2017 HCHB_digital

Influenza (continued)
TREATMENT OPTIONS
Category Examples Comments
Analgesic/antipyretics
Cough suppressants
(antitussives)
Combination products
Antiviral
Influenza vaccinations
Natural / herbal products /
supplements
[GENERAL SALE]
eg, paracetamol (Lemsip range, Panadol), ibuprofen up to
25s (Advil range, Nurofen range)
[PHARMACY ONLY MEDICINE]
eg, ibuprofen >25s (Advil range, Nurofen range),
ibuprofen suspension (Fenpaed, Nurofen for Children),
paracetamol suspension (Pamol, Panadol suspension)
[PHARMACY]
eg, Pholcodine (Duro-Tuss Dry Cough Range, Difflam
Cough Lozenges, Pholcodine linctus)
eg, dextromethorphan (Robitussin Dry Cough Forte,
Strepsils Dry Cough Lozenges)
[GENERAL SALE]
eg, phenylephrine + paracetamol (Codral Relief Max
Strength Cold & Flu Plus Decongestant*, Lemsip Max
Cold & Flu With Decongestant)
eg, decongestant + paracetamol + expectorant (Codral
Relief Max Strength 6 Signs Cold & Flu*, Lemsip Max All
In One Hot Drink)
[PHARMACY ONLY MEDICINE]
eg, decongestant + paracetamol (Maxiclear Cold & Flu
Relief, Sudafed PE Sinus + Pain Relief)
eg, decongestant + paracetamol + cough suppressant
(Panadol Cold & Flu Relief PE)
eg, decongestant + paracetamol + antihistamine (Codral
Nighttime Cold & Flu*, Sudafed PE Sinus Day & Night
Relief)
eg, decongestant + paracetamol + antihistamine + cough
suppressant (Codral All in One*,Codral Cold & Flu +
Cough*, Coldrex PE Cold & Flu Day & Night)
eg, decongestant + paracetamol + codeine (Codral Cold
and Flu*)
eg, decongestant + paracetamol + codeine +
antihistamine (Codral Day & Night*, Codral Multi Action
Cold & Flu*)
eg, paracetamol + phenylephrine + caffeine (Lemsip Max
Cold & Flu Day & Night Capsules*)
[PRESCRIPTION MEDICINE]
[PHARMACIST ONLY under certain conditions (see
comments)]
eg, oseltamivir (Tamiflu capsules)
[PRESCRIPTION MEDICINE] – except when
administered by a registered pharmacist vaccinator to
adults and children aged over 13 eg, Fluarix, Fluvax,
Influvac, Intanza, Vaxigrip
Comvita range, honey, Bifidobacterium, Lactobacillus,
ginseng (American), elderberry, echinacea, N-acetyl
cysteine, olive leaf, vitamin D
Products with an asterisk have a detailed listing in the Influenza section of OTC Products, on page 247.
Analgesics can make a person feel more comfortable. Paracetamol is effective for most
people. However, remind the customer not to exceed the recommended dose. Ibuprofen
can provide longer symptom relief and is the NSAID least likely to cause stomach irritation.
NSAIDs may be unsuitable for people on certain other medications or with some conditions
(eg, asthma, kidney disease – see Refer to pharmacist). Advise the person to stop
taking if stomach upsets, increased bruising or prolonged bleeding occur (see Reference
Section, OTC Medicine – Precautions). Aspirin is not recommended for adolescents or
children under 12 years old, or for children under 16 years old with a viral-related fever, or
fever with chickenpox (see Childhood Pain and Baby Teething: Treatment options).
Cough suppressants (eg, pholcodine, dextromethorphan) control or suppress the
cough reflex and can provide relief from a dry, unproductive cough. Be aware that
dextromethorphan can interact with other medicines that also have serotonergic activity
(eg, antidepressants, tramadol, lithium, St John’s wort) (see also Coughs: Dry).
Refer to the packet for ingredients which may include a decongestant to relieve nasal
congestion (eg, phenylephrine), an analgesic for pain relief, an antihistamine to dry up
runny noses (eg, loratadine, chlorpheniramine), a cough suppressant to stop a dry cough (eg,
pholcodine, dextromethorphan), or an expectorant to help expel mucus from the lungs (eg,
guaiphenesin).
Analgesics (eg, paracetamol, ibuprofen, codeine) can help make a person feel more
comfortable if they are in pain. Warn customers that codeine is an addictive substance and
should not be used for more than three days at a time. Constipation or drowsiness may
also occur. Monitor sales and be alert for any customers who may be misusing codeinecontaining
preparations.
Some antihistamines may cause drowsiness and affect a person’s ability to drive or operate
machinery. Avoid alcohol.
Cough suppressants (eg, pholcodine, dextromethorphan) can provide relief from a dry,
unproductive cough and expectorants (eg, guaiphenesin) can help a chesty cough. Coughs
associated with flu are more likely to be dry.
People who take other medicines or have other medical conditions may be unable to take
cold and flu tablets – check with your pharmacist.
Products containing guaiphenesin, ipecacuanha, dextromethorphan, pholcodine,
phenylephrine, pseudoephedrine [PRESCRIPTION], doxylamine, brompheniramine,
promethazine, chlorphenamine, triprolidine or diphenhydramine should NOT be given to
children aged less than six years, and pharmacist advice should be sought before using
them in children aged less than 12 years.
Shorten the duration and reduce the risk of complications of flu. Best when started within
48 hours of symptom onset. Can be sold by a pharmacist year round to adults and children
aged 13 or older who have been exposed to the influenza virus. Available on prescription
for younger children or for the prevention of influenza. Tamiflu is unfunded (customers pay
full cost).
For customers unable to swallow, Tamiflu capsules may be given by opening the capsule up
over a small bowl and mixing the contents with a teaspoonful of sweetened food product
(regular or sugar free), eg, honey, condensed milk, apple sauce, yoghurt to mask the taste.
Privately purchased influenza immunisations may be given by pharmacists who are
approved vaccinators. Funded influenza vaccinations may be given by pharmacist
vaccinators to pregnant women and those aged 65 and over.
Honey soothes the throat and stops cough. Bifidobacterium, Lactobacillus, ginseng and
vitamin D appear to protect against flu. Elderberry and echinacea root extracts and
N-acetyl cysteine may reduce flu symptoms. Olive leaf contains five times the antioxidant
capacity of vitamin C and helps boost immunity.
PharmacyToday.co.nz A part of your everyday.
New Zealand’s premier pharmacy website keeping you up to date between issues.
www.pharmacytoday.co.nz
Page 98 HEALTHCARE HANDBOOK 2017-2018 Common Disorders