When should you not use throat spray? Understanding Contraindications and Safety

October 8, 2025 •

4 min read

While over-the-counter throat sprays offer temporary relief for millions, the FDA has issued warnings about potential risks associated with ingredients like benzocaine, including the rare but serious blood disorder methemoglobinemia. Understanding when should you not use throat spray is crucial for ensuring patient safety and avoiding adverse health outcomes.

Quick Summary

Throat spray use is contraindicated for individuals with severe illness, allergies to ingredients like benzocaine, certain medical conditions, and specific age groups, necessitating consultation with a healthcare provider.

Key Points

Allergic Reactions: Do not use if you are allergic to any of the active or inactive ingredients, such as benzocaine or phenol, as this can cause serious allergic reactions.
Specific Health Conditions: Patients with severe liver disease, sepsis, or those taking MAOI antidepressants should avoid certain types of throat spray.
Children's Safety: Many throat sprays are not recommended for young children, with specific age restrictions depending on the active ingredients (e.g., benzocaine/menthol <12, phenol <3).
Severe Symptoms: Avoid using throat spray if you have high fever, difficulty breathing, excessive drooling, or severe, persistent pain, as these may signal a serious underlying condition.
Pregnancy and Breastfeeding: Consult a healthcare provider before using throat spray if you are pregnant or nursing, as the safety of some ingredients is not fully established.
Benzocaine Warning: Do not use benzocaine-containing sprays on infants for teething pain, due to the risk of methemoglobinemia, a rare but life-threatening blood disorder.
Temporary Use Only: Use throat spray only for short durations, typically not more than two days, and seek medical advice if symptoms persist or worsen.

When to Exercise Caution with Throat Spray

Throat sprays are a common over-the-counter remedy designed to numb the throat and provide temporary relief from minor pain and irritation. However, these products are not suitable for everyone and can be unsafe or ineffective in certain situations. The primary purpose of these sprays is symptomatic relief, not treatment of the underlying cause, which is why it's crucial to understand their limitations and potential dangers. Ignorance of these contraindications can lead to missed diagnoses for serious medical issues or even dangerous side effects.

Specific Medical Conditions and Symptoms

Certain underlying conditions or severe symptoms warrant avoiding throat spray and seeking immediate medical attention instead. Using a topical anesthetic to mask severe pain could delay critical treatment for a more serious problem.

Life-Threatening Symptoms

If you experience any of the following symptoms alongside a sore throat, immediately stop using throat spray and seek emergency medical care:

Difficulty breathing or swallowing: This may indicate a life-threatening airway obstruction due to significant throat swelling, possibly from an abscess or severe infection.
Excessive drooling: An inability to swallow saliva can be a sign of a severe condition like epiglottitis.
A muffled or "hot potato" voice: This is a key indicator of severe throat swelling.
Neck or facial swelling: Rapidly increasing swelling could point to a deep neck infection or severe allergic reaction.
High and persistent fever: A fever of 101°F (38.4°C) or higher, especially if accompanied by chills or night sweats, may signal a systemic infection.
Severe sore throat lasting more than 2 days: Pain that is intense and does not improve may indicate a bacterial infection like strep throat.

Other Relevant Medical History

Individuals with pre-existing health issues must also exercise caution:

Breathing problems: Patients with asthma or emphysema should be cautious, as some ingredients could cause an adverse reaction.
Severe liver disease or sepsis: Topical anesthetics like lidocaine should be used with caution in these patient groups.
Allergies: A known allergy or hypersensitivity to any ingredient, such as phenol, benzocaine, or chlorhexidine, is a complete contraindication.
MAOI antidepressants: Do not use phenol oropharyngeal sprays if you are currently taking or have recently taken (within the last 14 days) monoamine oxidase inhibitor (MAOI) antidepressants.

Ingredient-Specific Dangers

Different throat sprays contain different active ingredients, and each has its own set of precautions. Carefully read the label to know what you are using.

Benzocaine: The Food and Drug Administration (FDA) has issued warnings regarding benzocaine-containing products, as they can cause methemoglobinemia, a rare but potentially fatal blood disorder. This condition reduces the amount of oxygen in the blood and can occur after just one use. Symptoms include pale, gray, or blue skin, headache, lightheadedness, shortness of breath, fatigue, and a rapid heart rate. The risk is particularly high for young children, and the FDA has advised against using benzocaine-containing products for teething infants.

Phenol: Sprays with phenol, a common active ingredient, should not be used by individuals with a known hypersensitivity to any of the formulation's compounds. Furthermore, if pain, redness, or irritation persists or worsens after 7 days, discontinue use and consult a healthcare provider.

Precautions for Children and Pregnancy

Vulnerable populations, such as young children and pregnant or nursing individuals, require extra caution when considering throat spray.

Children: Many throat sprays are not suitable for young children. Benzocaine/menthol sprays, for example, are often contraindicated for children under 12. Phenol-based sprays should not be given to children under 3 years of age. Always check the product label for specific age restrictions. Never use throat spray on infants for teething pain due to the risk of methemoglobinemia.
Pregnancy and Breastfeeding: The safety of many throat spray ingredients, such as phenol, menthol, and benzocaine, has not been well-studied for use during pregnancy or breastfeeding. It is always best to consult a healthcare provider before using any medication, including throat sprays, if you are pregnant or nursing.

Duration of Use

Throat sprays are intended for short-term, temporary relief only. Most manufacturers recommend not using them for more than two days without consulting a doctor. If symptoms persist, it's a sign that the underlying cause may be more serious and requires a medical evaluation. Forgetting this can lead to masking a more serious infection and delaying proper treatment.

Comparison of Throat Spray with Alternative Remedies


Aspect	Throat Spray	Alternative Remedies
Mechanism	Delivers local anesthetics (e.g., benzocaine, phenol) to numb the throat.	Can include demulcents (coat and soothe, e.g., honey, pectin), hydrating agents, and anti-inflammatory properties (e.g., herbal teas).
Speed of Relief	Fast-acting, with numbing effects typically felt within minutes.	Variable; warm liquids can provide immediate soothing, while gargling can also offer quick, temporary comfort.
Serious Side Effects	Risk of allergic reactions, methemoglobinemia (with benzocaine), and other adverse effects.	Generally lower risk of serious side effects, but allergies to specific ingredients (e.g., honey) can occur.
Duration of Use	Short-term only, usually limited to 2 days without a doctor's advice.	Safe for extended use as needed for mild symptoms.
Use Case	Temporary relief for minor pain from viral illnesses or irritation.	General soothing for mild soreness; hydration is a key component for recovery.

Conclusion: Prioritizing a Diagnosis Over Symptom Relief

Throat sprays can be an effective tool for managing minor, temporary sore throat discomfort. However, they are not a cure and should be used with significant caution. It is paramount to recognize when a sore throat is more than just a nuisance and could indicate a serious medical condition. Never use a throat spray to ignore or mask severe symptoms like high fever, difficulty breathing, or swallowing problems. Always adhere to the age restrictions and usage duration recommendations on the product label. If symptoms are severe, persistent, or accompanied by other concerning signs, the correct action is to consult a healthcare provider to receive a proper diagnosis and appropriate treatment. Masking pain with a numbing agent is never a substitute for medical evaluation when the body signals a serious issue.

Frequently Asked Questions

You should consult a doctor if your sore throat is severe or lasts longer than 5-7 days, if it's accompanied by a high fever (over 101°F), a rash, headache, or if you have difficulty swallowing or breathing.

Not all throat sprays are safe for children. Many have age restrictions, such as those with benzocaine/menthol (not for children under 12) or phenol (not for children under 3). Always check the product label for specific age recommendations.

No, you should not use throat spray while pregnant or breastfeeding without consulting a healthcare provider. The safety of ingredients like phenol, menthol, and benzocaine has not been fully evaluated for this population.

Signs of an allergic reaction can include hives, rash, swelling of the face, tongue, or throat, wheezing, or difficulty breathing. If you experience these symptoms, stop use immediately and seek medical help.

Methemoglobinemia is a serious blood disorder that can be caused by overuse or misuse of benzocaine-containing sprays. It reduces oxygen in the blood and can cause symptoms like pale or blue skin, fatigue, and shortness of breath.

Most throat sprays are only intended for short-term use. You should not use them for more than two days without consulting a healthcare professional. Prolonged use can mask serious issues.

No, throat spray only provides temporary symptomatic relief. It will not treat the underlying bacterial infection like strep throat. A doctor must diagnose and prescribe antibiotics for bacterial infections.

No. If your pain, redness, or irritation worsens or persists after using the spray, you should discontinue use and contact your doctor. Worsening symptoms could indicate a more serious condition.