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What Pharmacy Staff Need To Know About Managing Congestion

Cold Vs Flu: What's The Difference?

Download the Managing Congestion poster for your pharmacy here.

The symptoms of cold and flu are similar, but flu symptoms are often more severe. Cold symptoms usually appear gradually, and mainly affect the nose and throat. Those affected by flu may feel exhausted and unable to carry on as normal. In contrast, flu symptoms come on very quickly.1,2


Sinusitis, swelling of the sinuses usually caused by infection, is common after a cold or flu.3

Symptoms of congestion associated with sinusitis after a cold or flu:

  • Pain, swelling and tenderness around cheeks, eyes or forehead
  • Blocked nose
  • Reduced sense of smell
  • Green or yellow mucus from the nose
  • Sinus headache
  • High temperature of 38°C or above
  • Toothache
  • Bad breath.

Healthy Sinus Vs Congestion4,5


Self-care Tips

Self-care tips to help with nasal congestion:6

The Consultation

Congestion relief

Nasal congestion is the stuffed up feeling in the nose due to the membranes lining the nasal passages becoming inflamed and irritated.6 Over-the-counter products are available as single ingredient products or as combination ‘all-in-one’ remedies. They are available as tablets, capsules, nasal sprays and liquids. Patients should be reminded to take only one medicine with the same type of active ingredient at a time.

Product How does it work? Active ingredients
  • Phenylephrine narrows blood vessels in the nose to decrease swelling, making it easier to breathe
  • Pseudoephedrine and xylometazoline also narrow the blood vessels in the nose to decrease swelling and congestion7,8,9
  • Phenylephrine
  • Pseudoephedrine
  • Xylometazoline*
  • Pain relief and reduces fever
  • Paracetamol
  • Pain relief and reduces fever and inflammation
  • Ibuprofen

*Manufacturer advises decongestant nasal sprays should only be used for maximum of seven days due to the risk of rebound nasal congestion.10

Asking appropriate questions

During the consultation you can advise on appropriate management options for the patient’s symptoms.

  • Who is the medication for?
  • What symptoms do they have?
  • How long have they had the symptoms?
  • Have they already taken anything for the symptoms?
  • Are they taking any other medication?

When Should Patients Be Signposted To Their GP?

  • Develop a high temperature (above 39°C or 102.2°F), which can be a sign of a more serious type of infection
  • Feeling confused or disorientated
  • Notice a sharp pain in their chest
  • Cough up blood-stained phlegm (thick mucus)
  • Find it difficult to breathe
  • Notice a marked swelling of the glands in their neck and/or armpits
  • Symptoms lasted longer than three weeks11

*For claims verification please click here to contact us. For further product information please click here or see SmPC.12


  1. NHS. Overview Common cold. Available at: (accessed 30/09/2019)
  2. NHS* Flu. Available at: (accessed 30/09/2019)
  3. NHS. Sinusitis (Sinus infection). Available at: (accessed 30/09/2019)
  4. Healthy sinus vs Sinusitis. Available at: (accessed 02/10/2019)
  5. How Chiropractic Care Can Help Relieve Sinus Pressure. Exuberance: chiropractic and wellness centre. Available at: (accessed 10.10.2019)
  6. Nasal Congestion Pressure Home and OTC Remedies. Web MD. Available at: (accessed 10.10.2019)
  7. Phenylephrine. Web MD. Available via: (accessed 10.10.2019)
  8. Pseudoephedrine. Web MD. Available at: (accessed 10.10.2019)
  9. Xylometazoline. Web MD Available at: (accessed 10.10.2019)
  10. Decongestants, NHS. Available at (accessed 07.10.2019)
  11. Colds and Nasal Congestion.  Available at (accessed 10.10.2019)
  12. Sudafed Decongestant Tablets (Pseudoephedrine hydrochloride) 60 mg Summary of Product Characteristics (SmPC) 30 Jan 2013. Available at: (accessed 28.10.2019)



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