Cough, Cold and Flu Remedies

A blocked nose is the symptom people most want gone, and there are two ways to go about it. Decongestant nasal sprays containing xylometazoline or oxymetazoline, including Sudafed spray and Otrivine, shrink the swollen lining within minutes and are the best choice for a night's sleep. The catch is rebound congestion: use a spray for longer than the pack allows, which is five days on some and seven on others, and the nose swells up again as each dose wears off, which is why we ask how long you have been using one (https://www.nhs.uk/medicines/decongestants/).

Decongestant tablets are slower but can be taken for longer. The one that works is pseudoephedrine, found in Sudafed tablets and sold from behind the counter as a pharmacy medicine, which is why we keep it there and will ask you a couple of questions. Phenylephrine is the ingredient in most shelf products and cold and flu capsules; the evidence that it does anything at the dose in tablets is weak, and in 2023 an FDA advisory panel concluded it is no better than placebo when swallowed. If you want a tablet that unblocks your nose, ask for pseudoephedrine.

Decongestants raise blood pressure and heart rate, so they are not suitable if you have high blood pressure, heart disease, diabetes, an overactive thyroid or glaucoma, if you take MAOI antidepressants or a beta blocker, or in pregnancy. Men with an enlarged prostate should ask us first. Sudafed products are for adults and children aged 12 and over. Blocked ears during a cold are usually caused by a congested Eustachian tube, and while people often ask for a decongestant for ears, a steam inhalation and time usually do more; ear pain that lasts beyond a couple of days is something we can assess under Pharmacy First.

Most sore throats are viral and settle within a week. Paracetamol or ibuprofen ease the pain, and medicated lozenges or sprays such as Strepsils, Difflam and Ultra Chloraseptic numb the throat for an hour or so at a time. Honey in a warm drink is as effective as many of the sprays for adults and children over 1. Gargling with warm salt water costs nothing and helps.

A sore throat that comes with a high temperature, white spots on the tonsils, swollen glands and no cough may be a bacterial infection. Under NHS Pharmacy First our pharmacists can examine your throat, score it and supply antibiotics where the score says they will help, without a GP appointment. Our sore throat page at /services/pharmacy-first/sore-throat-medway explains how the assessment works.

All-in-one cold and flu products combine paracetamol with a decongestant and sometimes caffeine or an antihistamine. They are convenient, but every one of them contains paracetamol, and taking them alongside separate paracetamol tablets is the commonest way people accidentally exceed the daily maximum. Check the box, and do not take more than eight 500 mg paracetamol tablets in 24 hours from all sources combined, leaving at least four hours between doses. Buying paracetamol and a decongestant separately lets you take each only when you need it.

Flu is different from a cold: it hits within hours, with a high temperature, aching muscles and exhaustion that keeps you in bed. Rest, fluids and paracetamol are the treatment for healthy adults. If you are over 65, pregnant, or have a long-term heart, lung or immune condition, contact your GP or 111 early, because antiviral treatment is most useful in the first two days. The flu jab is available in the pharmacy every autumn and is the only thing that actually prevents it.

Congestion and facial pain that lasts beyond ten days may be sinusitis, which we can assess and treat under Pharmacy First. Call 999 for chest pain, difficulty breathing, blue lips, confusion, or a child who is floppy, has a rash that does not fade under a glass, or is breathing fast and hard.