Hong Kong Consumers Council reveals most throat lozenges are classified as food, with sugar content reaching 70% and hidden drug risks.
Hong Kong residents who reach for a throat lozenge at the first sign of a scratchy throat may be consuming little more than sugar-coated candy, according to a recent investigation by the Hong Kong Consumers Council. Testing 41 popular throat lozenge brands available across the city, the Council found that a staggering 30 products are legally classified as “general food items” rather than registered medicines or Chinese proprietary drugs. Alarmingly, some of these so-called remedies contain up to 70 percent sugar, with experts warning that misusing medicated lozenges as everyday sweets could trigger stomach pain, dizziness, and even increased phlegm production.
Published in the Council’s 513th research report, the study examined the ingredient labels, sugar content, and drug classifications of widely available throat lozenges. Among the 41 samples, only 10 were registered Western medicines and one was a registered Chinese proprietary drug. The remaining 30 fell under food regulations, meaning they lack strict dosage guidelines and detailed medicinal ingredient listings.
Medicated Lozenges: Three Categories of Active Ingredients
The Consumers Council categorised the active ingredients in medicated lozenges into three primary groups: disinfectants, pain relievers, and anti-allergy agents. Each category carries specific usage instructions and potential side effects.
Disinfectant Ingredients for Sore Throat Relief
Dequalinium Chloride – Found in brands like “得果定” (Dequadin) and “Scassh” Trouch Lozenge, this antiseptic targets bacterial, yeast, and fungal infections in the mouth and throat. Experts recommend taking 0.25mg every two to three hours, with a maximum daily intake of 2mg—equivalent to eight lozenges. Children under six should avoid this ingredient. Overconsumption can lead to tongue pain or oral discomfort.
Benzalkonium Chloride – Present in “得果適” (Dagess) lemon honey lozenges, this compound inhibits bacteria and fungi on throat mucous membranes. Adults and children aged 12 and above should not exceed eight lozenges daily. Children under seven are advised against use. Excessive intake may trigger rashes or asthma symptoms.
Cetylpyridinium Chloride – Used in “特快靈” (Specfaster) sugar-free lozenges, this ingredient soothes oral and throat infections. Suitable for individuals aged six and older, but overuse can cause skin rashes, allergic reactions, or gastrointestinal discomfort.
2,4-dichlorobenzyl alcohol and Amylmetacresol – A common combination found in “使立消” (Strepsils) products, these two agents work together as disinfectants. Adults should take no more than 12 lozenges in 24 hours, while children are limited to eight. Overdosing on the first compound may irritate the stomach and central nervous system, while excessive amylmetacresol can cause facial swelling and breathing difficulties.
Pain Relief Ingredients: When Swallowing Feels Like Broken Glass
For severe throat pain, some lozenges contain local anaesthetics or non-steroidal anti-inflammatory drugs (NSAIDs). However, experts caution that these are potent medications with real risks.
Hexylresorcinol – A mild local anaesthetic in “得果適” and “使立消” MAX, this ingredient numbs the throat to relieve pain. Recommended dosage is 2.4mg every two hours, with a daily maximum of 24mg—roughly nine lozenges for standard products. Suitable only for children over six. Overuse may cause stomach upset.
Ambroxol Hydrochloride – Found in “使立消” expectorant formulas, this compound combines local anaesthetic and anti-inflammatory effects while thinning thick phlegm. Adults aged 12 and above should take 60 to 120mg daily in two to three doses, but not for more than three consecutive days. Pregnant women in their first trimester and breastfeeding mothers should avoid it entirely.
Benzydamine Hydrochloride – An NSAID in “特快靈” lozenges, this ingredient reduces swelling and throat pain. Maximum daily intake is 36mg, and use should not exceed seven days. Suitable for ages six and above. Those allergic to NSAIDs risk developing rashes or throat ulcers. This product requires consultation with a pharmacist before purchase.
Anti-Allergy Ingredients: Hidden Drowsiness Risk
Chlorpheniramine Maleate – An antihistamine in “Scassh” Trouch Lozenge, this ingredient relieves runny noses and indirectly eases throat pain caused by post-nasal drip. Common side effects include dizziness, drowsiness, and dry mouth. Adults should take 4mg every four to six hours, with a maximum of 24mg daily. Children require strict dose reduction, and professional medical advice is essential before use.
Sugar Shock: 80% of Throat Lozenges Are Essentially Candy
The Consumers Council’s findings reveal that over 80 percent of tested lozenges are legally classified as confectionery. Three high-sugar samples contained more than 3 grams of sugar per lozenge. To put this in perspective, consuming just six lozenges daily—two after each meal—could deliver over 18 grams of sugar, nearly one-third of the World Health Organization’s recommended daily limit of 50 grams. Some samples pushed consumption to nearly half the daily allowance with just six pieces.
Dr. Leung Ching, a doctor of Chinese medicine, warned that traditional Chinese medicine theory links sugar to “phlegm-dampness” accumulation. Patients already experiencing phlegm should avoid high-sugar lozenges, as they may worsen coughs and throat discomfort.
Nine lozenges were identified as lower-sugar alternatives, offering consumers a better option for those watching their intake.
Honey-Based Lozenges: Danger for Infants
Approximately half of the food-grade lozenge samples contained honey, which acts as a soothing demulcent for throat mucous membranes. However, natural honey carries a risk of botulism spore contamination. Infants under one year old should never consume honey, as their immature digestive systems cannot handle potential bacterial infection. Even adults may experience nausea, vomiting, or stomach pain with excessive honey intake, while those with bee product allergies face serious allergic reactions.
Traditional Chinese Medicine Lozenges: Look for the HKP Mark
For consumers seeking Chinese proprietary medicine lozenges, experts advise checking for the “HKP” transitional registration number on packaging. This mark indicates the product was manufactured, sold, or supplied in Hong Kong before March 1, 1999, and complies with the city’s Chinese Medicine Ordinance. Registered products must clearly list active ingredients, their quantities, functions, and intended uses.
Expert Verdict: Lozenges Treat Symptoms, Not Causes
Medical professionals stress that throat lozenges—even medicated varieties—only provide temporary relief. Sucking on any candy or herbal drop increases saliva production, coating and soothing irritated throat tissues. Adding menthol or cooling agents enhances the sensation of comfort.
“The effect is purely symptomatic,” one expert explained. “Once the lozenge dissolves, the discomfort typically returns.”
For persistent symptoms such as severe redness, swelling, voice loss, or ongoing cold symptoms, residents should seek medical attention rather than relying solely on lozenges. Delaying proper treatment can worsen underlying conditions.
The Consumers Council report serves as a crucial reminder that not all throat lozenges are created equal. Before reaching for that next lozenge, Hong Kong consumers should check the label, understand the ingredients, and consider whether they are treating a symptom or simply eating candy. For anyone with underlying health conditions, pregnant women, or parents giving lozenges to children, consulting a healthcare professional is strongly advised.