Menthol


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Cough As 7.6 mg menthol loz: Dissolve 1 loz slowly in the mouth, may be repeated 2 hourly as needed or as prescribed. As loz containing 8 mg levomenthol (including amylmetacresol and 2,4-dichlorobenzyl alcohol): Dissolve 1 loz slowly in the mouth 2-3 hourly. Max: 12 loz/day. As syrup containing 2.5 mg/5 mL menthol (including dextromethorphan hydrobromide): 10 mL, may be repeated after 4 hours if necessary. Sore throat As 7.6 mg menthol loz: Dissolve 1 loz slowly in the mouth, may be repeated 2 hourly as needed or as prescribed. As loz containing 8 mg levomenthol (including amylmetacresol and 2,4-dichlorobenzyl alcohol): Dissolve 1 loz slowly in the mouth 2-3 hourly. Max: 12 loz/day. Nasal congestion As loz containing 8 mg levomenthol (including amylmetacresol and 2,4-dichlorobenzyl alcohol): Dissolve 1 loz slowly in the mouth 2-3 hourly. Max: 12 loz/day. Topical Musculoskeletal pain As 2% or 4% w/w gel or 5% patch: Apply onto the affected area 3-4 times/day. As cream or ointment (usually in combination with camphor, eucalyptus oil, or methyl salicylate): Apply and rub gently onto the affected area 2-3 times/day. As spray containing menthol alone or usually in combination with methyl salicylate: Spray onto the affected area, may repeat up to 3-4 times/day. Inhalation Nasal congestion As solution for vapour inhalation containing 17.5% w/v menthol (including peppermint oil): Sprinkle few drops on a handkerchief, then inhale the vapour. As solution for vapour inhalation containing 2% w/v menthol (including eucalyptus oil): Add 5 mL to a pint of hot (not boiling) water, then inhale the vapour, may be repeated 4 hourly if necessary. As nasal stick containing 40% w/w levomenthol (including cajuput oil, peppermint oil, and eucalyptus oil): Insert into each nostril then inhale for up to 4 times/hour. Medical advice should be considered if symptoms persist or worsen. Contents, formulation, and dosing may vary among countries, refer to specific product guideline for detailed information.
Dosage Details
Inhalation/Respiratory
Nasal congestion
Adult: As solution for vapour inhalation containing 17.5% w/v menthol (including peppermint oil): Sprinkle few drops on a handkerchief, then inhale the vapour. As solution for vapour inhalation containing 2% w/v menthol (including eucalyptus oil): Add 5 mL to a pint of hot (not boiling) water then inhale the vapour, may be repeated 4 hourly if necessary. As nasal stick containing 40% w/w levomenthol (including cajuput oil, peppermint oil, and eucalyptus oil): Insert into each nostril then inhale for up to 4 times per hour. Medical advice should be considered if symptoms persist or worsen. Contents, formulation, and dosing may vary among countries, refer to specific product guideline for detailed information.
Child: As solution for vapour inhalation containing 2% w/v menthol (including eucalyptus oil): >3 months Same as adult dose. As solution for vapour inhalation containing 17.5% w/v menthol (including peppermint oil):  >2 years Same as adult dose. As nasal stick containing 40% w/w levomenthol (including cajuput oil, peppermint oil, and eucalyptus oil): ≥6 years Same as adult dose.

Oral
Cough
Adult: As 7.6 mg menthol loz: Dissolve 1 loz slowly in the mouth, may be repeated 2 hourly as needed or as prescribed. As loz containing 8 mg levomenthol (including amylmetacresol and 2,4-dichlorobenzyl alcohol): Dissolve 1 loz slowly in the mouth 2-3 hourly. Max: 12 loz daily. As syrup containing 2.5 mg/5 mL menthol (including dextromethorphan hydrobromide): 10 mL, may be repeated after 4 hours if necessary. Medical advice should be considered if symptoms persist or worsen. Contents, formulation, and dosing may vary among countries, refer to specific product guideline for detailed information.
Child: As loz containing 8 mg levomenthol (including amylmetacresol and 2,4-dichlorobenzyl alcohol): >6 years Same as adult dose. As 7.6 mg loz or as syrup containing 2.5 mg/5 mL menthol (including dextromethorphan hydrobromide): ≥12 years Same as adult dose.

Oral
Sore throat
Adult: As 7.6 mg menthol loz: Dissolve 1 loz slowly in the mouth, may be repeated 2 hourly as needed or as prescribed. As loz containing 8 mg levomenthol (including amylmetacresol and 2,4-dichlorobenzyl alcohol): Dissolve 1 loz slowly in the mouth 2-3 hourly. Max: 12 loz daily. Medical advice should be considered if symptoms persist or worsen. Contents, formulation, and dosing may vary among countries, refer to specific product guideline for detailed information.
Child: As loz containing 8 mg levomenthol (including amylmetacresol and 2,4-dichlorobenzyl alcohol): >6 years Same as adult dose. As 7.6 mg menthol loz: ≥12 years Same as adult dose.

Oral
Nasal congestion
Adult: As loz containing 8 mg levomenthol (including amylmetacresol and 2,4-dichlorobenzyl alcohol): Dissolve 1 loz slowly in the mouth 2-3 hourly. Max: 12 loz daily. Medical advice should be considered if symptoms persist or worsen. Contents, formulation, and dosing may vary among countries, refer to specific product guideline for detailed information.
Child: >6 years Same as adult dose.

Topical/Cutaneous
Musculoskeletal pain
Adult: As 2% or 4% w/w gel or 5% patch: Apply onto the affected area 3-4 times daily. As cream or ointment (usually in combination with camphor, eucalyptus oil, or methyl salicylate): Apply and rub gently onto the affected area 2-3 times daily. As spray containing menthol alone or usually in combination with methyl salicylate: Spray onto the affected area, may repeat up to 3-4 times daily. Medical advice should be considered if symptoms persist or worsen. Contents, formulation, and dosing may vary among countries, refer to specific product guideline for detailed information.
Child: As ointment: ≥2 years Same as adult dose. As 2% w/w gel: >5 years Same as adult dose. As spray, cream, or patch: >12 years Same as adult dose.
Contraindications
Hypersensitivity. Topical: Application on damaged or irritated skin, sensitive skin, serious burns, and wounds; tight covering or bandages on the site of application.
Special Precautions
Patient with persistent or chronic cough associated with smoking, asthma or emphysema; cough with excessive mucus (oral). Children. Pregnancy and lactation.
Adverse Reactions
Significant: Hypersensitivity reactions (e.g. contact dermatitis, flushing). Topical: Serious burns (e.g. 1st- to 3rd-degree burns) or burning sensation at the application site.
Nervous system disorders: Headache.
Skin and subcutaneous tissue disorders: Skin irritation.
Patient Counseling Information
Topical: Avoid contact with mucous membranes, application into nostrils, and application of heat to the affected area. Solution for vapour inhalation: Avoid direct application into the nostrils particularly in infants and young children; avoid contact with the eyes or skin.
Overdosage
Symptoms: Oral: Gastrointestinal disturbances (e.g. nausea, vomiting, severe abdominal pain, diarrhoea), and CNS effects (e.g. drowsiness, vertigo, ataxia). Inhalation: Confusion, ataxia, euphoria, diplopia, and nystagmus. Management: Symptomatic and supportive treatment.
Action
Description: Menthol exhibits a mild local anaesthetic activity on the throat and the nasal mucosa to relieve symptoms of cough and nasal congestion. Additionally, it dilates the blood vessels which causes a sensation of coldness followed by an analgesic effect.
Pharmacokinetics:
Absorption: Rapidly absorbed from the gastrointestinal tract; well absorbed through the skin.
Metabolism: Metabolised mainly in the liver via hydroxylation then undergoes conjugation with glucuronide.
Excretion: Via urine and bile (as glucuronide).
Chemical Structure

Chemical Structure Image
Menthol_01

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 1254, Menthol. https://pubchem.ncbi.nlm.nih.gov/compound/Menthol. Accessed Sept. 25, 2020.

Storage
Store below 25°C. Storage may vary among products and countries, refer to specific product guideline for further information.
References
Anon. Camphor and Menthol. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 03/07/2020.

Anon. Methyl Salicylate and Menthol. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 03/07/2020.

Anon. Peppermint (Natural Products Database). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 03/07/2020.

Assured Cold N Hot Pain Relief Menthol Patch (Greenbrier International, Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 03/07/2020.

Buckingham R (ed). Menthol. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/07/2020.

Covonia Chesty Cough Mixture Mentholated (Thornton & Ross Ltd). MHRA. https://products.mhra.gov.uk/. Accessed 03/07/2020.

Covonia Original Bronchial Balsam Syrup (Thornton & Ross Ltd). MHRA. https://products.mhra.gov.uk/. Accessed 11/09/2020.

Covonia Vapour Drops (Thornton & Ross Ltd). MHRA. https://products.mhra.gov.uk/. Accessed 03/07/2020.

Deep Freeze Cold Gel 2% w/w (The Mentholatum Company Limited). MHRA. https://products.mhra.gov.uk/. Accessed 03/07/2020.

Ecoolax Pain Relieving Cool Spray 12% w/v (Syarikat Wen Ken Drug Sdn Bhd). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my/. Accessed 10/09/2020.

Fisherman’s Friend Sugar Free Spearmint Lozenges (DCH Contract Manufacturing Sdn. Bhd). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my/. Accessed 10/09/2020.

iGesic Ointment (IKOP Sdn Bhd). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my/. Accessed 10/09/2020.

Joint Formulary Committee. Eucalyptus with Menthol. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/07/2020.

Menthol - Cough Suppressant Lozenge (McKesson). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 03/07/2020.

Menthol and Eucalyptus Inhalation BP 1980 (Wise Pharmaceuticals Ltd). MHRA. https://products.mhra.gov.uk/. Accessed 03/07/2020.

Menthol and Wintergreen Cream (Sterling Pharmaceuticals Limited). MHRA. https://products.mhra.gov.uk/. Accessed 03/07/2020.

Menthol. Gold Standard Drug Database in ClinicalKey [online]. Elsevier Inc. https://www.clinicalkey.com/. Accessed 10/09/2020.

Mentholatum Deep Cold Patch (Teh Seng Pharmaceuticals Mfg Co. Ltd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my/. Accessed 10/09/2020.

Menzza Ice Gel (HOE Pharmaceuticals Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my/. Accessed 03/07/2020.

Olbas for Children Inhalation Vapour, Liquid (G. R. Lane Health Products Limited). MHRA. https://products.mhra.gov.uk/. Accessed 03/07/2020.

Olbas Inhaler Nasal Stick (G. R. Lane Health Products Limited). MHRA. https://products.mhra.gov.uk/. Accessed 03/07/2020.

Radian B Pain Relief Spray (Thornton & Ross Limited). MHRA. https://products.mhra.gov.uk/. Accessed 03/07/2020.

Strepsils Sore Throat and Blocked Nose Lozenges (Reckitt Benckiser Healthcare [UK] Ltd). MHRA. https://products.mhra.gov.uk/. Accessed 03/07/2020.

Tiger Balm Neck & Shoulder Rub Boost (Tiger Balm [M] Sdn Bhd). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my/. Accessed 10/09/2020.

Tiger Balm Red (Omega Pharma Ltd). MHRA. https://products.mhra.gov.uk/. Accessed 03/07/2020.

Vicks Vaporub Ointment (Procter & Gamble Manufactura S de RL de CV). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 10/09/2020.

Disclaimer: This information is independently developed by MIMS based on Menthol from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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