Betolo: Uses, Dosage & Side Effects
A combination throat antiseptic with local anesthetic for the temporary relief of sore throat pain and minor oropharyngeal infections
Betolo is an over-the-counter throat preparation used for the temporary relief of pain and discomfort associated with sore throats and minor mouth infections. It contains a triple-action formula combining two antiseptic agents — 2,4-dichlorobenzyl alcohol (1.2 mg) and amylmetacresol (0.6 mg) — with lidocaine hydrochloride (2 mg), a local anesthetic. The antiseptic components provide broad-spectrum antibacterial and antiviral activity against common pathogens responsible for pharyngitis, while lidocaine delivers rapid numbing pain relief by blocking nerve signal transmission in the oropharyngeal mucosa. Betolo is available as an oromucosal spray solution and as lozenges in several flavors including mint, orange, and honey & lemon.
Quick Facts: Betolo
Key Takeaways
- Betolo combines two antiseptic agents (2,4-dichlorobenzyl alcohol and amylmetacresol) with the local anesthetic lidocaine to provide both antimicrobial action and rapid pain relief for sore throats.
- Available over the counter as an oromucosal spray solution and as lozenges in several flavors, Betolo does not require a prescription and is suitable for self-care of mild to moderate sore throat symptoms.
- The antiseptic components have demonstrated in vitro activity against a range of bacteria and enveloped viruses commonly associated with upper respiratory tract infections and pharyngitis.
- Betolo lozenges are suitable for adults and children aged 6 years and older, while the spray formulation is generally recommended for those aged 12 years and older. The product should not be used in children under 6.
- Side effects are generally mild and transient, most commonly temporary oral numbness from the lidocaine component. If sore throat symptoms persist beyond 3 days or worsen, medical consultation is recommended.
What Is Betolo and What Is It Used For?
Betolo is a topical oropharyngeal preparation designed to address two of the most troublesome aspects of a sore throat: the underlying microbial infection and the pain itself. It belongs to the ATC (Anatomical Therapeutic Chemical) classification R02AA20, which covers throat preparations containing antiseptic agents. What sets Betolo apart from many simple throat lozenges is its triple-action formula that combines antimicrobial activity with local anesthetic pain relief.
The product contains three active ingredients, each serving a distinct pharmacological purpose. The first active ingredient, 2,4-dichlorobenzyl alcohol (1.2 mg per lozenge or dose), is a halogenated aromatic alcohol with broad-spectrum antiseptic properties. It works by disrupting the lipid membranes of microorganisms, leading to cell lysis and death. In vitro studies have demonstrated its activity against a range of Gram-positive and Gram-negative bacteria commonly implicated in pharyngitis, including Staphylococcus aureus, Streptococcus pyogenes (group A streptococcus), and Moraxella catarrhalis. It also shows virucidal activity against enveloped respiratory viruses, which is particularly relevant given that the majority of acute sore throats (approximately 60–90%) are caused by viral infections.
The second antiseptic component, amylmetacresol (0.6 mg per lozenge or dose), is a phenolic compound that similarly disrupts microbial cell membranes. It works synergistically with 2,4-dichlorobenzyl alcohol to provide enhanced antimicrobial coverage. Research published in peer-reviewed journals has shown that the combination of these two antiseptics achieves greater antimicrobial efficacy than either agent alone, a phenomenon attributed to their complementary mechanisms of action on bacterial and viral membranes. The combination has been shown to reduce viral titres of respiratory syncytial virus (RSV) and influenza A virus in laboratory studies.
The third active ingredient, lidocaine hydrochloride (2 mg per lozenge or dose), is one of the most widely used local anesthetics in clinical medicine. Lidocaine works by blocking voltage-gated sodium channels in sensory nerve endings in the oropharyngeal mucosa. By preventing the generation and conduction of nerve impulses, lidocaine effectively numbs the throat, providing rapid pain relief that typically begins within minutes of application. This analgesic effect is particularly valuable for patients who find it difficult to eat, drink, or swallow due to sore throat pain.
Betolo is indicated for the symptomatic treatment of sore throat (pharyngitis) and minor infections or inflammation of the mouth and throat. It is suitable for relieving symptoms associated with a wide range of causes, including viral upper respiratory tract infections (the common cold, influenza), bacterial pharyngitis, tonsillitis, and non-infectious causes of throat irritation such as postnasal drip, environmental irritants, or voice strain. However, it is important to understand that Betolo provides symptomatic relief and does not treat the underlying cause of the infection. Patients with suspected bacterial throat infections (particularly group A streptococcal pharyngitis) may require antibiotic therapy as determined by a healthcare professional.
The product is available in two formulations to suit different patient preferences. The oromucosal spray solution delivers the active ingredients directly to the back of the throat through a targeted spray mechanism, allowing precise application to the affected area. This can be particularly useful for patients who have difficulty dissolving a lozenge due to severe pain or who prefer a spray format. The lozenge formulation is available in several flavors — including mint, orange, and honey & lemon — and works by gradually dissolving in the mouth, bathing the oropharyngeal mucosa in the active ingredients over a prolonged period. This sustained local contact maximizes both the antiseptic and anesthetic effects.
Betolo is most effective when used at the first sign of sore throat symptoms. The antiseptic components help limit microbial growth on the throat surface, while the lidocaine provides immediate comfort. Betolo is suitable for self-care of mild to moderate sore throat lasting up to 3 days. If symptoms persist beyond 3 days, worsen significantly, or are accompanied by high fever, difficulty breathing, or inability to swallow, seek medical attention promptly.
What Should You Know Before Taking Betolo?
Contraindications
Betolo should not be used by individuals with a known hypersensitivity (allergy) to any of its active ingredients — 2,4-dichlorobenzyl alcohol, amylmetacresol, or lidocaine hydrochloride — or to any of the excipients contained in the formulation. Hypersensitivity to amide-type local anesthetics (the class to which lidocaine belongs) is a specific contraindication, as cross-reactivity may occur with other local anesthetics in this class, such as bupivacaine and mepivacaine.
The lozenge formulation should not be given to children under 6 years of age due to the risk of choking. Young children may not be able to dissolve a lozenge safely in the mouth without biting or swallowing it whole. The spray formulation has a different age restriction and is generally not recommended for children under 12 years. Always check the specific age recommendations on the product packaging for the formulation you are using.
Patients with a history of methemoglobinemia or glucose-6-phosphate dehydrogenase (G6PD) deficiency should exercise caution, as lidocaine can theoretically contribute to methemoglobin formation, although this risk is extremely low at the doses contained in Betolo. If you have a rare hereditary condition affecting carbohydrate metabolism (such as fructose intolerance), check the excipient list carefully, as some lozenge formulations may contain sugars.
Warnings and Precautions
If your sore throat is severe, persists for more than 3 days, or is accompanied by high fever (above 38.5°C / 101.3°F), difficulty breathing, difficulty swallowing, a rash, or swollen lymph nodes, stop using Betolo and consult a healthcare professional. These symptoms may indicate a more serious condition requiring medical treatment, such as bacterial tonsillitis, peritonsillar abscess, or epiglottitis.
Before using Betolo, be aware of the following precautions:
- Temporary numbness: Due to the lidocaine content, Betolo causes temporary numbness of the tongue, mouth, and throat. This is a normal and expected effect. However, be cautious when eating or drinking hot beverages shortly after use, as reduced sensation may increase the risk of accidental burns or biting injuries. Wait until full sensation returns before consuming very hot foods or drinks.
- Overuse: Do not exceed the maximum recommended daily dose. Excessive use of products containing lidocaine can lead to systemic absorption and potential toxicity, particularly in individuals with impaired hepatic function. Symptoms of lidocaine toxicity include dizziness, drowsiness, tingling sensations, blurred vision, and in severe cases, cardiac arrhythmias.
- Other throat preparations: Avoid using Betolo simultaneously with other throat lozenges, sprays, or local anesthetic products, as this may lead to additive local anesthetic effects and increased risk of adverse reactions.
- Dental procedures: If you have a dental appointment scheduled, inform your dentist that you have recently used a product containing lidocaine, as this may affect the assessment of oral sensation.
Pregnancy and Breastfeeding
There is limited clinical data on the use of Betolo during pregnancy. The active ingredients are applied topically to the oropharyngeal mucosa and systemic absorption at recommended doses is expected to be minimal. However, as a general precaution, pregnant women should consult a healthcare professional before using Betolo, particularly during the first trimester. Lidocaine is classified as FDA pregnancy category B, meaning that animal studies have not demonstrated fetal risk, but adequate studies in pregnant women are lacking.
It is not known whether the active ingredients of Betolo are excreted in human breast milk in clinically significant amounts after oromucosal use. Given the low doses and minimal systemic absorption expected with topical use, the risk to the breastfed infant is considered very low. Nevertheless, breastfeeding mothers should consult a pharmacist or doctor before use and should avoid applying the spray immediately before breastfeeding.
Driving and Operating Machinery
Betolo is not expected to affect the ability to drive or operate machinery when used at the recommended doses. The lidocaine content is too low to cause systemic effects that could impair cognitive or motor function. However, if you experience any unusual dizziness or drowsiness after use (which would be very rare at therapeutic doses), refrain from driving or operating machinery until these effects have resolved.
How Does Betolo Interact with Other Drugs?
One of the advantages of Betolo as an over-the-counter throat preparation is its favorable drug interaction profile. Because the active ingredients — 2,4-dichlorobenzyl alcohol, amylmetacresol, and lidocaine — are applied topically to the oropharyngeal mucosa and act locally, systemic absorption is minimal at the recommended doses. This means that the risk of systemic drug-drug interactions is very low compared with orally administered medications that achieve significant blood levels.
However, there are some theoretical considerations and practical precautions to be aware of:
| Drug Category | Examples | Interaction Level | Notes |
|---|---|---|---|
| Other throat lozenges/sprays | Products containing benzocaine, cetylpyridinium, hexetidine | Avoid combination | Additive local anesthetic/antiseptic effects; increased risk of oral numbness and mucosal irritation |
| Class I antiarrhythmics | Mexiletine, tocainide, procainamide | Theoretical (very low risk) | Theoretical additive cardiac effects with systemic lidocaine; clinically negligible at Betolo doses |
| CYP1A2 and CYP3A4 inhibitors | Fluvoxamine, ciprofloxacin, ketoconazole, erythromycin | Theoretical (very low risk) | Could theoretically reduce lidocaine metabolism; clinically irrelevant at topical doses |
| Antibiotics for throat infection | Penicillin V, amoxicillin, azithromycin | No interaction | Safe to use alongside prescribed antibiotics for symptomatic relief |
| Analgesics | Paracetamol, ibuprofen, aspirin | No interaction | Can be used together for enhanced pain relief; complementary mechanisms of action |
| Cough and cold medicines | Dextromethorphan, pseudoephedrine, guaifenesin | No interaction | Safe to use concurrently for comprehensive symptom management |
It is worth emphasizing that the drug interaction profile of Betolo is very favorable precisely because of its local mechanism of action. The antiseptic components (2,4-dichlorobenzyl alcohol and amylmetacresol) exert their effects directly on the oropharyngeal mucosa and are not absorbed into the systemic circulation in meaningful quantities. Lidocaine, while it is a drug that can have significant systemic interactions when administered intravenously or in large topical doses, is present in Betolo at a dose (2 mg per lozenge) that results in negligible plasma levels.
For context, therapeutic systemic lidocaine for cardiac arrhythmias is administered at doses of 50–100 mg intravenously, approximately 25–50 times the amount in a single Betolo lozenge. The small amount of lidocaine in Betolo that may be swallowed undergoes extensive first-pass hepatic metabolism, further reducing systemic exposure. Therefore, interactions with CYP enzyme inhibitors or other systemically active medications are of theoretical interest only and have no practical clinical significance at Betolo’s recommended doses.
You can safely use Betolo alongside common over-the-counter pain relievers such as paracetamol (acetaminophen) or ibuprofen for enhanced sore throat relief. If you are taking prescribed antibiotics for a bacterial throat infection, Betolo can be used concurrently for symptomatic comfort. The only products to avoid combining with Betolo are other throat lozenges or sprays that contain local anesthetics, to prevent excessive oral numbness.
What Is the Correct Dosage of Betolo?
Betolo should always be used according to the instructions on the product packaging or as advised by your pharmacist. The dosage varies depending on the formulation (spray or lozenges) and the age of the patient. It is important not to exceed the recommended daily dose and to limit use to a maximum of 3 days for self-treatment without medical guidance.
Adults (18 years and older)
| Formulation | Single Dose | Frequency | Maximum Daily Dose |
|---|---|---|---|
| Lozenges | 1 lozenge | Every 2–3 hours as needed | 8 lozenges per day |
| Oromucosal spray | 2–3 sprays | Every 2–3 hours as needed | As per packaging (typically 8 applications) |
When using lozenges, allow the lozenge to dissolve slowly in the mouth. Do not chew or swallow the lozenge whole. Moving the lozenge gently around the mouth can help distribute the active ingredients more evenly across the oropharyngeal mucosa. The full dissolution typically takes 5–10 minutes, during which time the antiseptic and anesthetic effects are being delivered directly to the affected tissues.
When using the spray, direct the nozzle toward the back of the throat and apply 2–3 sprays. Hold the spray in the mouth for a few seconds before swallowing to maximize local contact time with the throat mucosa. The spray format offers the advantage of more precise targeting and may be preferred by patients with severe sore throat who find it painful to suck on a lozenge.
Children and Adolescents
| Age Group | Lozenges | Spray | Important Notes |
|---|---|---|---|
| Under 6 years | Not recommended | Not recommended | Choking risk with lozenges; insufficient safety data |
| 6–11 years | 1 lozenge every 3–4 hours (max 4–5/day) | Not generally recommended | Under adult supervision only; ensure child can dissolve lozenge safely |
| 12–17 years | 1 lozenge every 2–3 hours (max 8/day) | 2–3 sprays every 2–3 hours | Same dosing as adults |
Children aged 6–11 years should only use Betolo lozenges under adult supervision. The supervising adult should ensure that the child is able to dissolve the lozenge slowly in the mouth without chewing it or attempting to swallow it whole. If a child is unable to do this safely, the product should not be used. For children in this age group, a lower maximum daily dose is recommended — typically no more than 4–5 lozenges per day, with a minimum interval of 3–4 hours between doses.
Elderly Patients
No dose adjustment is required for elderly patients. Betolo can be used at the standard adult dose in older adults. However, elderly patients should be aware of the temporary numbness caused by lidocaine and take particular care when eating or drinking hot beverages after use, as reduced oral sensation combined with potential age-related sensory changes may increase the risk of accidental burns. Patients with dentures should ensure that the lozenge does not become lodged under dental appliances.
Missed Dose
As Betolo is used on an as-needed basis for symptomatic relief rather than on a fixed dosing schedule, a “missed dose” is not clinically relevant. Simply use the next dose when you experience symptoms again, maintaining the recommended minimum interval between doses. There is no need to take extra doses to compensate for a period during which the product was not used.
Overdose
If significantly more Betolo has been taken than recommended, or if a child has accidentally consumed multiple lozenges, contact your local poison control center or seek immediate medical attention. Symptoms of lidocaine overdose may include dizziness, drowsiness, visual disturbances, numbness and tingling around the mouth, muscle twitching, and in severe cases, seizures or cardiac effects.
At the recommended doses, lidocaine toxicity from Betolo is extremely unlikely. Each lozenge contains only 2 mg of lidocaine, whereas systemic toxicity is typically associated with blood levels achieved through much higher doses (the toxic plasma threshold for lidocaine is approximately 5 μg/mL, which would require absorption of far more lidocaine than is present in multiple lozenges). However, accidental ingestion of large numbers of lozenges by children could potentially lead to systemic effects. In the event of suspected overdose, symptomatic and supportive treatment should be provided, with monitoring of cardiac and respiratory function as appropriate.
What Are the Side Effects of Betolo?
Like all medicines, Betolo can cause side effects, although not everybody experiences them. As an over-the-counter throat preparation with topical action, Betolo has an overall favorable safety profile when used at the recommended doses. The majority of reported side effects are related to the local anesthetic effect of lidocaine and are mild, transient, and expected pharmacological consequences of the product’s mechanism of action.
The following side effect frequency categories are based on the standard convention used by the European Medicines Agency (EMA) and international pharmacovigilance guidelines:
Common
May affect up to 1 in 10 people
- Temporary numbness of the tongue, mouth, and throat (expected pharmacological effect of lidocaine)
- Tingling sensation in the oral cavity
- Mild taste disturbance during and shortly after use
Uncommon
May affect up to 1 in 100 people
- Local irritation or burning sensation at the application site
- Nausea (particularly if the product is swallowed rather than dissolved slowly)
- Dry mouth
- Headache
Rare
May affect up to 1 in 1,000 people
- Allergic reactions: skin rash, itching, urticaria (hives)
- Swelling of the lips, tongue, or face (angioedema)
- Contact dermatitis at the oral mucosa
Not Known
Frequency cannot be estimated from available data
- Severe allergic reaction (anaphylaxis) — extremely rare with topical use
- Methemoglobinemia (theoretical risk with lidocaine; not reported at Betolo doses)
The temporary numbness and tingling caused by lidocaine is the most frequently reported side effect and is, in fact, an intended therapeutic effect of the product — it is this numbness that provides pain relief. The sensation typically resolves within 15–30 minutes after the lozenge has fully dissolved or after the spray has been applied. While this numbness is not harmful, patients should be careful not to bite their tongue or inner cheeks and should avoid very hot foods and beverages until sensation returns.
Allergic reactions to Betolo are rare but can occur. Lidocaine allergy, while uncommon, has been documented in the medical literature. True allergy to amide-type local anesthetics (such as lidocaine) is estimated to occur in fewer than 1% of patients and is much less common than allergy to ester-type local anesthetics (such as benzocaine). If you experience any signs of an allergic reaction — including rash, itching, swelling of the face or throat, or difficulty breathing — stop using Betolo immediately and seek medical attention.
The antiseptic components (2,4-dichlorobenzyl alcohol and amylmetacresol) are generally very well tolerated when applied topically to the oropharyngeal mucosa. Local irritation has been reported rarely, typically in patients who use the product more frequently than recommended or who have pre-existing mucosal damage or sensitivity.
If you experience any side effects, including those not listed above, talk to your pharmacist or doctor. You can also report side effects directly to your national medicines regulatory authority (e.g., the Medicines and Healthcare products Regulatory Agency [MHRA] in the UK, the European Medicines Agency [EMA], or the FDA MedWatch program in the United States). By reporting side effects, you help provide more information on the safety of this medicine.
How Should You Store Betolo?
Proper storage of Betolo is important to ensure that the product remains effective and safe throughout its shelf life. The active ingredients — particularly lidocaine — can degrade if exposed to extreme temperatures, excessive moisture, or direct sunlight, potentially reducing the product’s efficacy.
Follow these storage guidelines for Betolo:
- Temperature: Store at room temperature, below 25°C (77°F). Do not refrigerate or freeze the product unless specifically indicated on the packaging. Avoid storing in locations subject to extreme temperature fluctuations, such as a car dashboard or bathroom cabinet.
- Light and moisture: Store in the original packaging to protect from light and moisture. Keep the product in a dry place away from direct sunlight.
- Lozenges: Individual lozenges should be kept in their original blister packaging until ready for use. Do not remove lozenges from the blister pack for storage in another container, as this may expose them to moisture and affect their quality.
- Spray: After opening, use the spray within the period indicated on the packaging (typically within 6 months of first opening). Replace the protective cap after each use.
- Children: Keep Betolo out of the sight and reach of children. The lozenges may resemble sweets and could be attractive to young children, posing both a choking hazard and a risk of lidocaine overexposure if multiple lozenges are consumed.
- Expiry date: Do not use Betolo after the expiry date stated on the packaging (the month and year shown). The expiry date refers to the last day of that month.
- Disposal: Do not dispose of medicines via household waste or wastewater. Take unused or expired medicines to a pharmacy for proper disposal. This helps protect the environment.
What Does Betolo Contain?
Understanding what Betolo contains can help you make an informed decision about whether the product is suitable for you, particularly if you have known allergies or intolerances to specific substances.
Active Ingredients
| Ingredient | Amount per Lozenge | Function | Mechanism |
|---|---|---|---|
| 2,4-Dichlorobenzyl alcohol | 1.2 mg | Antiseptic | Disrupts microbial cell membranes; broad-spectrum antibacterial and antiviral activity |
| Amylmetacresol | 0.6 mg | Antiseptic | Phenolic compound; synergistic antimicrobial action with dichlorobenzyl alcohol |
| Lidocaine hydrochloride monohydrate | 2 mg | Local anesthetic | Blocks voltage-gated sodium channels in sensory nerve endings; numbs throat for pain relief |
Excipients (Inactive Ingredients)
The excipients in Betolo vary depending on the specific formulation and flavor. Common excipients found in the lozenge formulations include:
- Sucrose and liquid glucose: Used as base ingredients for the lozenge matrix. Patients with diabetes should be aware that each lozenge contains a small amount of sugar.
- Tartaric acid: Provides a slightly acidic taste that enhances flavor perception.
- Flavoring agents: Vary by product variant (peppermint oil for mint flavor, orange flavoring for orange variant, honey flavoring and lemon oil for honey & lemon variant).
- Colorants: May include quinoline yellow (E104), sunset yellow (E110), or other permitted food colorants depending on the flavor variant.
- Levomenthol: Present in some formulations to provide a cooling sensation that further soothes the throat.
For the spray formulation, additional excipients may include ethanol, glycerol, purified water, and flavoring agents. The spray may have a slightly different excipient profile compared with the lozenges. Always read the full list of ingredients on the specific product you are purchasing, particularly if you have known allergies or intolerances.
If you are allergic to any local anesthetics of the amide type (lidocaine, bupivacaine, mepivacaine), do not use Betolo. Some formulations may contain colorants (E104, E110) that can cause allergic reactions in susceptible individuals. Patients with fructose intolerance should note that the lozenges contain sucrose and glucose. Check the complete ingredient list on the product packaging before use.
Frequently Asked Questions About Betolo
Both formulations contain the same three active ingredients (2,4-dichlorobenzyl alcohol, amylmetacresol, and lidocaine) and provide equivalent therapeutic effects. The main differences are in the method of application and convenience. The spray delivers the active ingredients directly to the back of the throat through a targeted spray mechanism, which can be useful for patients with very sore throats who find it painful to suck on a lozenge. The lozenges dissolve slowly in the mouth over several minutes, providing sustained contact of the active ingredients with the throat mucosa. Lozenges are also available in several flavors (mint, orange, honey & lemon). The spray is generally recommended for ages 12 and older, while lozenges can be used from age 6 under supervision.
Yes, Betolo can be safely used alongside paracetamol (acetaminophen) or ibuprofen for enhanced sore throat relief. These medications work through completely different mechanisms: Betolo acts locally on the throat mucosa as an antiseptic and local anesthetic, while paracetamol and ibuprofen work systemically to reduce pain and inflammation (ibuprofen also reduces inflammation). Using them together can provide more comprehensive symptom relief, particularly for moderate to severe sore throats. Always follow the dosing instructions for each product separately.
Betolo can provide symptomatic relief for sore throat caused by any virus, including SARS-CoV-2 (COVID-19), influenza, and the common cold. The antiseptic components (2,4-dichlorobenzyl alcohol and amylmetacresol) have demonstrated in vitro activity against enveloped viruses, and the lidocaine component provides pain relief regardless of the cause of the sore throat. However, Betolo is a symptomatic treatment only — it does not cure the viral infection or prevent its spread. If you suspect you have COVID-19 or influenza, follow local public health guidelines regarding testing, isolation, and antiviral treatments.
The pain-relieving effect of Betolo begins within minutes of use, thanks to the local anesthetic action of lidocaine. Most patients notice a significant reduction in throat pain within 1–5 minutes of the lozenge beginning to dissolve or within seconds of using the spray. The antiseptic effect begins immediately upon contact with the oropharyngeal mucosa. The duration of pain relief varies but typically lasts 1–2 hours after the lozenge has fully dissolved. The speed and duration of effect make Betolo particularly useful before meals or at bedtime when throat pain is most bothersome.
Betolo lozenges contain small amounts of sugar (sucrose and liquid glucose) as part of the lozenge base. While the amount of sugar per lozenge is relatively small, patients with diabetes should be aware of this and factor it into their daily carbohydrate intake, particularly if using multiple lozenges per day. Sugar-free alternatives may be available in some markets. The spray formulation may contain less or no sugar. Consult the packaging information or ask your pharmacist about the sugar content of the specific Betolo product you are considering, and discuss with your healthcare provider if you have concerns about blood glucose management.
Betolo differs from many basic throat lozenges in that it contains three active pharmaceutical ingredients rather than simple soothing agents. While regular throat lozenges may contain only menthol, honey, or demulcent ingredients that soothe the throat through a coating effect, Betolo provides clinically proven antiseptic action (from 2,4-dichlorobenzyl alcohol and amylmetacresol) combined with true local anesthetic pain relief (from lidocaine). This makes Betolo a medicated product rather than a simple confectionery-type lozenge, and it is regulated as a pharmaceutical product rather than a food supplement.
References
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- Shephard A, Smith G, Aspley S, et al. Randomised, double-blind, placebo-controlled studies on flurbiprofen 8.75 mg lozenges in patients with/without group A or C streptococcal throat infection, with an assessment of clinical outcome. International Journal of Clinical Practice. 2015;69(1):59-71.
- National Institute for Health and Care Excellence (NICE). Sore throat (acute): antimicrobial prescribing. NICE guideline [NG84]. Updated 2023.
- British National Formulary (BNF). Oropharyngeal preparations: Antiseptics and local anesthetics. 2025 edition.
- World Health Organization (WHO). WHO Model List of Essential Medicines – 23rd list, 2023. Geneva: WHO; 2023.
- European Medicines Agency (EMA). Community herbal monograph and assessment report on oropharyngeal antiseptic preparations. 2024.
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- Wonnemann M, Helm I, Strauss-Grabo M, et al. Lidocaine 8 mg sore throat lozenges in the treatment of acute pharyngitis: A new therapeutic option investigated in comparison to placebo treatment. International Journal of Clinical Pharmacology and Therapeutics. 2007;45(6):327-332.
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