Page content

Page breadcrumb

3.4 Cough and congestion

First line drugs Second line drugs Specialist drugs Secondary care drugs

Traffic light status (TLS) explained:

  • Green: Routine prescribing within licensed indication
  • Amber 1: specialist recommendation followed by GP initiation and continuation
  • Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
  • Amber 3: specialist initiation and stabilisation followed by GP continuation
  • Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
  • Red: Hospital or specialist prescribing only

 

 

Cough suppressants

Opioids

Pholcodine

  • Linctus, sugar free, 5mg in 5mL 

 

 

Expectorant and demulcent cough preparations

Citric Acid

  • Simple Linctus BP, sugar free

Notes:

  • Should not be prescribed in Primary Care or at Discharge
  • Advise patient to purchase, unless prescription is for long-term regular use
  • The BNF recommends that cough preparations should be avoided but recognises that Simple linctus has the advantage of being harmless and inexpensive.

 

 

Menthol and Derivatives

Eucalyptus with menthol

  • Inhalation, BP 1980

Notes:

  • Should not be prescribed in Primary Care or at Discharge
  • Advise patient to purchase

 

 

Resins 

Benzoin tincture (Friars' Balsam) 

  • Tincture, Compound, BP

Notes:

  • Should not be prescribed in Primary Care or at Discharge
  • Advise patient to purchase

 

 

Systemic nasal decongestants

Pseudoephedrine hydrochloride

  • Elixir 30mg in 5mL 

Notes: 

  • Should not be prescribed in Primary Care or at Discharge
  • Advise patient to purchase, unless prescription is for long-term regular use
  • Systemic nasal decongestants are of doubtful value but unlike the preparations for local application they do not give rise to rebound nasal congestion. Sympathomimetics should be avoided in patients with hypertension, hyperthyroidism, coronary heart disease, or diabetes, and in patients taking monoamine-oxidase inhibitors.   

 

 

 

 

 

Traffic light status (TLS) explained:

  • Green: Routine prescribing within licensed indication
  • Amber 1: specialist recommendation followed by GP initiation and continuation
  • Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
  • Amber 3: specialist initiation and stabilisation followed by GP continuation
  • Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
  • Red: Hospital or specialist prescribing only

 

Return to Chapter: 3. Respiratory System

Last updated by: Dupe Fagbenro on 12-12-2018 16:48