For most sore throats, over-the-counter pain relievers like ibuprofen or acetaminophen are the most effective first step, and you can combine them with numbing sprays, lozenges, and simple home remedies like warm salt water or honey. The best choice depends on whether your sore throat is caused by a virus (the vast majority are) or a bacterial infection like strep, which requires antibiotics.
Ibuprofen vs. Acetaminophen
Both ibuprofen and acetaminophen relieve sore throat pain, but ibuprofen consistently outperforms acetaminophen in clinical trials. In a head-to-head study, a standard 400 mg dose of ibuprofen reduced throat pain by 80% at three hours, compared to a 50% reduction with 1000 mg of acetaminophen. By six hours, the gap widened further: ibuprofen still provided 70% relief while acetaminophen had dropped to just 20%.
Ibuprofen has an additional advantage because it reduces inflammation, not just pain. Since a sore throat involves swollen, irritated tissue, that anti-inflammatory effect matters. Side effects between the two drugs were comparable in trials, so for most adults, ibuprofen three times a day is the stronger option. If you can’t take ibuprofen (due to stomach issues, kidney problems, or certain medications), acetaminophen still provides meaningful relief, especially in the first few hours.
For children, the same pattern holds at weight-based doses. Never give aspirin to children or teenagers with a sore throat or any viral illness, as it’s linked to a rare but serious condition called Reye’s syndrome. The FDA also recommends against giving any OTC cough and cold products to children under four years old.
Throat Sprays and Lozenges
Numbing sprays and lozenges work differently from pain relievers. Instead of reducing pain throughout your body, they numb the throat tissue directly on contact. The most common active ingredient in throat sprays is phenol, found in brands like Chloraseptic. You spray it on the back of your throat and it creates temporary numbness within seconds, though the effect typically fades after 15 to 30 minutes.
Medicated lozenges dissolve slowly, keeping the active ingredient in contact with your throat longer. They can be used alongside oral pain relievers since they work through a completely different mechanism. Lozenges are a choking hazard for young children, so they’re generally appropriate only for kids old enough to understand not to swallow them whole.
Salt Water Gargles
A warm salt water gargle is one of the simplest and most effective home remedies. Mix half a teaspoon of salt into one cup of warm water, gargle for 15 to 30 seconds, and spit it out. The salt draws moisture out of swollen tissue, temporarily reducing inflammation and loosening mucus. You can repeat this several times a day. It won’t cure anything, but many people find it noticeably soothes the raw feeling, especially first thing in the morning when throat pain tends to be worst.
Honey
Honey does more than just taste soothing. A systematic review and meta-analysis published in BMJ Evidence-Based Medicine found that honey was superior to usual care for improving symptoms of upper respiratory infections, including sore throat. It reduced cough frequency and severity and improved overall symptom scores. Honey has mild antimicrobial properties, and it also works as a physical barrier, coating irritated tissue and protecting it from further irritation.
You can take honey straight by the spoonful, stir it into warm tea, or mix it with warm water and lemon. One important exception: never give honey to children under one year old due to the risk of botulism.
Zinc Lozenges
If your sore throat is part of a cold, zinc lozenges may shorten how long you’re sick. The key is dose and timing. Trials using more than 75 mg of elemental zinc per day (spread across multiple lozenges throughout the day) consistently showed benefits, while lower doses did not. High-dose zinc acetate lozenges reduced the total duration of cold symptoms by roughly 42% in pooled trial data. To hit that threshold, you’d typically need to take a lozenge every two to three waking hours. Starting within the first 24 hours of symptoms matters most. Zinc lozenges can cause nausea or leave a metallic taste, so they’re not for everyone.
Keeping Your Throat Moist
Dry air makes a sore throat worse. If you’re recovering at home, a humidifier can help keep your mucous membranes from drying out further. The Mayo Clinic recommends keeping indoor humidity between 30% and 50%. Above that range, you risk mold growth. Below it, the dry air irritates your nose and throat. Warm liquids in general (broth, tea, warm water) also help by keeping the throat hydrated and loosening any mucus buildup.
Herbal Options
Marshmallow root and slippery elm bark are two traditional herbs that contain mucilage, a substance that swells when mixed with liquid and forms a gel-like coating. When taken as a tea or lozenge, this coating sits on irritated throat tissue and acts as a physical barrier, similar to how honey works. Neither herb has robust clinical trial data behind it for sore throat specifically, but the mechanical soothing effect is real and has a long history of use. You’ll find both in many “throat coat” style herbal teas.
When It Might Be Strep
Most sore throats are caused by viruses and resolve on their own within five to seven days. Strep throat, caused by group A streptococcus bacteria, is the main exception and requires antibiotics. The distinction matters because untreated strep can, in rare cases, lead to serious complications.
Strep typically comes on suddenly with fever and painful swallowing but without the cough, runny nose, or hoarseness you’d expect from a cold. If you have a cough, congestion, or a raspy voice, your sore throat is almost certainly viral. Strep can only be confirmed with a rapid strep test or throat culture. There’s no reliable way to diagnose it just by looking at the throat, even for doctors.
Prescription Options for Severe Pain
For sore throats that are especially painful, regardless of whether the cause is viral or bacterial, a single dose of an oral corticosteroid can help. A clinical practice guideline published in The BMJ found that a one-time dose shortened pain duration by about a day and increased the likelihood of complete pain resolution within 24 to 48 hours. This applies to both adults and children and in both viral and bacterial sore throats. A single dose carries minimal risk of side effects. This isn’t something you’d pick up over the counter, but it’s worth knowing about if your pain is severe enough that standard remedies aren’t cutting it.