Self Help

Over the Counter Medication/Treatments for Self-Limiting Conditions

Station View Health Centre along with other prescribing practitioners has been issued with guidance concerning the prescribing of over the counter medicines (OTC).  OTC medicines are those medicines that can be purchased in a pharmacy under the supervision of a pharmacist.  A limited number of medicines can also be purchased without pharmacy supervision in shops and supermarkets but are often sold in limited pack sizes or a lower strength. This guidance was issued by West Leicestershire Clinical Commissioning Group (WLCCG) and is supported by NHS England.

As you may be aware, the NHS is under unprecedented financial pressure and it is vital that all NHS resources are used in the best way possible, therefore we are encouraging Patients to self-care in the first instance by managing symptoms through non-medicinal intervention or alternatively, to seek advice from a community Pharmacist and purchase an OTC medication to manage minor ailments as outlined in the ‘Guidance for Self-Limited Conditions’ further down.

This will also help to reduce the number of unnecessary appointments.  If a Patient consults with a GP, or an Advanced Nurse Practitioner the Practice will no longer prescribe medicines which are available over the counter for self-limiting conditions, unless there are exceptional circumstances.   

We hope our patients will understand this decision which is due to the increasing cost of medicines to the NHS at a time of CRITICAL financial pressures.  To illustrate this, a pack of 100 paracetamol tablets can be purchased for under £2.00 over the counter, but if this item was prescribed by a Doctor the cost would be over £30.00 when taking into consideration the administration costs, Pharmacist time to issue the prescription and the time of a GP.

If you are taking medication that has been prescribed by your GP and you are concerned about taking OTC treatment, a Pharmacist will be able to advise you on any possible interactions/side effects.  If you have consented to third party access to your Summary Care Records this enables Community Pharmacists to view details of any medicines supplied to you directly by the Pharmacy and also any Hospital Pharmacy if you are undergoing any hospital treatment.

If your symptoms persist or you feel your symptoms have deteriorated we advise that you contact your GP to seek further advice. The Station View Health Centre appreciates the support of our patients. Further information can be found on WLCCG’s website https://www.westleicestershireccg.nhs.uk/your-ccg/publications/your-health-and-services/self-care-and-prescribing.

Alternatively, you can contact WLCCG on 01509 567700 or you can email them via enquiries@westleicestershireccg.nhs.uk.

Guidance for Self-limiting Conditions

If you have a self-limiting condition that is listed below, this can be treated with a medication that is available to buy over the counter from your local Pharmacy without the need for an appointment.

You can ask the Pharmacist for help and advice on the most appropriate medication to relieve symptoms for:

Self-limiting Conditions
Acne (Mild) Diarrhoea (short term) Eczema/Dry Skin
Athlete’s foot Fever (high temperature) Earache/Earwax
Aches and pains/back ache Piles (haemorrhoids) Skin rashes
Cold and Flu Like Symptoms Hay Fever and allergies Sore throats
Cold Sores Headaches/Migraines Teething
Allergic/Bacterial Conjunctivitis Head Lice Threadworm
Cough Heartburn and Indigestion Preventing Sunburn
Colic Insect Bites and Stings Period Pain
Constipation Motion Sickness Vaginal Thrush
Cystitis in women Mouth Ulcers Warts (non-facial) and verruca’s
Dandruff    

If at any time you are concerned about your condition or if your symptoms are not improving after a few days of treatment with the over the counter medication you should contact the local Pharmacist or your GP Surgery for further advice.

For more information you can visit www.nhs.uk/conditions

Self-Limiting Conditions

Please find below a list of Self-Limiting Conditions that can be treated by medication that can be bought over the counter (OTC) from a pharmacy and recommendations on when to seek medical advice if necessary.

Condition: When to see a GP:
Acne (Mild) – Although acne can’t be cured, it can be controlled with treatment.  Several creams, lotions and gels for treating spots are available at pharmacies for mild acne
  • Over the Counter (OTC) products have failed
  • Development of nodules or cysts
Athlete’s Foot – Treatment usually involves anti-fungal pharmacy-bought creams, sprays or liquids and good foot hygiene
  • Symptoms lasting more than a week
  • Symptoms causing significant pain or discomfort
Back pain in adults – Back pain will usually improve within a few weeks or months. There are several things you can try to help to reduce your pain in the meantime
  • Pain hasn’t improved after several weeks of taking OTC treatments
  • Severe pain
  • Night sweats
  • Sudden onset incontinence
Cold and Flu like symptoms – A cold is a mild viral infection of the nose, throat, sinuses and upper airways.  It’s very common and usually clears up on its own within a week or two
  • Symptoms persist for more than three weeks
  • Symptoms that suddenly get worse
  • Breathing difficulties
  • Development of complications of a cold, such as chest pain or coughing up bloodstained mucus
  • Concern for a baby or an elderly person, or presence a long-term illness such as a lung condition
Cold Sores – Cold sores are small blisters that develop on the lips or around the mouth.  They’re caused by the herpes simplex virus and usually clear up without treatment within 7 to 10 days
  • Confirmation of diagnosis
  • Severe symptoms that have spread further than the lips
  • Hasn’t healed after 7 to 10 days
Allergic Conjunctivitis (seasonal) – Eye drops are available from your pharmacist to treat the hay fever symptoms that affect your eyes, such as redness, itchiness and watering  
Bacterial Conjunctivitis – Antibiotics aren’t usually prescribed for infective conjunctivitis because it usually clears up by itself and there’s a very low risk of complications for untreated conjunctivitis
  • Eye pain
  • Sensitivity to light
  • Loss of vision
  • Intense redness in one eye or both eyes
  • Blurred vision not relieved by blinking
  • Pain in the eye rather than gritty feeling on the eye
  • If you still have symptoms after two weeks
Cough – Most coughs go away on their own within 3 weeks.  There’s usually no need to see a Doctor
  • Cough for more than 3 weeks (persistent cough)
  • Cough is very bad or quickly gets worse
  • Chest pain
  • Losing weight for no reason
  • Side of neck feels swollen and painful
  • Difficulty in breathing/Breathlessness

*SEE A GP URGENTLY IF PATIENT IS COUGHING UP BLOOD

Cystitis in women – Cystitis is inflammation of the bladder, usually caused by a bladder infection.  Women don’t necessarily need to see their GP if they have cystitis, as mild cases often get better without treatment
  • You’re not sure whether you have cystitis
  • Your symptoms don’t start to improve within a few days
  • You get cystitis frequently
  • You have severe symptoms, such as blood in your urine, a fever or pain in your side
  • You’re pregnant and have symptoms of cystitis
  • You’re a man and have symptoms of cystitis
  • Your child has symptoms of cystitis
Dandruff (but not psoriasis) – Dandruff is a common skin condition that causes white or grey flakes of skin to appear on the scalp and in the hair
  • You’ve tried anti-dandruff shampoos for at least a month and your symptoms haven’t improved
  • Your dandruff is very severe or your scalp is very itchy
  • Your scalp is red or swollen
  • You have a weakened immune system – for example, you’re having chemotherapy, you have HIV, or you’re taking medication that supresses your immune system
Acute diarrhoea in adults and children 13 years and above – Most cases of diarrhoea clear up after a few days without treatment
  • There is blood in your poo
  • You’re vomiting persistently
  • You’ve lost a lot of weight
  • You’ve passed a large amount of very watery diarrhoea
  • It occurs at night and is disturbing your sleep
  • You’ve recently taken antibiotics or been treated in hospital
  • You have symptoms of dehydration such as thirst and dark-coloured urine.  Other symptoms may include dizziness or light-headedness, headache, tiredness, dry mouth, lips and eyes, loss of strength and stamina
  • Passing small amounts of urine infrequently (less than three or four times a day)
  • Your poo is dark or black and like tar
  • Persistent/frequent vomiting every hour
Acute diarrhoea in children up to 12 years

Babies

  • Babies who have had six or more episodes of diarrhoea in the past 24 hours, or if they’ve vomited three times or more in the past 24 hrs
  • Symptoms of dehydration

A baby may be dehydrated if they have:

  • A sunken soft spot on their head
  • Few or no tears when they cry
  • A dry mouth
  • Fewer wet nappies
  • Dark yellow urine
  • Drowsiness
  • Fast breathing
  • Cold and blotchy-looking hands and feet

Children:

  • Children who have had six or more episodes of diarrhoea in the past 24 hrs
  • Diarrhoea and vomiting at the same time
  • Blood or watery faeces
  • A severe or continuous stomach ache
  • Symptoms of dehydration such as thirst and dark-coloured urine
  • Other symptoms may include dizziness, light headedness, headache, tiredness, dry mouth, lips and eyes, loss of strength and stamina
  • You should also contact your GP if your child has persistent diarrhoea. Most cases will pass in five to seven days
Dry Skin – Patients with dry skin should purchase emollients based on personal preference  
Earache (acute onset) – Earache is a common problem, particularly in children.  Earache is usually caused by a minor infection and will often get better in a few days without treatment
  • You or your child also has other symptoms, such as a high temperature (fever), vomiting, a severe sore throat, swelling around the ear, or discharge from the ear
  • There’s something stuck in your /your child’s ear
  • The earache doesn’t improve within a few days
Earwax – A build-up of ear wax is a common problem that can often be treated using eardrops bought from a pharmacy. Don’t try to remove a build-up of earwax yourself with a finger, a cotton bud or any other object
  • Medical supervision recommended in children <5 years of age
  • If OTC treatment doesn’t work after three to five days
Fever – As a general rule, a temperature of 38oC (100.4oF) or above is a fever
  • Children under 3 months old who have a temperature of 38oC (100.4oF) or above
  • Children between 3-6 months old who have temperature of 39oC (102.2oF) or above
  • Children with other signs of being unwell, such as persistent vomiting, refusal to feed, floppiness or drowsiness
Haemorrhoids – Haemorrhoids (piles) often clear up by themselves after a few days.  However, there are many treatments that can reduce itching and discomfort
  • Persistent or severe symptoms of haemorrhoids
  • Any rectal bleeding
Hay Fever – Before going to see your GP, you could visit your pharmacist and try to treat your hay fever symptoms with over-the-counter medications, such as antihistamines
  • Persistent symptoms not relived by OTC medication
  • You have persistent hay fever that doesn't respond to antihistamines
  • Your main symptom is a blocked nose
  • You're pregnant or breastfeeding
Headaches and migraines – Many people who have migraines find that over-the-counter painkillers, such as paracetamol, aspirin and ibuprofen, can help to reduce their symptoms If ordinary painkillers aren't helping to relieve your migraine symptoms or if you have frequent or severe symptoms you should make an appointment to see your GP or ANP

Head Lice – Treatments to get rid of head lice are available to buy from pharmacies, supermarkets and online.
Wet combing with conditioner is very effective

If a treatment doesn't work the first time, you can try it again, try a different treatment, or get advice from your school nurse, health visitor, pharmacist or GP Surgery
Heartburn and Indigestion – Heartburn and gastro-oesophageal reflux disease (GORD) can often be treated with self-help measures and over-the-counter medicines
  • Keep getting indigestion
  • Are in bad pain
  • Are 55 or older
  • Have lost a lot of weight without meaning to
  • Have difficulty swallowing (dysphagia)
  • Keep vomiting
  • Have iron deficiency anaemia
  • Feel like you have a lump in your stomach
  • Have bloody vomit or poo
Insect bites and stings – Insect bites and stings normally improve within a few hours or days, although sometimes they can last a little longer Occasionally, a severe allergic reaction can occur, causing symptoms such as breathing difficulties, dizziness and a swollen face or mouth. This requires immediate medical treatment
Motion sickness – More severe motion sickness can be treated with medication. It's usually better to take medication for motion sickness before your journey to prevent symptoms developing  
Mouth ulcers – Mouth ulcers are painful sores that appear in the mouth. Although they're uncomfortable, they’re usually harmless and most clear up by themselves within a week or two
  • Your mouth ulcer has lasted three weeks
  • You keep getting mouth ulcers
  • Your mouth ulcer becomes more painful or red – this could be a sign of a bacterial infection, which may need treatment with antibiotics
  • Children under the age of 12 years
  • Mouth ulcers are also a possible symptom of a viral infection that mainly affects young children, called hand, foot and mouth disease. Speak to your GP Surgery or call NHS 111 if you're unsure
Period pain – In most cases period pain is mild enough to treat at home When ordinary painkillers are ineffective
Sore throats – Sore throats are very common and usually nothing to worry about. They normally get better by themselves within a week. Your pharmacist can advise you on how to help relieve the pain and discomfort of a sore throat
  • Your sore throat doesn’t improve after a week
  • You often get sore throats
  • You’re worried about your sore throat
  • You have a sore throat and a temperature of 38oC or above which doesn’t respond to paracetamol
  • You have a weakened immune system – for example because of HIV or chemotherapy

When to get emergency help

  • Symptoms are severe or getting worse quickly
  • Difficulty breathing
  • Making a high-pitched sound as you breathe (called stridor)
  • Difficulty swallowing
  • Drooling
Sprain and strains – Most sprains and strains can be managed at home using over-the-counter painkillers to ease any pain
  • Severe pain
  • Can't move the injured joint or muscle
  • Can't put any weight on the injured limb or it gives way when you try to use it
  • Injured area looks crooked or has unusual lumps or bumps (other than swelling)
  • Presence of numbness, discolouration or coldness in any part of the injured area
  • Symptoms haven't started to improve within a few days of self-treatment
Preventing sunburn – When buying sunscreen, make sure it's suitable for your skin and blocks both ultraviolet A (UVA) and ultraviolet B (UVB) radiation  
Thread worm – If you think you or your child may have threadworms, you can usually treat the infection yourself with medication available at pharmacies without a prescription You only need to see your GP Surgery if you think you have threadworms and you're pregnant or breastfeeding, or if you think your child has threadworms and they're under two years old. In these circumstances, the recommended treatment is usually different
Vaginal thrush – Vaginal thrush is treated with medications you can buy over the counter from a pharmacy, or get on prescription from your GP Surgery

It's a good idea to get medical advice from your GP Surgery or a sexual health clinic if:

  • You have thrush for the first time
  • You're under the age of 16 or over 60
  • You're pregnant or breastfeeding – read more about thrush in pregnancy
  • You have unusual symptoms, such as coloured or smelly discharge, or sores on the skin around your vagina
  • You have abnormal vaginal bleeding or pain in your lower tummy
  • You've had two episodes of thrush within the last six months
  • You've reacted badly to antifungal treatment in the past, or it didn't work
  • You or your partner have previously had a sexually transmitted infection (STI) and you think it might have returned
  • Your symptoms don't improve after 7-14 days of treatment
Warts (non-facial) and verrucas – Most warts and verrucas will eventually clear up without treatment
  • You're not sure whether a lump is a wart – your GP/ANP can usually identify a wart by looking at it
  • Pharmacy treatments haven't worked
  • You have a wart on your face – don't treat these yourself
  • You have lots of warts or get warts frequently
  • A wart bleeds, changes in appearance, spreads or causes significant pain, distress or embarrassment

 

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