2,4-dichlorobenzyl alcohol + amylmetacresol + levomenthol: clinical use

Prescribing considerations

• Confirm symptoms are appropriate for self-care and assess persistent, worsening or red-flag symptoms.
• Review excipients in people with diabetes, carbohydrate-intolerance disorders, wheat allergy, sulphite sensitivity or fragrance allergy.
• The products contain sucrose and glucose, which may be relevant to dental health and carbohydrate intake.
• They are considered gluten-free at the stated trace level but should not be used by people with wheat allergy.

Contraindications and cautions

• Hypersensitivity to an active ingredient or excipient.
• Rare hereditary fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency.
• Wheat allergy.
• Children under 6 years.

Monitoring

• Reassess if symptoms persist, do not improve or worsen.
• Advise immediate assessment for angioedema, breathing difficulty, inability to swallow or rapidly worsening severe illness.
• Monitor for oral discomfort, tongue burning or hypersensitivity.

Clinical pharmacology

2,4-dichlorobenzyl alcohol and amylmetacresol have local antiseptic properties. Levomenthol has a mild local anaesthetic effect and relieves symptoms of cough and nasal congestion. Product-specific pharmacokinetic data are unavailable.

Formulation and product differences

• The two selected products are described as the same blue circular lozenge with the same active-ingredient combination.
• The formulation contains liquid sucrose, liquid glucose derived using wheat starch, sulphites and eucalyptus oil containing d-limonene.