Drugs List

Therapeutic Indications

Uses

Relief of sore throat

Contraindications

Children under 12 years

Precautions and Warnings

Breastfeeding
Dysphagia
Pregnancy

Contains alcohol
Avoid contact with eyes
Advise patient to report severe sore throat with fever, headache and nausea
Do not use and consult doctor if difficulty in swallowing
Avoid prolonged use
Discontinue and consult a doctor if there is no improvement within 3 days

Pregnancy and Lactation

Pregnancy

Use chlorhexidine gluconate with lidocaine with caution in pregnancy.

The manufacturer notes that there is little evidence of the safety of lidocaine and chlorhexidine in human pregnancy but they have been in wide use for many years without any adverse effects. The medication should only be used on the advice of a doctor.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Use chlorhexidine gluconate with lidocaine with caution in lactation.

The manufacturer notes that lidocaine is excreted in breast milk but in such small quantities that there is generally no risk of the infant being affected at therapeutic doses.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Anaphylactic shock
Blistering
Breathing difficulties
Burning tongue
Dermatitis
Discolouration of teeth and tongue
Eczema
Erythema
Hypersensitivity reactions
Oropharyngeal oedema
Parotid gland swelling
Pruritus
Rash
Skin irritation
Taste disturbances
Urticaria

Presentation

Oromucosal spray containing chlorhexidine gluconate with lidocaine hydrochloride.

Drugs List

Therapeutic Indications

Uses

Relief of sore throat

Dosage

Adults

Children

Contraindications

Children under 12 years

Precautions and Warnings

Breastfeeding
Dysphagia
Pregnancy

Contains alcohol
Avoid contact with eyes
Advise patient to report severe sore throat with fever, headache and nausea
Do not use and consult doctor if difficulty in swallowing
Avoid prolonged use
Discontinue and consult a doctor if there is no improvement within 3 days

Pregnancy and Lactation

Pregnancy

Use chlorhexidine gluconate with lidocaine with caution in pregnancy.

The manufacturer notes that there is little evidence of the safety of lidocaine and chlorhexidine in human pregnancy but they have been in wide use for many years without any adverse effects. The medication should only be used on the advice of a doctor.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Use chlorhexidine gluconate with lidocaine with caution in lactation.

The manufacturer notes that lidocaine is excreted in breast milk but in such small quantities that there is generally no risk of the infant being affected at therapeutic doses.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Anaphylactic shock
Blistering
Breathing difficulties
Burning tongue
Dermatitis
Discolouration of teeth and tongue
Eczema
Erythema
Hypersensitivity reactions
Oropharyngeal oedema
Parotid gland swelling
Pruritus
Rash
Skin irritation
Taste disturbances
Urticaria

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: November 2018

Reference Sources

Summary of Product Characteristics: Covonia Sore Throat 0.2/0.05% w/v Oromucosal Spay Lemon Flavour. Thornton & Ross Ltd. October 2018.

Summary of Product Characteristics: Covonia Sore Throat 0.2/0.05% w/v Oromucosal Spay Menthol Flavour. Thornton & Ross Ltd. July 2018.