Can You Overdose on Cough Drops? Symptoms, Risks, and What To Do

Cough drops are often believed to be safe because they taste good, are easy to carry, and do not have any known side effects associated with use in moderation [1]. However, the significant risk for overdose occurs based on the ingredients present in the cough drop product consumed [2].

Most cough drop products will include menthol and should only have a small concentration of menthol. Dextromethorphan (DXM) can potentially produce numbing effects, as can benzocaine, if taken in overdose forms [3].

To help you understand when it is advisable to take cough drops, following the directions for use, we have reviewed the available research on cough drop products and listed below what we found regarding the active ingredient, how the active ingredient works in the body, its effects on the body if consumed in excessive amounts, when a symptom may warrant contacting a healthcare professional, and to what extent your body may be affected [2].

Quick Answer: Can You Overdose on Cough Drops?

Yes, it is possible but uncommon to overdose on cough drops. Risk depends on the active ingredient, most often menthol, and in some products, dextromethorphan or benzocaine [1]. Most issues occur when people exceed label directions or combine products with similar ingredients.

If a child ate an unknown amount or someone develops severe symptoms, contact the Poison Control Center right away [4].

Why Cough Drops Can Cause Problems: It Depends on the Ingredient

Cough drops are not all the same. Understanding what is in the product you are using helps explain why overuse can sometimes cause side effects [1].

Common active ingredients in cough drops

Menthol Most cough drops include menthol. Menthol is often used as both an anesthetic and a cough suppressant. It primarily stimulates the vagus nerve when ingested by directing its cooling sensation towards the throat to provide relief from throat irritation and cough. It is also used in cough drops because of the menthol flavor, which gives cough drops a pleasant taste. However, menthol cough drops can also irritate the stomach lining and cause stomach upset if consumed in higher amounts [2].

Dextromethorphan (DXM) DXM is the other active ingredient found in cough drops or medicated lozenge products. DXM will provide similar effects to that of menthol but will affect the brain and spine as well. DXM is a central nervous system depressant. DXM may produce dizziness, drowsiness, and confusion after it is ingested [3].

Benzocaine Benzocaine is a numbing agent used in some throat and mouth products. It can interfere with how oxygen is carried in the blood in rare cases [5].

What Are the Symptoms of Taking Too Many Cough Drops?

Symptoms of cough drop overdose vary, depending on the individual and how they metabolize the active ingredients. Most likely, the initial side effects from overdose will be stomach irritation, nausea, diarrhea, dizziness, or headache [2].

Mild to moderate symptoms

• Upset stomach, nausea, vomiting, or diarrhea
• Dizziness, headache, or sleepiness
• Mouth or throat irritation, sores, or discomfort with frequent use

These symptoms are more common and often resolve after stopping use and hydrating [1].

Severe symptoms: seek urgent help

• Confusion, severe weakness, trouble breathing, seizures, or collapse
• Blue or gray lips or nail beds, shortness of breath, fast heart rate [5]

Symptoms by ingredient mini-guide

• Sugar alcohols and sugar substitutes such as sorbitol or xylitol can cause gastrointestinal distress and have a laxative effect when consumed in large amounts [6].
• Menthol-heavy use may lead to stomach irritation and, at extreme exposures, systemic toxicity [2].
• DXM-containing products can cause central nervous system symptoms such as confusion, agitation, or disorientation [3].

How Many Cough Drops Are Too Many?

There is not one universal number.

Most cough drops include a maximum of any single cough drop product that may produce an adverse reaction. The number of cough drops that is safe to take will differ for each product based on many factors, including menthol content, which varies widely by brand. Many products also contain additional medications (many cough drops are just lozenges). Therefore, there is no one number that will be safe for everyone.

A practical, safety-first framework.

The best way to take a cough drop is to go with the Drug Facts label for that specific product. This will tell you how long to wait between using each cough drop and the maximum number that should be taken in a single day [1]. It is also not advised to combine products, or in other words, do not take multiple cough or cold medications that have similar ingredients at the same time. If you have been taking more cough drops than what the label recommends and do not feel well, do not take any more and evaluate your symptoms [4].

Using the Drug Facts label is the safest medical way to use cough drops instead of relying on average estimates on how many cough drops are considered safe for most people [1]. You can also ask your healthcare provider.

What to Do if You Took Too Many Cough Drops

If you experience mild symptoms:

Stop taking cough drops immediately. Drink plenty of water and wait at least 24 hours before taking any other cough or cold medications until you have confirmed ingredients through product labels and/or consulting with a medical professional. Watch yourself carefully over the next few hours for worsening symptoms [4].

When to contact Poison Control versus when to go to the Emergency Room:

Poison Control can provide individuals guidance concerning symptoms due to overdose or misuse of cough drops. In the United States, Poison Control’s number is 1-800-222-1222 [4].

If you are experiencing severe symptoms such as difficulty in breathing, seizures, confusion, or blue/grey-colored lips or nails, call emergency services right away.

Have this ready when you call:

When you call Poison Control or emergency medical services, please be prepared with the following information: name and active ingredient(s) of the product; approximate amount taken and time frame; person’s age, weight and additional medications that might be taken; and current symptoms.

Who Is at Higher Risk?

Children are at greater risk of overdose because they think cough drops taste like candy and may accidentally consume large amounts, as well as the risk of choking on them [4]. Individuals suffering from breathing difficulties, heart disease, and the elderly have a greater chance of complications from products containing benzocaine [5]. In addition, if an individual has over-the-counter medications that have similar ingredients, there is a greater risk of overdose.

Alternative Treatments for Easing a Sore Throat

If you find yourself using cough drops too often or are using them frequently, consider using non-medicated lozenges to help relieve your throat while avoiding overexposure to medication. Drinking warm liquids, honey for those over one year old, using a humidifier, and using salt water gargles can also be used to help support comfort in the throat area [7].

Additional Resources for Creating Healthy Recovery Habits

At Alpas Wellness, we know that it is easy for a person to underestimate medication risks associated with their daily habits, especially those dealing with active issues of sickness and stress. Education, mindfulness, healthy relationships, life skills and evidence-based therapies (cognitive behavioral therapy, dialectical behavioral therapy, and others) are being used as tools to create awareness and develop safer medication-use habits. Evidence-based therapy means using results of the latest research with the most effective use in real-world settings [1].

If these are concerning, creating a better plan of action to manage your symptoms with the help of outpatient support can help create clarity and confidence in developing safe long-term recovery from the symptoms related to medication use.