do not stop taking a prescribed medication on your own. Abruptly discontinuing some drugs can be dangerous. Your doctor will need to evaluate the situation and may be able to suggest an alternative or different dose.
Practice proper administration. As mentioned, always take pills with a sufficient amount of water and remain upright.
Maintain hydration. Drinking plenty of water throughout the day can help lubricate the throat, especially if dry mouth is the issue. Sucking on ice chips can also provide relief.
Consider OTC remedies. Lozenges, warm salt water gargles, or over-the-counter pain relievers like acetaminophen can help soothe the throat temporarily. Always check for potential drug interactions first.
Review inhaler technique. If you use an inhaler, ask your healthcare provider to review your technique and consider using a spacer.

Conclusion

A sore throat is a common ailment, but it's important to remember that it's not always a sign of an infection. In many cases, it could be a side effect of medication. Understanding what medications cause a sore throat, from pill-induced esophagitis to drug-related dry mouth or acid reflux, is key to getting the right relief. If you experience persistent throat pain after starting a new medication, speak with your doctor or pharmacist. They can help you identify the cause, make necessary adjustments, and ensure your treatment plan is both effective and comfortable.

For more detailed information on drug-induced esophagitis, you can consult resources like the National Institutes of Health. NIH

Frequently Asked Questions

Yes, certain antibiotics like doxycycline and tetracycline are common culprits for pill-induced esophagitis if they get stuck in the esophagus. The medication can dissolve and cause irritation or ulcers.

Yes, especially corticosteroid inhalers. They can cause direct throat irritation and sometimes lead to a fungal infection called oral thrush if the mouth isn't rinsed with water immediately after use.

To prevent pill esophagitis, always take pills with a full glass of water while sitting or standing upright. It is also important to remain upright for at least 10 minutes after swallowing.

Yes, ACE inhibitors like lisinopril can cause a chronic cough or throat irritation. Other blood pressure medications, such as calcium channel blockers, can also relax the esophageal muscles and worsen acid reflux.

No, you should not stop any prescribed medication without first consulting your healthcare provider. They can help determine if a change in dosage, timing, or medication is necessary.

NSAIDs like ibuprofen and aspirin, and supplements like iron and vitamin C, can all contribute to throat irritation, particularly if they get lodged in the esophagus during swallowing.

Symptoms of pill esophagitis typically include painful swallowing, chest pain, and discomfort that may worsen when lying down. The pain often begins suddenly after taking a pill.

Yes, reduced saliva production from medications like antidepressants and antihistamines can lead to a dry, irritated, and sore feeling in the throat.