Formulary

3.10 Systemic nasal decongestants

First Line
Second Line
Specialist
Hospital Only
SELF-CARE: NHS England has published guidance for various common conditions for which over the counter (OTC) items should not be routinely prescribed in primary care. One of these conditions is 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. 

Pseudoephedrine
  • Tablets 60mg (£2.25 = 24 tablets)
  • Oral solution sugar free 30mg/5ml (£0.70 = 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)