Benzydamine benefits and risks

• Main Authors: Katarzyna Dominiak, Julia Bartkiewicz, Katarzyna Dettlaff
• Format: Article
• Language: Polish
• Published: Polish Pharmaceutical Society 2021-02-01
• Series: Farmacja Polska
• Subjects: benzydamine; anti-inflamatory drug; psychoactive drug; hallucination
• Online Access: https://www.ptfarm.pl/download/?file=File%2FFarmacja+Polska%2F2021%2F1%2F04_OG_Benzydamina_n.pdf

Benzydamine (chemical name: 1-benzylindazol-3-yl)oxy-N,N-dimethylpropan-1-amine), is a drug that has been used in medicine for over half a century. It belongs to non-steroidal anti-inflammatory drugs (NSAIDs); however, it has a different action mechanism than other drugs within this group. It is a weak prostaglandin inhibitor, and it does not inhibit cyclooxygenase nor lipoxygenase. Its anti-inflammatory action is due to the inhibition of pro-inflammatory cytokines, including tumor necrosis factor-alpha and interleukin-1β. Benzydamine also has anti-edema, analgesic, antimicrobial, and local anesthetic properties. Benzydamine is registered only in topical dosage forms in Poland, i.e., lozenges, mouthwashes, sprays for the mouth and throat, a powder for a vaginal solution, and a ready-made irrigation solution. This drug is characterized by high safety use because administered topically, it achieves high concentrations in inflamed tissues, but systemic absorption is slight in this case. It causes that also children, pregnant, and breastfeeding women can take it. Despite the long history of benzydamine, new applications are still being researched. Clinical trials conducted in many sites worldwide have proven this drug's efficacy in preventing postoperative sore throat (POST) and treating inflammation after radiotherapy in patients with head and neck cancer. Moreover, new forms of the drug are being developed, including prolonged action, increasing the patient's comfort and therapy effectiveness. Benzydamine can penetrate the blood-brain barrier; when taken in high oral doses, significantly exceeding therapeutic doses causes psychoactive effects, most likely associated with the activation of 5 HT2A serotonin receptors. After taking over 500 mg of this compound, visual and auditory hallucinations, hallucinations, feeling unreal, psychomotor agitation, and euphoria may occur. Therefore the non-medical use of benzydamine has been observed globally for several decades, including Italy, Romania, Turkey, Brazil, and also Poland.