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 coughs, colds, and nasal congestion.

Many cough and cold treatments, including pseudoephedrine 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.

Pseudoephedrine

• Tablets 60mg (£2.25 = 24 tablets)
• Oral solution sugar free 30mg in 5ml (£2.15 = 100ml)

Indications

• Decongestant

Dose

• Adult: 60mg 3–4 times daily
• Child 6–12 years: 30mg 3–4 times daily

Notes

1. Systemic nasal decongestants are of doubtful value but unlike the preparations for local application they do not give rise to rebound nasal congestion.
   
2. Sympathomimetics should be avoided in patients with hypertension, hyperthyroidism, coronary heart disease, or diabetes, or severe renal impairment, and in patients taking monoamine-oxidase inhibitors.
3. MHRA Drug Safety Update (February 2024): Pseudoephedrine: very rare risk of posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS)