When to refer
When to refer
Pharmacy team members should refer to the pharmacist/GP:
-
Any customer with symptoms that have lasted more than three weeks -
Customers experiencing breathing difficulties
-
Symptoms such as chest pain, coughing up blood, unexplained weight loss or swollen glands4
-
Customers taking other medication -
Severe symptoms, or symptoms that are quickly getting worse
1. https://cks.nice.org.uk/cough#!topicsummary (Accessed Nov 2018)
2. https://www.brit-thoracic.org.uk/document-library/clinical-information/cough/cough-guidelines/recommendations-for-the-management-of-cough-in-adults (Accessed Nov 2018)
3. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/585584/RTI_infection_control_guidance.pdf (Accessed Nov 2018)
4. C Edwards and P Stillman. Minor Illness or Major Disease. 4th E d. Pharmaceutical Press. 2006
5. https://www.nhs.uk/conditions/Cough (Accessed Nov 2018)
6. https://www.gov.uk/government/news/green-phlegm-and-snot-not-always-a-sign-of-an-infection-needing-antibiotics (Accessed Nov 2018)
7. Chung K et al. Cough: Causes, Mechanisms and Therapy. Blackwell Publishing (2003)
8. Robert E. et al. Effectiveness of Guaifenesin as an Expectorant : A Cooperative Double-blind Study. 1977. 284-292. 22:2
9. Source ©2018 Nielsen data, value and unit share, Cough (client defined) 52 w/e 29/09/18 GB Total Coverage
10. Benylin Dry Coughs 7.5mg/5ml Syrup SmPC https://www.medicines.o rg.uk/emc/product/1523/smpc (Accessed Nov 2018)
Benylin Chesty Coughs (Original)
(Diphenhydramine hydrochloride, Levomenthol)
Product Information: Presentation: Red syrup containing 14mg Diphenhydramine HCl and 2mg Levomenthol per 5ml. Uses: Relief of cough and associated congestive symptoms. Dosage: Adults and children over 12 years: 10ml four times daily. Contraindications: Use in children under 12 years. Known hypersensitivity to ingredients; chronic or persistent cough e.g. asthma, or cough accompanied by excessive secretions. With or within two weeks of receiving MAOIs. Precautions: May cause drowsiness, if affected, do not drive or operate machinery. Use with caution in moderate to severe renal or hepatic impairment or urinary retention. Do not use in narrow-angle glaucoma or prostatic hypertrophy. May potentiate effects of alcohol, codeine, antihistamines and other CNS depressants. May potentiate the effects of anticholinergics. Pregnancy and lactation: Consult doctor before use. Side effects: Drowsiness, dizziness, gastrointestinal disturbance, dry mouth, nose and throat, difficulty in urination or blurred vision. Infrequently: palpitations, tremor, convulsions, paraesthesia. Hypersensitivity reactions. RRP (ex-VAT): 150ml £5.57; 300ml £8.15 Legal category: P. PL Holder: McNeil Products Ltd, Foundation Park, Maidenhead, Berks, SL6 3UG. PL Number: 15513/0048. Date of preparation: 30 Jul 2014 UK/BE/15-5840(2)
Benylin Dry Coughs 7.5mg/5ml Syrup
(Dextromethorphan hydrobromide)
Product Information: Presentation: Brown syrup containing 7.5mg Dextromethorphan hydrobromide per5ml. Uses: Relief of an unproductive cough. Dosage: Adults: 10ml four times daily. Contraindications: Use in children under 12 years. Known hypersensitivity to ingredients. With or within two weeks of receiving MAOIs. Patients in or at risk of respiratory failure. Patients taking SSRIs. Precautions: Not for use in patients with chronic or persistent cough, such as occurs with asthma or cough accompanied by excessive secretions. Caution in moderate to severe hepatic impairment. Caution in adolescents, young adults and in patients with a history of drug abuse or psychoactive substances. Do not take with other cough and cold medicines. Use of dextromethorphan with alcohol or other CNS depressants may increase the effects on the CNS and cause toxicity in relatively smaller doses. Caution in atopic children due to histamine release. Patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine. Ethanol content should be considered in high-risk groups. Pregnancy and lactation: Consult doctor before use. Side effects: Angioedema, pruritus, rash, urticaria, insomnia, confusional state, convulsion, dizziness, psychomotor, hyperactivity, somnolence, respiratory depression, abdominal pain, diarrhoea, gastrointestinal disturbance, nausea, vomiting. RRP (ex-VAT): 150ml £5.43 Legal category: P. PL Holder: McNeil Products Ltd, Foundation Park, Maidenhead, Berks, SL6 3UG. PL Number: 15513/0051. Date of preparation: 04 Jan 2017. UK/BE/17-8485(2)
Benylin Dry Coughs Night Syrup (Diphenhydramine hydrochloride, Dextromethorphan hydrobromide, Levomenthol)
Product Information: Presentation: Red syrup containing 14mg Diphenhydramine hydrochloride, 6.5mg Dextromethorphan hydrobromide and 2mg Levomenthol per 5ml. Uses: For night time relief of persistent, dry, irritating cough and aiding restful sleep. Dosage: Adults and children over 12 years: two 5ml spoonfuls at bedtime followed by two 5ml spoonfuls every 6 hours. Do not take more than 4 doses in 24 hours. Contraindications: Use in children under 12 years. Known hypersensitivity to any actives or excipients. With or within two weeks of receiving MAOIs. Patients in or at risk of respiratory failure. Precautions: May cause drowsiness, if affected do not drive or operate machinery. Use with caution in moderate to severe renal or hepatic impairment. Do not use in narrow-angle glaucoma or symptomatic prostate hypertrophy. Use with caution in patients with a history of drug abuse or psychoactive substances. Use with caution in patients who are slow metabolizers of CYP2D6 or use CYP2D6 inhibitors. May potentiate effects of alcohol and other CNS depressants. May potentiate the effects of anticholinergics. Pregnancy and lactation: Consult doctor before use. Side effects: Drowsiness, dizziness, gastrointestinal disturbance, dry mouth, nose and throat, difficulty in urination or blurred vision, nausea, vomiting. RRP (ex-VAT): 150ml £5.43 Legal category: P. PL Holder: McNeil Products Ltd, Foundation Park, Maidenhead, Berks, SL6 3UG. PL Number: 15513/0053. Date of preparation: 13 Dec 2016 UK/BE/15-5857(5)
Benylin Mucus Cough Max Honey & Lemon Flavour 100mg/5ml Syrup (Guaifenesin)
Product Information: Presentation: Clear yellow-brown coloured syrup containing 100mg Guaifenesin per 5ml. Uses: For the symptomatic relief of productive cough in adults and adolescents of 12 years and above. Dosage: Adults and adolescents over 12 years: 10ml (200mg guaifenesin) 4 times a day up to a maximum daily dose of 40ml (800mg guaifenesin) Contraindications: Hypersensitivity to the active substance or to any excipients. Precautions: Do not use in persistent or chronic cough, such as occurs with asthma, or where cough is accompanied by excessive secretions. Caution in severe renal & hepatic impairment. The concomitant use of cough suppressants is not recommended. Patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine. Contains 4.7 vol % alcohol; caution in alcoholism, pregnant and breastfeeding women, children and patients with liver disease or epilepsy. Pregnancy and lactation: Consult doctor. Side effects: GI disorders (frequency not known): abdominal pain, diarrhoea, nausea, vomiting. Immune System Disorders (frequency not known): Hypersensitivity reactions including pruritus, urticaria and rash. Please refer to Summary of Product Characteristics for detailed information RRP (ex-VAT): 150ml: £5.09; 300ml: £7.41 Legal category: GSL PL Holder: McNeil Products Ltd, Foundation Park, Maidenhead, Berks, SL6 3UG. PL Number: 15513/0377 Date of preparation: 07 July 2017
Benylin Chesty Coughs (Non-Drowsy) (Guaifenesin, Levomenthol)
Product Information: Presentation: Red syrup containing 100mg Guaifenesin and 1.1mg Levomenthol per 5ml. Uses: Symptomatic relief of cough. Dosage: Adults and children over 12 years: 10ml four times daily. Contraindications: Known hypersensitivity to ingredients. Use in children under 12 years. Precautions: Do not use in persistent or chronic cough, e.g. asthma, or cough accompanied by excessive secretions; caution in severe renal or hepatic impairment. Patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine. Contains 5 vol % ethanol (alcohol). Can be harmful for those suffering from alcoholism. The ethanol content should be taken into account in pregnant or breastfeeding women, children and high-risk groups such as patients with liver disease or epilepsy. This product contains 16.42mg of sodium per 5ml. This should be taken into consideration by those on a controlled sodium diet. This product contains Ponceau 4R (E124) red colouring which may cause allergic reactions. Pregnancy and lactation: Consult doctor. Side effects: Hypersensitivity reactions (hypersensitivity, pruritus and urticaria), rash. Abdominal pain upper, diarrhoea, nausea, vomiting RRP (ex-VAT): 150ml £5.09; 300ml £7.41. Legal category: GSL. PL Holder: McNeil Products Ltd, Foundation Park, Maidenhead, Berks, SL6 3UG. PL Number: 15513/0056. Date of preparation: 28 Sep 2016 UK/BE/15-5839(5)
Benylin Dry and Tickly Cough Syrup (Glycerol, Liquid sugar)
Product Information Presentation: Liquid containing 0.75ml Glycerol and 1.93ml Liquid sugar per 5ml. Uses: Relief of tickly dry coughs and sore throats. Dosage: Adults and children over 5 years: 10ml 3 to 4 times a day; children 1 - 5 years: 5ml 3 to 4 times a day; children under 1 year: not recommended. Contraindications: Known hypersensitivity or intolerance to ingredients. Precautions: Diabetics should take note of the carbohydrate content of this product. Contains glucose, sucrose and small amounts of alcohol. Patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrose-isomaltase insufficiency should not take this medicine. Pregnancy and lactation: The safety of this product during pregnancy and lactation has not been established. Consult doctor before use. RRP (ex-VAT): 150ml £4.57; 300ml £6.89. Legal category: GSL. PL Holder: McNeil Products Ltd, Foundation Park, Maidenhead, Berks, SL6 3UG. PL Number: 15513/0142. Date of preparation: 16 Mar 2017