Winter is the season for nasal congestion, coughs, and runny noses. Because of the prevalence of colds and flu at this time of year allergic rhinitis can frequently be misdiagnosed. Pharmacies are often the first port of call for people suffering from common colds or flu and it is important that pharmacy personnel correctly diagnose the malady in order to recommend appropriate treatment.

Both cold and flu conditions are contagious and spread easily from person to person by direct contact with infected secretions, from contaminated surfaces, or by inhaling the airborne virus.

Before recommending any treatments to patients it is important to check what other medicines they are taking — including prescription, OTC, and complementary (herbal, ‘natural’, vitamin, or mineral supplements) medicines. This is because all medicines, including herbal and natural medicines, can cause side effects and may interact with other medicines. A basic understanding of the treatment options available will enable you to assist the customer in making an informed choice.

OTC medication is aimed at providing symptomatic relief and improvement of the customer’s quality of life for the duration of the illness. Colds and flu sufferers experience varied symptoms, and convenient OTC preparations containing medication in combinations are available to treat these. It is essential that the customer takes products that contain only those medications that may relieve the symptoms present, in order to avoid unnecessary side-effects.


Allergic rhinitis is not a trivial disease. Although not life-threatening it can have a huge impact on quality of life. Affecting 20-30% of the population, allergic rhinitis is a common condition where there is swelling and inflammation in the lining of the nose. It is sometimes called hay fever, and the persistent form is sometimes called “sinus”. Symptoms are triggered by allergens such as house dust, grass, and tree pollens, and pet dander.

Symptoms table


  • Intranasal steroids: According to the Allergy Foundation of SA (AFSA) nose sprays containing an anti-inflammatory corticosteroid are the best treatment for all the symptoms of allergic rhinitis. They need to be used every day because they help with the underlying swelling and inflammation and take a few days before they work, so can’t really be used just occasionally for symptom relief. The way that they are used is really important to make sure that they have the best effect.

• Antihistamines: Antihistamines are very good for treating the symptoms of itching, running nose, and sneezing, but are less effective than nasal sprays on the blockage and have no effect on the underlying inflammation. All antihistamines are effective, but the older antihistamines can cause patients to be very sleepy so are not recommended unless they are the only option available. Newer, non-sedating antihistamines are safe to use for a very long time, and are available without a prescription.

  • Vasoconstrictor nose drops/sprays: Put into the nose, vasoconstrictor nose drops/sprays shrink the blood vessels and provide fast relief from blockage. These are very effective for short term use but should never be used for more than five days or the blood vessels rebound and cause even worse blockage. For this reason, they aren’t recommended unless all other treatments are being used and even then for short times under the direction of a doctor.
  • Allergen Immunotherapy: If none of these treatments provides relief from the symptoms, patients should contact a doctor with experience in allergy to determine whether they qualify for immunotherapy.