World Pharmacy

Category: Treatments And Advice

  • Period Pain

    Period Pain

    Period pain is common and a normal part of your menstrual cycle. Most women get it at some point in their lives.

    It’s usually felt as painful muscle cramps in the tummy, which can spread to the back and thighs.

    The pain sometimes comes in intense spasms, while at other times it may be dull but more constant.

    It may also vary with each period. Some periods may cause little or no discomfort, while others may be more painful.

    Sometimes you may get pelvic pain even when you do not have your period.

    What causes period pain?

    Period pain happens when the muscular wall of the womb tightens (contracts). Mild contractions continually occur in your womb, but they’re usually so mild that most women cannot feel them.

    During your period, the wall of the womb starts to contract more vigorously to help the womb lining shed as part of your period.

    When the wall of the womb contracts, it compresses the blood vessels lining your womb. This temporarily cuts off the blood supply – and oxygen supply – to your womb. Without oxygen, the tissues in your womb release chemicals that trigger pain.

    While your body is releasing these pain-triggering chemicals, it’s also producing other chemicals called prostaglandins. These encourage the womb muscles to contract more, further increasing the level of pain.

    It’s not known why some women have more period pain than others. It may be that some women have a build-up of prostaglandins, which means they experience stronger contractions.

    Period pain caused by a medical condition

    Less commonly, period pain can be caused by an underlying medical condition.

    Period pain linked to an underlying medical condition tends to affect older women. Women aged 30 to 45 are most commonly affected.

    Medical conditions that can cause period pain include:

    • endometriosis – where cells that normally line the womb grow in other places, such as in the fallopian tubes and ovaries; these cells can cause intense pain when they shed
    • fibroids – non-cancerous tumours that can grow in or around the womb and can make your periods heavy and painful
    • pelvic inflammatory disease – where your womb, fallopian tubes and ovaries become infected with bacteria, causing them to become severely inflamed
    • adenomyosis – where the tissue that normally lines the womb starts to grow within the muscular womb wall, making your periods particularly painful

    Period pain caused by contraceptive devices

    An intrauterine device (IUD) is a type of contraception made from copper and plastic that fits inside the womb. It can also sometimes cause period pain, particularly during the first few months after it’s inserted.

    You may notice a change in your normal pattern of pain if your period pain is linked to a medical condition or a contraceptive IUD. For example, the pain may be more severe or it may last much longer than normal.

    You may also have:

    • irregular periods 
    • bleeding in between periods
    • a thick or foul-smelling vaginal discharge
    • pain during sex

    See your GP if you have any of these symptoms as well as period pain.

    How long will my period pain last?

    Period pain usually starts when your bleeding begins, although some women have pain several days before the start of their period.

    The pain usually lasts 48 to 72 hours, although it can last longer. It’s usually at its worst when your bleeding is heaviest.

    Young girls often have period pain when they begin getting periods. Read more about starting periods.

    Period pain that does not have an underlying cause tends to improve as a woman gets older. Many women also notice an improvement after they’ve had children.

    How can I treat period pain?

    In most cases period pain is mild enough to treat at home.

    Painkillers

    You can take ibuprofen and aspirin to help manage your pain.

    However, do not take ibuprofen or aspirin if you have asthma or stomach, kidney or liver problems. Aspirin should not be taken by anyone under 16 years of age.

    You could also try paracetamol, but studies have shown that it does not reduce pain as well as ibuprofen or aspirin.

    If ordinary painkillers do not help, your GP may prescribe a stronger painkiller, such as naproxen or codeine.

    Other self-help measures to try

    You could also try:

    • stopping smoking – smoking is thought to increase the risk of period pain
    • exercise – you may not feel like exercising during a painful period, but being active may reduce pain; try some gentle swimming, walking or cycling
    • heat – putting a heat pad or hot water bottle (wrapped in a tea towel) on your tummy may help reduce pain
    • warm bath or shower – taking a warm bath or shower can relieve pain and help you relax
    • massage – light, circular massage around your lower abdomen may also help reduce pain
    • relaxation techniques – relaxing activities, such as yoga or pilates, may help distract you from feelings of pain and discomfort
    • transcutaneous electronic nerve stimulation (TENS) – a small battery-operated device that delivers a mild electrical current to your tummy to help reduce pain

    When should I see my GP?

    See your GP if you have severe period pain or your normal pattern of periods changes – for example, if your periods become heavier than usual or irregular.

    Contraceptives that can help period pain

    Your GP may give you the contraceptive pill. This can ease period pain because it thins the womb lining and reduces the amount of prostaglandin your body releases.

    A thinner womb lining means the muscles of the womb do not have to contract as much when it sheds. Your period will also be lighter.

    If the contraceptive pill is not suitable for you, the contraceptive implant or the contraceptive injection are good alternatives.

    The Mirena intrauterine system (IUS) can also sometimes help with painful periods.

    Having a pelvic examination

    Your GP may want to carry out a pelvic examination to help diagnose or rule out other causes of your period pain.

    They’ll insert gloved, lubricated fingers into your vagina to feel for any abnormalities in your womb or ovaries.

    The examination won’t be carried out without your permission. You can also ask to have a female doctor, choose to have a friend or relative present, or a practice nurse to act as a chaperone.

    In some cases your GP may also order a pelvic ultrasound, which may show any abnormalities.

    Referral to a specialist

    If your period pain has not been controlled after 3 months of treatment with painkillers or a suitable hormonal contraceptive, your GP may refer you to a specialist, which will usually be a gynaecologist.

    This is for further tests to rule out an underlying medical condition.

    Further tests

    To help find out the cause of your period pain, a gynaecologist may need to carry out:

    • a urine or blood test
    • pelvic ultrasound )– where high-frequency sound waves are used to produce an image of the inside of your body; it’s painless and will show any abnormalities in your reproductive organs
    • laparoscopy – under general anaesthetic, a small cut is made in your abdomen through which a fibro-optic telescope is inserted; it can be used to look at your internal organs, as well as take samples of tissue (a biopsy)
    • hysteroscopy – allows the inside of the womb to be examined using a fibro-optic telescope; it’s passed through your vagina and into the womb to check for abnormalities

    Treating an underlying medical condition

    If your period pain is caused by an underlying medical condition, your treatment will depend on which condition you have.

    For example, pelvic inflammatory disease (PID) may require antibiotics to treat the infection, while fibroids may need to be surgically removed.

    Can period pain affect fertility?

    Period pain that’s part of your normal menstrual cycle will not affect your fertility. However, if the cause is a medical condition, this may affect your fertility.

    For example, endometriosis and pelvic inflammatory disease can cause scarring and a build-up of tissue in your fallopian tubes, making it harder for sperm to reach and fertilise an egg.

     

    Period pain is a normal part of a women’s menstrual cycle. It is often felt as painful muscle cramps in the lower abdomen which can spread to the back. The pain is caused by the muscles in the womb tightening, which compresses the lining of your womb; temporarily cutting off the blood supply, triggering pain in the abdominal area.

    The most common symptom suffered by women are lower stomach cramps and pain. These can be experiences as a constant pain or intense spasms. However, these symptoms may vary each month, affecting different parts of the body including thighs, lower back and hips. However, the associated symptoms may also be headaches.

    Mefenamic Acid can be used to treat period pain by reducing inflammation and provides an effective pain relief.

    It is advised not to take Mefenamic acid if you smoke or drink, and are taking other NSAIDs at the same time, such as Ibuprofen. Furthermore, long-term use of Mefenamic acid is not recommended as it may increase the risk of its side effects. One tablet is to be taken three times a day, for a maximum of three days. If your symptoms do not improve, please seek further advice from a doctor or healthcare professional.

  • Antifungals

    Antifungals

    Antifungal medicines are used to treat fungal infections, which most commonly affect your skin, hair and nails.

    You can get some antifungal medicines over the counter from your pharmacy, but you may need a prescription from your GP for other types.

    Infections antifungals can treat

    Fungal infections commonly treated with antifungals include:

    • ringworm
    • athlete’s foot
    • fungal nail infection
    • vaginal thrush
    • some kinds of severe dandruff

    Less commonly, there are also more serious fungal infections that develop deep inside the body tissues, which may need to be treated in hospital.

    Examples include:

    • aspergillosis, which affects the lungs
    • fungal meningitis, which affects the brain

    You’re more at risk of getting one of these more serious fungal infections if you have a weakened immune system – for example, if you’re taking medicines to suppress your immunity.

    Types of antifungal medicines

    Antifungal medicines are available as:

    • topical antifungals – a cream, gel, ointment or spray you can apply directly to your skin, hair or nails
    • oral antifungals – a capsule, tablet or liquid medicine that you swallow
    • intravenous antifungals – an injection into a vein in your arm, usually given in hospital
    • intravaginal antifungal pessaries – small, soft tablets you can insert into the vagina

    Some common names for antifungal medicines include:

    • clotrimazole
    • econazole
    • miconazole
    • terbinafine
    • fluconazole
    • ketoconazole
    • amphotericin

    How antifungal medicines work

    Antifungal medicines work by either:

    • killing the fungal cells – for example, by affecting a substance in the cell walls, causing the contents of the fungal cells to leak out and the cells to die
    • preventing the fungal cells growing and reproducing

    When to see a pharmacist or GP

    See a pharmacist or GP if you think you have a fungal infection. They will advise you on which antifungal medicine to take and how to take or use it. See below for some questions you may want to ask them.

    The patient information leaflet that comes with your medicine will also contain advice on using your medicine.

    Speak to your pharmacist or GP if you accidentally take too much of your antifungal medicine. You may be advised to visit your nearest hospital’s accident and emergency (A&E) department if you’ve taken excessive amounts.

    If you’re advised to go to hospital, take the medicine’s packaging with you so the healthcare professionals who treat you know what you’ve taken.

    Things to consider when using antifungal drugs

    Before taking antifungal medicines, speak to a pharmacist or your GP about:

    • any existing conditions or allergies that may affect your treatment for fungal infection
    • the possible side effects of antifungal medicines
    • whether the antifungal medicine may interact with other medicines you may already be taking (known as drug interactions)
    • whether your antifungal medicine is suitable to take during pregnancy or while breastfeeding – many aren’t suitable

    You can also check the patient information leaflet that comes with your antifungal medicine for more information.

    Side effects of antifungal medicines

    Your antifungal medicine may cause side effects. These are usually mild and only last for a short period of time.

    They can include:

    • itching or burning
    • redness
    • feeling sick
    • tummy (abdominal) pain
    • diarrhoea
    • a rash

    Occasionally, your antifungal medicine may cause a more severe reaction, such as:

    • an allergic reaction – your face, neck or tongue may swell and you may have difficulty breathing
    • a severe skin reaction – such as peeling or blistering skin
    • liver damage (occurs very rarely) – you may experience loss of appetite, vomiting, nausea, jaundice, dark urine or pale faeces, tiredness or weakness

    Stop using the medicine if you have these severe side effects, and see your GP or pharmacist to find an alternative.

    If you’re having difficulty breathing, visit the accident and emergency (A&E) department of your nearest hospital or call 999 for an ambulance.

    Reporting side effects

    If you suspect that a medicine has made you unwell, you can report this side effect through the Yellow Card Scheme.

    The scheme is run by a medicines safety watchdog called the Medicines and Healthcare Products Regulatory Agency (MHRA).

    Antifungal medicines for children

    Some antifungal medicines can be used on children and babies – for example, miconazole oral gel can be used to treat oral thrush in babies.

    But different doses are usually needed for children of different ages

  • Dandruff

    Dandruff

    Dandruff is a common skin condition. It’s not harmful and you cannot catch it.

    Check if it’s dandruff

    Dandruff causes white or grey flakes of skin to appear on the scalp and in the hair

    The flakes are often more noticeable in darker hair and if they fall from your scalp on to your shoulders.

    Your scalp may also feel dry and itchy.

    How to treat dandruff yourself

    Use an anti-dandruff shampoo. There are several different types you can buy from pharmacies or supermarkets.

    Look for shampoo containing one of these ingredients:

    • zinc pyrithione
    • salicylic acid
    • selenium sulphide (or selenium sulfide)
    • ketoconazole
    • coal tar

    Your pharmacist can tell you how to use the shampoo.

    Use the shampoo for a month to see if your dandruff improves. You might need to try more than one type to find one that works for you.

    Causes of dandruff

    Dandruff is not caused by poor hygiene, although it may be more obvious if you do not wash your hair regularly.

    Stress and cold weather may also make dandruff worse.

    A list of conditions that cause dandruff and the main symptoms

    Symptoms

    Possible causes

    scaly, itchy and red patches on skin on scalp, face and other areas of the body

    seborrheic dermatitis

    red or silver rash on scalp, sometimes with patchy hair loss

    tinea capitis, known as ringworm

    dry, red, flaky and very itchy skin on areas of the body

    eczema

    red, inflamed (irritated) skin; may also have blisters and cracked skin – reaction to products such as hair dye, sprays, gels or mousses

    contact dermatitis

    red, flaky, crusty and sore patches of skin covered with silvery scales

    psoriasis

    greasy, yellowish crusts on baby’s scalp, eyebrows and nappy area

    cradle cap

    Information:

    Do not worry if you’re not sure what is causing your dandruff. Follow the advice on this page and see a GP if things do not improve in a month.

  • Head Lice and Nits

    Head Lice and Nits

    Head lice and nits are very common in young children and their families. They do not have anything to do with dirty hair and are picked up by head-to-head contact.

    Check if it’s head lice

    Head lice are small insects, up to 3mm long.

    They can be difficult to spot in your hair.

    Head lice eggs (nits) are brown or white (empty shells) and attached to the hair.

    Head lice can make your head feel:

    • itchy
    • like something is moving in your hair

    The only way to be sure someone has head lice is by finding live lice.

    You can do this by combing their hair with a special fine-toothed comb (detection comb). You can buy these online or at pharmacies.

    How to get rid of head lice

    Important

    You can treat head lice without seeing a GP.

    Treat head lice as soon as you spot them.

    You should check everyone in the house and start treating anyone who has head lice on the same day.

    There’s no need to keep your child off school if they have head lice.

    Wet combing

    Lice and nits can be removed by wet combing. You should try this method first.

    You can buy a special fine-toothed comb (detection comb) online or from pharmacies to remove head lice and nits.

    There may be instructions on the pack, but usually you:

    • wash hair with ordinary shampoo
    • apply lots of conditioner (any conditioner will do)
    • comb the whole head of hair, from the roots to the ends

    It usually takes about 10 minutes to comb short hair, and 20 to 30 minutes for long, frizzy or curly hair.

    Do wet combing on days 1, 5, 9 and 13 to catch any newly hatched head lice. Check again that everyone’s hair is free of lice on day 17.

    Medicated lotions and sprays

    Ask a pharmacist for advice if you have tried wet combing for 17 days, but your child still has live head lice.

    They may recommend using medicated lotions and sprays. These kill head lice in all types of hair, and you can buy them from pharmacies, supermarkets or online.

    Head lice should die within a day. Some lotions and sprays come with a comb to remove dead lice and eggs.

    Some treatments need to be repeated after a week to kill any newly hatched lice.

    Check the pack to see if they’re OK for you or your child and how to use them.

    If lotions or sprays do not work, speak to a pharmacist about other treatments.

    Some treatments are not recommended because they’re unlikely to work.

    For example:

    • products containing permethrin
    • head lice “repellents”
    • electric combs for head lice
    • tree and plant oil treatments, such as tea tree oil, eucalyptus oil and lavender oil herbal remedies

    Information:

    The charity Community Health Concern has a video about wet combing for head lice.

    You cannot prevent head lice

    There’s nothing you can do to prevent head lice.

    You can help stop them spreading by wet or dry combing regularly to catch them early.

    Do not use medicated lotions and sprays to prevent head lice. They can irritate the scalp.

    There’s no need for children to stay off school or to wash laundry on a hot wash.

  • Piles (Haemorrhoids)

    Piles (Haemorrhoids)

    Piles (haemorrhoids) are lumps inside and around your bottom (anus). They often get better on their own after a few days. There are things you can do to treat and prevent piles.

    Check if it’s piles

    Symptoms of piles include:

    • bright red blood after you poo
    • an itchy anus
    • feeling like you still need to poo after going to the toilet
    • slimy mucus in your underwear or on toilet paper after wiping your bottom
    • lumps around your anus
    • pain around your anus

    How you can treat or prevent piles

    Do

    • drink lots of fluid and eat plenty of fibre to keep your poo soft
    • wipe your bottom with damp toilet paper
    • take paracetamol if piles hurt
    • take a warm bath to ease itching and pain
    • use an ice pack wrapped in a towel to ease discomfort
    • gently push a pile back inside
    • keep your bottom clean and dry
    • exercise regularly
    • cut down on alcohol and caffeine (like tea, coffee and cola) to avoid constipation

    Don’t

    • do not wipe your bottom too hard after you poo
    • do not ignore the urge to poo
    • do not push too hard when pooing
    • do not take painkillers that contain codeine, as they cause constipation
    • do not take ibuprofen if your piles are bleeding
    • do not spend more time than you need to on the toilet

    Ask a pharmacist about treatment for piles

    A pharmacist can suggest:

    • creams to ease the pain, itching and swelling
    • treatment to help constipation and soften poo
    • cold packs to ease discomfort

    Many pharmacies have private areas if you do not want to be overheard.

    See a GP if:

    • there’s no improvement after 7 days of treatment at home
    • you keep getting piles

    Your GP may prescribe stronger medicines for haemorrhoids or constipation.

    Ask for an urgent GP appointment or call 111 if:

    • you have piles and your temperature is very high or you feel hot and shivery and generally unwell
    • you have pus leaking from your piles

    Hospital treatment for piles

    If there’s no improvement to your piles after home treatments, you may need hospital treatment.

    Talk to your doctor about the best treatment for you. Treatment does not always prevent piles coming back.

    Treatment without surgery

    Common hospital treatments include:

    • rubber band ligation: a band is placed around your piles to make them drop off
    • sclerotherapy: a liquid is injected into your piles to make them shrink
    • electrotherapy: a gentle electric current is applied to your piles to make them shrink
    • infrared coagulation: an infrared light is used to cut the blood supply to your piles to make them shrink

    You’ll be awake for this type of treatment, but the area will be numbed.

    You should be able to go home on the same day.

    If these treatments do not work, you may need surgery to remove your piles.

    Surgery

    Surgical treatments include:

    • haemorrhoidectomy: your piles are cut out
    • stapled haemorrhoidopexy: your piles are stapled back inside your anus
    • haemorrhoidal artery ligation: stitches are used to cut the blood supply to your piles to make them shrink

    You’ll usually need to be asleep for this type of treatment and may need to stay in hospital for more than 1 day.

    If Immediate action required, go to A&E or call 999 if you have piles and:

    • you’re bleeding non-stop
    • there’s a lot of blood – for example, the toilet water turns red or you see large blood clots
    • you’re in severe pain

    What causes piles?

    Piles are swollen blood vessels. It’s not clear what causes them.

    Things that make piles more likely:

    • constipation
    • pushing too hard when pooping
    • pregnancy
    • heavy lifting
  • Antihistamines

    Antihistamines

    Antihistamines are medicines often used to relieve symptoms of allergies, such as hay fever, hives, conjunctivitis and reactions to insect bites or stings.

    They’re also sometimes used to prevent motion sickness and as a short-term treatment for insomnia.

    Most antihistamines can be bought from pharmacies and shops, but some are only available on prescription.

    Types of antihistamine

    There are many types of antihistamine.

    They’re usually divided into 2 main groups:

    • antihistamines that make you feel sleepy – such as chlorphenamine (including Piriton), hydroxyzine and promethazine
    • non-drowsy antihistamines that are less likely to make you feel sleepy – such as cetirizine, fexofenadine and loratadine

    They also come in several different forms – including tablets, capsules, liquids, syrups, creams, lotions, gels, eyedrops and nasal sprays.

    Which type is best?

    There’s not much evidence to suggest any particular antihistamine is better than any other at relieving allergy symptoms.

    Some people find certain types work well for them and others do not. You may need to try several types to find one that works for you.

    Non-drowsy antihistamines are generally the best option, as they’re less likely to make you feel sleepy. But types that make you feel sleepy may be better if your symptoms stop you sleeping.

    Ask a pharmacist for advice if you’re unsure which medicine to try as not all antihistamines are suitable for everyone.

    How to take antihistamines

    Take your medicine as advised by the pharmacist or doctor, or as described in the leaflet that comes with it.

    Before taking an antihistamine, you should know:

    • how to take it – including whether it needs to be taken with water or food, or how to use it correctly (if eyedrops or a nasal spray)
    • how much to take (the dose) – this can vary depending on things such as your age and weight
    • when to take it – including how many times a day you can take it and when to take it (some types should be taken before bedtime)
    • how long to take it for – some types can be used for a long time, but some are only recommended for a few days
    • what to do if you miss a dose or take too much (overdose)

    The advice varies depending on the exact medicine you’re taking. If you’re not sure how to take your medicine, ask a pharmacist.

    Side effects of antihistamines

    Like all medicines, antihistamines can cause side effects.

    Side effects of antihistamines that make you drowsy can include:

    • sleepiness (drowsiness) and reduced co-ordination, reaction speed and judgement – do not drive or use machinery after taking these antihistamines
    • dry mouth
    • blurred vision
    • difficulty peeing

    Side effects of non-drowsy antihistamines can include:

    • headache
    • dry mouth
    • feeling sick
    • drowsiness – although this is less common than with older types of antihistamines

    Check the leaflet that comes with your medicine for a full list of possible side effects and advice about when to get medical help.

    If you think your medicine has caused an unwanted side effect, you can report it through the Yellow Card Scheme.

    Taking antihistamines with other medicines, food or alcohol

    Speak to a pharmacist or GP before taking antihistamines if you’re already taking other medicines.

    There may be a risk the medicines do not mix, which could stop either from working properly or increase the risk of side effects.

    Examples of medicines that could cause problems if taken with antihistamines include some types of:

    • antidepressants
    • stomach ulcer or indigestion medicines
    • cough and cold remedies that also contain an antihistamine

    Try not to drink alcohol while taking an antihistamine, particularly if it’s a type that makes you drowsy, as it can increase the chances of it making you feel sleepy.

    Food and other drinks do not affect most antihistamines, but check the leaflet that comes with your medicine to make sure.

    Who can take antihistamines

    Most people can safely take antihistamines.

    But speak to a pharmacist or GP for advice if you:

    • are pregnant – read about taking hay fever medicines in pregnancy
    • are breastfeeding – read about taking hay fever medicines while breastfeeding
    • are looking for a medicine for a young child
    • are taking other medicines
    • have an underlying health condition, such as heart disease, liver disease, kidney disease or epilepsy

    Some antihistamines may not be suitable in these cases. A pharmacist or doctor can recommend one that’s best for you.

    Always read the leaflet that comes with your medicine to check it’s safe for you before taking it or giving it to your child.

    How antihistamines work

    Antihistamines block the effects of a substance called histamine in your body.

    Histamine is normally released when your body detects something harmful, such as an infection. It causes blood vessels to expand and the skin to swell, which helps protect the body.

    But in people with allergies, the body mistakes something harmless – such as pollen, animal hair or house dust – for a threat and produces histamine. The histamine causes an allergic reaction with unpleasant symptoms including itchy, watering eyes, a running or blocked nose, sneezing and skin rashes.

    Antihistamines help stop this happening if you take them before you come into contact with the substance you’re allergic to. Or they can reduce the severity of symptoms if you take them afterwards.

  • Decongestants

    Decongestants

    Decongestants are a type of medicine that can provide short-term relief for a blocked or stuffy nose (nasal congestion).

    They can help ease the symptoms of conditions such as colds and flu, hay fever and other allergic reactions, catarrh and sinusitis.

    They work by reducing the swelling of the blood vessels in your nose, which helps to open the airways.

    Types of decongestants

    Decongestants are available as:

    • nasal sprays
    • drops
    • tablets or capsules
    • liquids or syrups
    • flavoured powders to dissolve in hot water

    Some products may just contain decongestant medicine, but many are sold as “all-in-1” remedies that contain decongestants, painkillers or antihistamines.

    Most decongestants can be bought over the counter from pharmacies without a prescription.

    Who can take decongestants

    Most people can use decongestants safely, but they’re not suitable for everyone.

    They should not be used by the following groups of people without getting advice from a pharmacist or GP first:

    • people taking other medicines
    • people with diabetes
    • people with high blood pressure
    • people with an overactive thyroid gland (hyperthyroidism)
    • men with an enlarged prostate
    • people with liver, kidney, heart or circulation problems
    • people with increased pressure in the eye glaucoma

    Babies and children

    Decongestants should not be given to children under 6.

    Children aged 6 to 12 should take them for no longer than 5 days. Ask a pharmacist for advice about this.

    Pregnant and breastfeeding women

    It’s not clear whether it’s safe to take any type of decongestant if you’re pregnant, so you should only use them if told to by a healthcare professional.

    Decongestants that come as tablets, liquids or powders that you swallow are not recommended if you’re breastfeeding.

    Some decongestants that come as nose sprays or drops are safe to use if you’re breastfeeding, but check with a pharmacist or GP first before using them.

    The patient information leaflet that comes with your medicine will say who should not use it and who should get advice before using it.

    How to use decongestants

    Most decongestants should only be used between 1 and 4 times a day.

    Check the patient information leaflet that comes with your medicine for advice about how much to take and how often to take it.

    If you’re not sure, ask a pharmacist for advice.

    Decongestant nasal sprays and drops should not be used for more than a week at a time because using them for too long can make your stuffiness worse.

    Speak to a GP if your symptoms do not improve after this time.

    Side effects of decongestants

    Decongestant medicines do not usually have side effects, and any side effects you may experience are usually mild.

    Possible side effects can include:

    • feeling sleepy (look for non-drowsy medicines)
    • irritation of the lining of your nose
    • headaches
    • feeling or being sick
    • a dry mouth
    • feeling restless or agitated
    • a rash

    These side effects should go away once you stop taking the medicine.

    More serious side effects can also happen, such as hallucinations and severe allergic reactions (anaphylaxis), but these are very rare.

    Taking decongestants with other medicines

    Ask a pharmacist or GP before taking decongestants if you’re taking other medicines.

    Decongestants can increase or decrease the effect of some other medicines.

    For example, taking decongestants alongside some antidepressants can cause a dangerous rise in blood pressure.

    It’s also important to be careful when taking other medicines if you’re using an “all-in-1” decongestant remedy.

    “All-in-1” decongestants also contain painkillers or antihistamines, so it could be dangerous to take extra doses of these medicines at the same time.

  • Headaches

    Headaches

    Most headaches will go away on their own and are not a sign of something more serious.

    How you can ease headaches yourself

    Headaches can last between 30 minutes and several hours.

    Do

    • drink plenty of water
    • get plenty of rest if you have a cold or the flu
    • try to relax – stress can make headaches worse
    • exercise when you can
    • take paracetamol or ibuprofen

    Don’t

    • do not drink alcohol
    • do not skip meals (even if you might not feel like eating anything)
    • do not sleep more than you usually would – it can make the headache worse
    • do not strain your eyes for a long time – for example, by looking at a screen

    See a GP if:

    • your headache keeps coming back
    • painkillers do not help and your headache gets worse
    • you have a bad throbbing pain at the front or side of your head – this could be a migraine or, more rarely, a cluster headache
    • you feel sick, vomit and find light or noise painful
    • you get other symptoms – for example, your arms or legs feel numb or weak

    Call 999 or go to A&E if:

    • you injured your head badly – for example, from a fall or accident
    • the headache came on suddenly and is extremely painful

    You have an extremely painful headache and:

    • sudden problems speaking or remembering things
    • loss of vision
    • you’re feeling drowsy or confused
    • you have a very high temperature, feel hot and shivery, and have a stiff neck or a rash
    • the white part of your eye is red

    What can cause headaches

    The most common reasons are:

    • having a cold or the flu
    • stress
    • drinking too much alcohol
    • bad posture
    • eyesight problems
    • not eating regular meals
    • not drinking enough fluids (dehydration)
    • taking too many painkillers
  • Pregnancy

    Pregnancy

    A Guide to Pregnancy

    During pregnancy it’s completely normal to have many questions and concerns. Your local pharmacy is a great place to go for support during your pregnancy (and beyond), they’ll help you you make the right choices when it comes to looking after your and your baby’s health.

    This is a very important stage on your life and it is normal to ask yourself a lot of questions and have many concerns. Do not worry, A pharmacist can support your way during pregnancy and beyond, making sure you make the right choices and helps you looking after your health and your baby.

    Healthy eating

    A healthy diet is a vital part of a healthy lifestyle at any time, but is especially important if you’re pregnant or planning a pregnancy. Eating healthily during pregnancy will help your baby to develop and grow.

    You don’t need to go on a special diet, but it’s important to eat a variety of different foods every day to get the right balance of nutrients that you and your baby need.

    It’s always best to get vitamins and minerals from the foods you eat, but when you’re pregnant you need to take a folic acid supplement as well during the first few months, to make sure you get everything you and your baby may need.

    There are also certain foods that should be avoided in pregnancy.

    You will probably find that you are hungrier than usual, but you don’t need to “eat for two” – even if you are expecting twins or triplets. This is one of the most common myths of pregnancy.

    EXERCISE IN PREGNANCY

    The more active and fit you are during pregnancy, the easier it will be for you to adapt to your changing shape and weight gain. It will also help you with labour and get back into shape after the birth of your baby.

    Keep up your normal daily physical activity or exercise (sport, running, yoga, dancing, or even walking to the shops and back) for as long as you feel comfortable.

    Exercise is not dangerous for your baby but there are certain exercises that should be avoided, so it is always worth to check with your Doctor or pharmacist.

    Postnatal depression

    Postnatal depression is a type of depression that many parents experience after having a baby.  t’s a common problem, affecting more than 1 in every 10 women within a year of giving birth. It can also affect fathers and partners, although this is less common.

    It’s important to seek help as soon as possible if you think you might be depressed, as your symptoms could last months or get worse and have a significant impact on you, your baby and your family.

    It is difficult to understand if you are depressed as many women feel a bit down, tearful or anxious in the first week after giving birth. This is often called the “baby blues” and is so common that it’s considered normal as you need to adjust to your new situation and sometimes it can be challenging. The “baby blues” don’t last for more than two weeks after giving birth.

    If your symptoms last longer or start later, you could have postnatal depression. Postnatal depression can start any time in the first year after giving birth.

    How can we help you?

    Request a one to one consultation with one of our pharmacist who can answer your questions and give you advice about.

    • Healthy eating in pregnancy
    • Exercise in pregnancy
    • Medicines in pregnancy. What can you take to ease your symptoms and which medicines you need to avoid.
    • Post-natal depression
  • Antimalarials

    Antimalarials

    Antimalarial medication is used to prevent and treat malaria.

    You should always consider taking antimalarial medicine when travelling to areas where there’s a risk of malaria. Visit your GP or local travel clinic for malaria advice as soon as you know when and where you’re going to be travelling.

    It’s very important to take the correct dose and finish the course of antimalarial treatment. If you’re unsure, ask your GP or pharmacist how long you should take your medication for.

    Preventing malaria

    It’s usually recommended you take antimalarial tablets if you’re visiting an area where there’s a malaria risk as they can reduce your risk of malaria by about 90%.

    The type of antimalarial tablets you will be prescribed is based on the following information:

    • where you’re going
    • any relevant family medical history
    • your medical history, including any allergies to medication
    • any medication you’re currently taking
    • any problems you’ve had with antimalarial medicines in the past
    • your age
    • whether you’re pregnant

    You may need to take a short trial course of antimalarial tablets before travelling. This is to check that you don’t have an adverse reaction or side effects. If you do, alternative antimalarials can be prescribed before you leave.

    Types of antimalarial medication

    The main types of antimalarials used to prevent malaria are described below.

    Atovaquone plus proguanil

    • Dosage – the adult dose is 1 adult-strength tablet a day. Child dosage is also once a day, but the amount depends on the child’s weight. It should be started 1 or 2 days before your trip and taken every day you’re in a risk area, and for 7 days after you return.
    • Recommendations – a lack of clear evidence means this antimalarial shouldn’t be taken by pregnant or breastfeeding women. It’s also not recommended for people with severe kidney problems.
    • Possible side effects – stomach upset, headaches, skin rash and mouth ulcers.
    • Other factors – it can be more expensive than other antimalarials, so may be more suitable for short trips.

    Doxycycline (also known as Vibramycin-D)

    • Dosage – the dose is 100mg daily as a tablet or capsule. You should start the tablets 2 days before you travel and take them each day you’re in a risk area, and for 4 weeks after you return.
    • Recommendations – not normally recommended for pregnant or breastfeeding women, but your GP will advise. Not recommended for children under the age of 12 (because of the risk of permanent tooth discolouration), people who are sensitive to tetracycline antibiotics, or people with liver problems.
    • Possible side effects – stomach upset, heartburn, thrush, and sunburn as a result of light sensitivity. It should always be taken with food, preferably when standing or sitting.
    • Other factors – it is relatively cheap. If you take doxycycline for acne, it will also provide protection against malaria as long as you’re taking an adequate dose. Ask your GP.

    Mefloquine (also known as Lariam)

    • Dosage – the adult dose is 1 tablet weekly. Child dosage is also once a week, but the amount will depend on their weight. It should be started 3 weeks before you travel and taken all the time you’re in a risk area, and for 4 weeks after you get back.
    • Recommendations – it’s not recommended if you have epilepsy, seizures, depression or other mental health problems, or if a close relative has any of these conditions. It’s not usually recommended for people with severe heart or liver problems.
    • Possible side effects – dizziness, headache, sleep disturbances (insomnia and vivid dreams) and psychiatric reactions (anxiety, depression, panic attacks and hallucinations). It’s very important to tell your doctor about any previous mental health problems, including mild depression. Don’t take this medication if you have a seizure disorder.
    • Other factors – if you haven’t taken mefloquine before, it’s recommended you do a 3-week trial before you travel to see whether you develop any side effects.

    Chloroquine and proguanil

    A combination of antimalarial medications called chloroquine and proguanil is also available, although these are rarely recommended nowadays because they’re largely ineffective against the most common and dangerous type of malaria parasite, Plasmodium falciparum.

    However, chloroquine and proguanil may occasionally be recommended for certain destinations where the Plasmodium falciparum parasite is less common than other types, such as India and Sri Lanka.

    Treating malaria

    If malaria is diagnosed and treated promptly, a full recovery can be expected. Treatment should be started as soon as a blood test confirms malaria.

    Many of the same antimalarial medicines used to prevent malaria can also be used to treat the disease. However, if you’ve taken an antimalarial to prevent malaria, you shouldn’t take the same one to treat it. This means it’s important to tell your doctor the name of the antimalarials you took.

    The type of antimalarial medicine and how long you need to take it will depend on:

    • the type of malaria you have
    • where you caught malaria
    • the severity of your symptoms
    • whether you took preventative antimalarial tablets
    • your age
    • whether you’re pregnant

    Your doctor may recommend using a combination of different antimalarials to overcome strains of malaria that have become resistant to single types of medication.

    Antimalarial medication is usually given as tablets or capsules. If someone is very ill, it will be given through a drip into a vein in the arm (intravenously) in hospital.

    Treatment for malaria can leave you feeling very tired and weak for several weeks.

    Emergency standby treatment

    In some cases, you may be prescribed emergency standby treatment for malaria before you travel. This is usually if there’s a risk of you becoming infected with malaria while travelling in a remote area with little or no access to medical care.

    Examples of emergency standby medications include:

    • atovaquone with proguanil
    • artemether with lumefantrine
    • quinine plus doxycycline
    • quinine plus clindamycin

    Your GP may decide to seek advice from a travel health specialist before prescribing standby emergency treatment.

    Read more about standby emergency treatment for malaria.

    Antimalarials in pregnancy

    If you’re pregnant, it’s advisable to avoid travelling to areas where there’s a risk of malaria.

    Pregnant women have an increased risk of developing severe malaria, and both the baby and mother could experience serious complications.

    It’s very important to take the right antimalarial medicine if you’re pregnant and unable to postpone or cancel your trip to an area where there’s a malaria risk.

    Some of the antimalarials used to prevent and treat malaria are unsuitable for pregnant women because they can cause side effects for both mother and baby.

    The list below outlines which medications are safe or unsafe to use while pregnant:

    • Mefloquine – not usually prescribed during the first trimester of pregnancy, or if pregnancy is a possibility during the first 3 months after preventative antimalarial medication is stopped. This is a precaution, even though there’s no evidence to suggest mefloquine is harmful to an unborn baby.
    • Doxycycline – never recommended for pregnant or breastfeeding women as it could harm the baby.
    • Atovaquone plus proguanil – not generally recommended during pregnancy or breastfeeding because research into the effects is limited. However, if the risk of malaria is high, they may be recommended if there’s no suitable alternative.

    Chloroquine combined with proguanil is suitable during pregnancy, but it is rarely used as it’s not very effective against the most common and dangerous type of malaria parasite.