Treatment for common colds.

Legal and professional obligations

Pharmacists play a critical role in providing high-quality care for patients with common colds. This includes ensuring advice aligns with professional standards, codes, and guidelines while prioritising patient safety. Pharmacists must maintain confidentiality, respect patient privacy, and document interactions such as recommendations, referrals, and follow-ups. Accurate documentation supports continuity of care and professional accountability.

Clinical features

Common colds are self-limiting viral infections typically resolving within 7–10 days. Symptoms include:

• Blocked or runny nose
• Sore or scratchy throat
• Cough
• Mild headache or body aches
• Sneezing
• General malaise

These symptoms are usually mild, but their severity can vary depending on the patient’s health and risk factors.

Certain factors can increase the risk and severity of a cold, including:

• Smoking
• Chronic illnesses or weakened immune systems
• Stress or poor sleep

Identifying these factors allows pharmacists to tailor advice and support for patients.

Gathering patient information

When consulting with a patient, pharmacists should ask:

• When did the symptoms start?
• Are symptoms improving, worsening, or staying the same?
• Are you experiencing any shortness of breath, chest pain, or persistent high fever?
• Do you have any chronic health conditions or take regular medications?
• Are there symptoms suggesting a secondary bacterial infection (e.g. coloured mucus >10 days)?

The need to refer

Patients should be referred to a medical practitioner if they exhibit:

Adults

• Fever > 39°C lasting more than 3 days
• Severe chest pain or breathing difficulty
• Persistent cough > 3 weeks
• Thick yellow/green nasal discharge lasting > 10 days
• Severe sore throat with white patches (possible strep throat)
• Ear pain or pressure worsening over time

Children

• Fever ≥38 °C in infants ≤3 months
• Fever not improving after 2 days
• Symptoms worsening or not improving after 2 days
• Ear pain, poor feeding, drowsiness or excessive irritability
• Bulging fontanelle, refusal to drink for 6 hours
• Less than half the usual number of wet nappies
• Neck stiffness or a rash that does not blanch

Treatment

While there is no cure for the common cold, symptomatic relief is available through both pharmacological and non-pharmacological strategies.

Symptom	Treatment
Fever and body aches	Paracetamol and NSAIDs
Nasal congestion	Decongestants and nasal irrigation/ saline
Runny nose and sneezing	Antihistamines
Cough	Cough suppressants, mucolytics and expectorants
Sore throat	Lozenges, throat spary and home remedies

Medicine	Contraindications/ precautions	Pregnancy	Breastfeeding
Paracetamol	Hepatic impairment	Category A; safe to use	Safe to use
NSAIDs (e.g.,ibuprofen)	Cardiovascular disease Certain coagulation disorders Dehydration Gastrointestinal ulcer, bleeding or perforation Renal failure Severe hepatic impairment	Category C; avoid in pregnancy	Safe to use
Oral decongestants	Closed-angle glaucoma Severe coronary artery disease Severe or uncontrolled hypertension	Category B2; consider alternative	Consider alternative; may reduce breast milk production
Intranasal decongestants	Closed-angle glaucoma	Considered Safe to use	Considered Safe to use
Sedating Antihistamines	Bladder neck obstruction (e.g. prostate hypertrophy) Closed-angle glaucoma Epilepsy Pyloroduodenal obstruction Stenosing peptic ulce	Brompheniramine, chlorphenamine, triprolidine: Category A; safe to use	Considered Safe to use
Intranasal Saline	Not applicable	Safe to use	Safe to use

Non-pharmacological strategies

Advise patients to:

• Rest and stay hydrated with water or warm liquids.
• Avoid caffeine and alcohol.
• Use cool-mist humidifiers or steam inhalation to relieve nasal congestion.
• Gargle warm, salty water or suck on throat lozenges for a sore throat.
• Soothe dry skin around the nose with ointments.

Prevention

Preventive measures include:

• Regular handwashing with soap or hand sanitiser.
• Cleaning commonly touched surfaces.
• Using tissues and disposing of them properly after sneezing or coughing.
• Avoiding close contact with sick individuals.
• Staying home when unwell.

Conclusion

Managing the common cold requires a combination of symptomatic treatments and preventive strategies. By educating patients on effective self-care measures and recognising when referrals are necessary, pharmacists can ensure patient safety and support a quicker recovery.

Source

Common colds. Australian Pharmaceutical Formulary and Handbook. Published November 28, 2024. Accessed April 20, 2025.

https://apf.psa.org.au/treatment-guidelines-pharmacists/common-colds

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