There’s something comforting about Lemsip, the “hug in a mug”, which might explain why it’s still one of Britain’s best-selling cold remedies more than 50 years after it was first launched in 1969.
Yet some experts now believe that the active ingredient of Lemsip, phenylephrine, is actually ineffective as a decongestant when taken orally, in a pill or a drink like Lemsip. The US Food and Drug Administration (FDA) has even gone as far as proposing a ban on the ingredient, unless used in nasal sprays. So does our beloved tonic actually work?
What actually is Lemsip?
“Lemsip” is a brand name for a range of medicines to treat colds and flu, but it’s best known for the sachets of powder that are stirred into hot water to make a lemon-flavoured drink. It was one of the first cold remedies to contain lemon.
“The Lemsip products contain a range of medicines such as paracetamol, phenylephrine, guaifenesin, cetylpyridinium chloride, plus sweeteners and lemon flavouring,” says Ron Eccles, an emeritus professor and the former director of the Common Cold Centre, Cardiff University.
He explains: “Paracetamol relieves sore throat pain, headache, muscle aches and pains, sinus pain and fever. Cetylpyridinium [found in some Lemsip cough syrups] has antibacterial and antiviral activity and may help to treat a sore throat. Guaifenesin [also found in some Lemsip cough syrups] relieves chesty coughs.”
According to NHS guidelines, decongestants like phenylephrine work by reducing swelling of the blood vessels inside the nostrils, which opens the airways and helps you to breathe more easily. However, Prof Eccles takes the view that “phenylephrine is ineffective as a decongestant” – a view that is shared by many experts in his field.
How effective is Lemsip really?
How effective Lemsip is has recently been called into question.
The US Food and Drug Administration (FDA) has proposed banning the use of oral phenylephrine, the common decongestant that’s found in many OTC (over the counter) cold remedies, including Lemsip. This is because clinical trials indicate that it’s ineffective when taken orally, either as pills, capsules, syrups – or liquids such as Lemsip.
Veerpal Sandhu, a clinical pharmacist, explains: “When taken orally, phenylephrine is an ineffective decongestant because it is metabolised in the gut and liver before it reaches the nose.”
In other words, as phenylephrine is processed in the liver and gut, so little remains in the bloodstream that, even if it does reach the nose, the levels are too low to relieve congestion.
If the proposed changes go ahead, this could mean the ingredient is ultimately removed from products in the UK, meaning products like Lemsip could be taken off the shelves or reformulated. As a result, some consumers are now questioning whether Lemsip actually works.
However, phenylephrine is just one of the active ingredients in Lemsip, and Prof Eccles takes the view that it’s the combination of ingredients, not to mention the delivery method, that provides relief. He says: “Lemon flavouring is a traditional remedy to soothe cold symptoms by promoting salivation and mucus secretions in the throat. Research shows that the hot drink formulation helps relieve all cold symptoms and therefore is more effective than a tablet or capsule.”
How does Lemsip compare with other cold remedies?
With so many cold remedies available, it’s hard to know which one is best. We asked Prof Ron Eccles to help us rate some of the most popular options:
How to take Lemsip safely
If you make a mug of Lemsip in place of your usual caffeine fix, it’s easy to forget that it contains paracetamol, especially if you’re feeling tired. This means there’s a risk of overdose if combined with other paracetamol-based cold remedies, so take no more than one sachet every four hours, with a maximum of four sachets in a 24-hour period.
Due to the paracetamol content, you should also avoid drinking large quantities of alcohol while taking Lemsip, although a small amount, such as a glass of wine or pint of beer, is unlikely to cause any problems.
There is no caffeine in the Lemsip sachets of any type but there is in some of the capsules (25mg), including Lemsip Max Cold & Flu Relief Capsules and Lemsip Max Day & Night Cold & Flu Relief Capsules, so keep this in mind if also consuming caffeine throughout the day.
If you take two capsules this is less than the equivalent of a cup of tea (which has up to about 60mg per cup) and less than a cup of coffee (95-200mg per cup), or the equivalent of about and and a half cans of Coke (33mg per can)
Lemsip is not suitable for children under the age of 16.
Expert verdict: Does Lemsip actually work?
Yes, but only to a point: While there’s sadly no cure for the common cold, both our experts agree that Lemsip can help to relieve some of the discomfort. While some other remedies work just as well – if not better – Lemsip is a convenient option when you’re feeling under the weather.
Prof Eccles says: “Lemsip works well as a hot drink formulation, but you could also make up your own honey and lemon hot drink at home. One advantage of making your own is that you can take the drink as often as you wish without any side effects, and [a homemade brew] can be taken by children as often as needed. However, if you want quick relief from cold symptoms, Lemsip is an easy option.”
No, says Sandhu: “Lemsip may help to soothe cold and flu symptoms but, personally, I would rather take paracetamol and ibuprofen, along with a warm drink, such as lemon and honey. This is the advice I always give to my patients.”
FAQs
Can I take Lemsip with other medications?
“You should not take Lemsip with any other medicine that contains paracetamol, and taking other cough and cold medicines at the same time could lead to an overdose,” cautions Sandhu.
It’s wise to check with your pharmacist if you’re taking any other prescribed medications to avoid potential interactions. “Don’t take Lemsip if you are taking monoamine oxidase inhibitors (MAOIs), or have taken them within the last 14 days. These are a type of drug used to treat depression,” explains Sandhu.
Is Lemsip safe during pregnancy or breastfeeding?
“Lemsip should not be used during pregnancy, and should also be avoided if you’re breastfeeding,” advises Sandhu.
Does Lemsip help with a sore throat?
“Most Lemsip products are taken as a hot drink and this is good as hot drinks have been shown to relieve all symptoms of colds, especially cough and sore throat,” adds Prof Eccles. If your throat feels like you’re swallowing razor blades, the paracetamol in Lemsip will also help to ease the discomfort.