NHS England (NHSE) has published new prescribing
guidance for various common conditions for which over-the-counter (OTC) items should not be routinely prescribed in primary care (quick reference guide). These conditions include mild to moderate hay fever/seasonal allergic rhinitis and coughs, colds, and nasal congestion.
Many of these products are cheap to buy and are readily available OTC along with advice from pharmacies. Some self-care medicines are available from shops and supermarkets. Please click
here for further information, exceptions, and a patient leaflet.
- Nasal drops 0.9% (£0.99 = 10ml)
- Sodium Chloride 0.9% given as nasal drops may help relieve nasal congestion by helping to liquefy mucous secretions.
- Isotonic nasal spray (£2.49 = 50ml)
- Hypertonic nasal spray (£2.89 = 50ml)
Topical nasal decongestants containing sympathomimetics, ephedrine and xyometazoline, can cause rebound congestion following prolonged use (more than 7 days) and are therefore of limited value.
- Nasal drops 0.1% (£1.91 = 10ml)
- Paediatric nasal drops 0.05% (£2.18 = 10ml)
- Spray 0.1% (£2.18 = 10ml)
- Nasal drops: 2–3 drops into each nostril 2–3 times daily when required; maximum duration 7 days; not recommended for children under 12 years
- Paediatric nasal drops: 6–12 years 1–2 drops into each nostril 1–2 times daily when required; maximum duration 5 days
- Spray: 1 spray into each nostril 1–3 times daily when required; maximum duration 7 days; not recommended for children under 12 years
- Xylometazoline 0.05% nasal drops are only licensed for children aged 6 years or over (short-term use only).
- Nasal spray 0.03% (£6.54 = 180 dose unit)
- Rhinorrhoea associated with allergic and non-allergic rhinitis
- Adult and child over 12 years, 2 sprays into each nostril 2–3 times daily
- Ipratropium may be useful to treat non-allergic watery rhinorrhoea. It does not act directly to reduce blood flow to the nose but reduces watery secretions.
Systemic nasal decongestants
Systemic nasal decongestants used here, but listed elsewhere in the formulary:
12. Ear, nose & oropharynx >
12.2 Drugs acting on the nose >
12.2.2 Topical nasal decongestants
- First line
- Second line