Cold and Flu

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Many patients may have misconceptions about the duration of a cold or flu1

Many patients underestimate the duration of a cold or flu. The worst cold & flu symptoms should be over in 4-5 days but complete recovery can take up to 10 days, and sometimes longer.1

Person blowing nose

Adults experience an average of 2-3 colds a year2

  • The common cold is the conventional term used to describe a mild, self-limited, viral, upper respiratory tract infection.3
  • It is characterised by nasal stuffiness and discharge, sneezing, sore throat and cough.
  • There is no cure for the common cold as it can be caused by a wide range of viruses from several different families.3 Treatment is therefore aimed at symptomatic relief.
  • The common cold is a self-treatable condition and advice can be sought from pharmacists to help reduce pressure on local GP services.

  • Symptoms

    Symptoms of the common cold

    A sore throat is usually the first symptom of a cold and this is then followed by other symptoms including:4

    • Blocked or runny nose
    • Headaches
    • Muscle aches
    • Cough
    • Sneezing
    • A raised temperature
    • Pressure in the ears or face
    • Loss of taste and smell

    Symptoms are the same in adults and children but may last longer in children.4

  • When to refer

    When to refer patients with a cold or flu symptoms to the GP

    It is important to highlight to customers that you are able to offer cold & flu advice and product recommendations to help reduce the number of unnecessary GP appointments. There are times when It is important to highlight to customers that you are able to offer cold & flu advice and product recommendations to help reduce the number of unnecessary GP appointments. There are times when customers will need to be referred to the doctor such as:5

    • Prolonged or recurrent symptoms, especially cough.
    • Infections resulting in exacerbation of chronic respiratory symptoms (asthma or COPD)
    • Suspected dehydration
    • High-grade fever
    • Young infants and the elderly
    • A cough that persists for greater than 3 weeks or is concomitant with breathing difficulties, wheezing, pain on inspiration or blood in the sputum or a persistent nocturnal cough (particularly in children)

  • Antibiotics advice

    Antibiotics are ineffective for cold & flu viruses6

    Patients seeking antibiotics for their cold & flu symptoms may require supportive education around self-treatable conditions and self-care practice. Self-care advice from NICE details:6

    • Explain that symptom relief and rest are the most appropriate management
    • Advise that antibiotics and antihistamines are ineffective and may cause adverse effects
    • Adequate fluid should be taken during the course of the illness
    • Healthy food is recommended although no specific diet or mineral or vitamin supplementation is necessary
    • Adequate rest is advised however it is not necessary to stay off work or school and normal activity will not prolong the illness
    • Transmission cannot be completely prevented but basic good hygiene can help prevent the spread: wash hands frequently with soap and hot water.

  • Treatment

    Person showing cold symptoms

    Treating common cold symptoms

    Treatment for the common cold is aimed at symptomatic relief, and includes the following for adults and children over 6 years:6

    • Analgesics
    • Intranasal decongestants
    • Cough medicines

    It is important to advise patients to follow usage instructions, particularly if using multiple products.

Product Information

  • Product Information – Night Nurse Cold Remedy Oral Solution and capsules

    Night Nurse Cold Remedy Oral Solution / Night Nurse Capsules (paracetamol, promethazine hydrochloride, dextromethorphan hydrobromide).

    Indications: Symptomatic relief of colds, chills and influenza, including cough at night.

    Dosage: Adults and children 16 years and over: 20 ml or 2 capsules before bed. Max 1 dose in 24 hours. Max duration of use without medical advice: 7 days.

    Contraindications: Hypersensitivity to the active ingredients or excipients. Hepatic or renal impairment. Patients with or at risk of developing, respiratory failure. Patients who are taking or have taken monoamine oxidase inhibitors (MAOIs) in the last two weeks. Use in children under 16 years of age.

    Precautions: Contains paracetamol. Do not use with any other paracetamol-containing products, antihistamines or cold and flu medicines. Paracetamol overdose may cause liver failure. Avoid alcohol. Medical advice should be sought if taking warfarin. Caution in patients with chronic or persistent cough, or where cough is accompanied by excessive secretions, narrow angle glaucoma, cardiovascular problems, prostatic hypertrophy, urinary retention, epilepsy, glutathione depleted states and glucose-galactose malabsorption, history of dextromethorphan abuse and dependence, poor metabolizers of CYP2D6. Concomitant use with serotonergic agents can result in serotonergic effects, including serotonin syndrome. Use with caution in the elderly. Caution, due to paracetamol, if administered with flucloxacillin due to increased risk of high anion gap metabolic acidosis. Medical advice should be sought if symptoms persist, or are accompanied by high fever, skin rash or persistent headache. May cause urine pregnancy tests to produce false results. Oral solution only: Patients suffering from alcoholism, diabetes mellitus or on a low sodium diet.

    Side effects: See SPC for full details. Hypersensitivity reactions including anaphylaxis and skin rashes, thrombocytopenia, bronchospasm, hepatic dysfunction, GI disturbance, nervous system disorders (including drowsiness), confusion, paradoxical excitation, dry mouth, eye disorders, blurred vision, urinary retention.

    Legal category: Supply through pharmacy only.

    Product licence number: Night Nurse Cold Remedy: PA 0678/014/001, Night Nurse Capsules: PA 0678/021/001.

    MAH: Haleon Ireland Limited, 12 Riverwalk, Citywest Business Campus, Dublin 24, Ireland. Full product information is available in the SPC. Additional information is available upon request.

    Text prepared: March 2023.

    Ask pharmacist for advice. Contains paracetamol, promethazine hydrochloride and dextromethorphan hydrobromide. Always read the label/leaflet.

  • Product Information - Otrivine Extra Dual Relief

    Otrivine Extra Dual Relief 0.5mg/ml + 0.6mg/ml nasal spray, solution (xylometazoline hydrochloride and ipratropium bromide)

    Indications: Symptomatic treatment of nasal congestion and rhinorrhea in connection with common colds.

    Dosage and method of administration: Adults: 1 puff in each nostril up to 3 times daily. 6 hours min. between 2 doses. Max. 3 puffs daily into each nostril. Max. 7 days use. Do not exceed the stated dose. Paediatric population: Not for use under 18 years of age. Geriatrics: Limited experience of use in patients above 70 years of age.

    Contraindications: Hypersensitivity to ingredients, atropine or atropine like substances. After surgical operations where dura mater may have been penetrated. Patients with glaucoma, rhinitis sicca or atrophic rhinitis.

    Precautions: Use with caution in patients with hypertension, cardiovascular diseases, long QT syndrome, hyperthyroidism, diabetes mellitus, hypertrophy of the prostate, stenosis of the bladder bar, pheochromocytoma, cystic fibrosis, on monoamine oxidase inhibitors treatment, on tri/tetra cyclic antidepressants (or have been on either within the last two weeks), on beta 2-agonist treatment and a sensitivity to adrenergic substances. Use with caution in patients predisposed to angle closure glaucoma, epistaxis and paralytic ileus. Immediate hypersensitivity - may occur. Avoid spraying in or around the eye.

    Side effects: Very Common: Epistaxis. Common: nasal dryness, dysgeusia, headache, nasal discomfort, nasal congestion, dry throat, throat irritation, rhinalgia, dry mouth, dizziness, nausea, application site burn. Uncommon: insomnia, parosmia, tremor, eye irritation, dry eye, palpitations, tachycardia, nasal ulcer, dysphonia, orophyaryngeal pain, sneezing, dyspepsia, fatigue, corneal oedema, conjunctival hyperaemia, cough. See SPC for full list.

    Legal category: Pharmacy Only.

    Product licence number: PA 0678/131/001.

    MAH: Haleon Ireland Limited, 12 Riverwalk, Citywest Business Campus, Dublin 24, Ireland. Full product information is available in the SPC. Additional information is available upon request.

    Text prepared:December 2024.

    Ask your pharmacist for advice. Always read the label/leaflet.

  • Product Information - Otrivine Sinusitis Relief

    Product Information: Please refer to the Summary of Product Characteristics for full product information. Otrivine Sinusitis Relief 0.1% w/v Nasal Spray, Solution (xylometazoline hydrochloride).

    Indications: As a nasal decongestant for relief of the symptoms of acute rhinitis in allergic or upper respiratory tract infections, including the common cold or influenza, and sinusitis.

    Dosage and administration: Adults (including the elderly) and adolescents over 12 years of age: 1 spray into each nostril, up to 3 times daily as needed. Do not exceed 3 applications daily into each nostril.

    Contraindications: Hypersensitivity to xylometazoline or to any of the excipients. Trans-sphenoidal hypophysectomy or surgery exposing the dura mater. Acute coronary disease, hyperthyroidism or narrow angle glaucoma. Treatment with monoamine oxidase inhibitors, or within 14 days of stopping such treatments. Rhinitis sicca and Atrophic rhinitis. Children aged less than 12 years old.

    Precautions: Use with caution in patients with hypertension, cardiovascular disease, diabetes mellitus, phaeochromocytoma, prostatic hypertrophy and in patients on tri- and tetracyclic antidepressants. Not to be used for more than seven consecutive days: prolonged or excessive use may cause rebound congestion and/or atrophy of the nasal mucosa. Caution in patients with a strong reaction to adrenergic substances. Patients with long QT syndrome, due to increased risk of serious ventricular arrhythmias. Contains benzalkonium chloride which may cause nasal irritation or swelling inside the nose. Do not exceed the recommended dose, especially in children and the elderly. It is recommended that each product package is used by one person only.

    Side effects: For full details see SPC. Common: headache, nasal dryness and discomfort, nausea, application site burning. Uncommon: Epistaxis.

    Legal category: Pharmacy only.

    Licence number: PA 0678/120/003..

    Licence holder: Haleon Ireland Limited, 12 Riverwalk, Citywest Business Campus, Dublin 24, Ireland.

    Date of preparation: November 2023. Additional information available on request.

    Contains Xylometazoline hydrochloride. Always read the label/leaflet. Ask your pharmacist for advice

Help your customers find relief for their cold and flu

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The Otrivine range

Find the right Otrivine product for your customers and patients. Otrivine Sinusitis Relief 0.1% w/v Nasal Spray, Solution contains xylometazoline hydrochloride for relief of symptoms of acute rhinitis. Always read the label/leaflet. Ask your pharmacist for advice.

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Night Nurse product range

Find out how Night Nurse products can help your customers with cold & flu. Night Nurse Capsules contains paracetamol, promethazine hydrochloride, dextromethorphan hydrobromide for symptomatic relief of colds at night. Always read the label/leaflet. Ask your pharmacist for advice.

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