Hong Kong residents who reach for a soothing throat lozenge at the first tickle may be swallowing little more than sugar, according to a comprehensive investigation by the Consumer Council. In its latest round of testing, published in Issue 513 of its monthly magazine, the watchdog examined 41 popular throat lozenge products available across the city—and found that a staggering 30 of them are legally classified as ordinary food, not medicine.
What the Consumer Council Found
The investigation, which analyzed lozenges sold at pharmacies, convenience stores, and supermarkets, revealed that only 10 products are registered as Western medicines and one as a registered Chinese proprietary medicine. The remaining 30 samples fall under food regulations, meaning they lack the rigorous labeling requirements applied to pharmaceutical products. Many of these food-grade lozenges contain sugar levels exceeding 70 percent, leading experts to question whether they offer any genuine therapeutic benefit.
Dr. Leung Ching, a specialist in Chinese medicine, warned that high sugar content can actually worsen symptoms. “In traditional Chinese medicine theory, sugar generates phlegm and dampness,” she explained. “Patients already suffering from throat discomfort with excessive phlegm should avoid high-sugar lozenges, as they may aggravate coughing and congestion.”
Hidden Drug Ingredients in Common Brands
Among the 11 medicated lozenges, the Council identified three categories of active ingredients: antiseptics, pain relievers, and antihistamines. Pharmacist Chui Chun-ming and specialist Dr. Wong Tak-cheung provided detailed guidance on safe usage.
Antiseptic Ingredients for Infection Relief
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Dequalinium Chloride (found in “得果定” and “Scassh” Trouch Lozenge): Used to treat bacterial, yeast, and fungal infections in the mouth and throat. Recommended dosage is 0.25 mg every 2–3 hours, with a maximum of 8 lozenges daily. Not suitable for children under six. Overuse may cause tongue pain or oral discomfort.
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Benzalkonium Chloride (found in “得果適” Lemon Honey): Helps suppress and kill bacteria and fungi on throat membranes. Adults and children 12 and older should take no more than 8 lozenges daily. Excessive intake may trigger rashes or asthma symptoms.
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Cetylpyridinium Chloride (found in “特快靈” Sugar-Free Lemon Honey): Aimed at soothing oral and throat infections. Suitable for individuals six and older. Overconsumption may lead to skin rashes, allergic reactions, or gastrointestinal upset.
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2,4-dichlorobenzyl alcohol & Amylmetacresol (found in “使立消” multiple products): A dual-action antiseptic combination. Adults may take up to 12 lozenges per 24 hours; children up to 8. Excessive use of the former may cause stomach upset and central nervous system stimulation, while the latter may trigger facial swelling and breathing difficulties.
Pain Relief Ingredients for Severe Sore Throats
For those experiencing intense pain—often described as “swallowing glass”—some lozenges contain local anesthetics or non-steroidal anti-inflammatory drugs (NSAIDs).
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Hexylresorcinol (found in “得果適” and “使立消” MAX): A mild local anesthetic that numbs the throat. Maximum daily intake is 24 mg (approximately 9 lozenges). Not for children under six. Overuse may cause stomach discomfort.
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Ambroxol Hydrochloride (found in “使立消” Cough Relief Formula): Combines local anesthesia with phlegm-thinning properties. For individuals 12 and older, daily dosage is 60–120 mg divided into 2–3 doses. Should not be used for more than three consecutive days. Pregnant women in their first trimester and breastfeeding mothers should avoid it.
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Benzydamine Hydrochloride (found in “特快靈”): An NSAID that reduces swelling and pain. Maximum daily intake is 36 mg, with use not exceeding seven days. Must be purchased with pharmacist consultation. Those allergic to NSAIDs should never take it, as it may cause skin rashes or throat ulcers.
Antihistamine Ingredients for Allergy-Related Discomfort
- Chlorpheniramine Maleate (found in “Scassh” Trouch Lozenge): A traditional antihistamine that relieves runny nose and post-nasal drip-related throat pain. Common side effects include drowsiness, dizziness, and dry mouth. Adults should take 4 mg every 4–6 hours, with a maximum of 24 mg daily. Doses for children must be strictly reduced.
Sugar Content: A Hidden Health Risk
The Council’s analysis highlighted that many food-grade lozenges contain alarmingly high sugar levels. Three products stood out, each containing over 3 grams of sugar per lozenge. Based on the World Health Organization’s recommended daily sugar limit of 50 grams for adults, consuming just six lozenges daily—two after each meal—would account for nearly one-third of that allowance. For some high-sugar samples, six lozenges could approach half the daily limit.
On the brighter side, the Council identified nine lozenge varieties with comparatively low sugar content, offering consumers better options for those seeking minimal sugar intake.
Honey-Based Lozenges: Not for Infants
Approximately half of the food-grade lozenges tested contained honey, which serves as a demulcent—a substance that soothes irritated throat membranes. However, the Council issued a strong warning: natural honey can carry botulism spores. Infants under 12 months should never consume honey-based products, as their immature digestive systems cannot fight off the bacteria. Overconsumption in adults may cause nausea, vomiting, and stomach pain, while individuals with bee product allergies risk severe reactions.
How to Choose the Right Lozenge
For Medicated Lozenges
Look for the “HKP” transitional registration number on Chinese proprietary medicine packaging. This mark indicates the product was manufactured, sold, or supplied in Hong Kong before March 1, 1999, and has undergone regulatory review. All registered Chinese patent medicines must clearly list active ingredients, dosages, usage instructions, and therapeutic functions.
For Food-Grade Lozenges
Recognize that these products offer only symptom relief, not a cure. Many contain ingredients like licorice, loquat leaf, monk fruit, olive, and menthol—substances classified in mainland China as “both food and medicine.” While they can temporarily soothe dryness by increasing saliva production, their effects fade once the lozenge dissolves.
Expert Consensus: Temporary Relief, Not a Cure
Medical professionals unanimously stress that lozenges address symptoms, not underlying causes. “Any candy or sweet fruit can temporarily soothe a sore throat by stimulating saliva flow and lubricating the throat,” said pharmacist Chui. “Adding menthol or cooling agents enhances the sensation. But once the lozenge dissolves, the discomfort typically returns.”
Dr. Wong advised that individuals experiencing severe redness, swelling, voice loss, or persistent cold symptoms should consult a doctor rather than self-medicating with lozenges. “Delaying proper medical treatment can lead to complications,” he warned.
Key Takeaways for Consumers
- Check the label: Medicated lozenges require registration numbers and clear dosage instructions. Food-grade lozenges do not.
- Watch sugar intake: Some lozenges contain over 70 percent sugar. Consuming six daily can account for nearly half your recommended sugar limit.
- Avoid overuse: Exceeding recommended doses of medicated lozenges can cause tongue pain, stomach upset, dizziness, rashes, facial swelling, and breathing difficulties.
- Keep away from infants: Never give honey-based lozenges to children under 12 months.
- Do not drive after antihistamine lozenges: Ingredients like chlorpheniramine maleate cause drowsiness and dizziness.
The Consumer Council encourages the public to make informed choices by reviewing product labels and consulting pharmacists or doctors when in doubt. For full test results and product lists, readers can refer to Consumer Council Issue 513, available on its official website.