“Pharmacists have to be extremely curious, that’s our job.”

“Pharmacists have to be extremely curious, that’s our job. You have to do that active recommendation practice. In case of a cold with obvious symptoms, what will help us is always to recommend one product or another depending on the needs of the patient. Because there is a product for every need and we have to accommodate them and avoid giving them excessive medication, or dispensing products with active ingredients they do not need,” said Pablo García (@medicadoo), pharmacist and Says health communicator, expert in cosmetics and dermopharmacy. Founder of Bandito Cosmetics.

As Irene González Ortes, a rural pharmacy owner and member of SEFAR and secretary of AFARPA, says: “You always have to ask questions of the patient, especially polypharmacy patients. It is important to get to the heart of the symptoms without adding more medicine. “This avoids adding side effects and adverse reactions.”

Why do you start recommending cold and flu products?

A question that cannot be missing from cold and flu recommendations is: “Do your symptoms get worse at night?”

Cold symptoms worsen at night in 9 out of 10 patients1Because of its connection with circadian rhythms, the immune system is more active at night.2, In particular, cough and nasal congestion are cold symptoms that worsen most at night.1,

“Cold symptoms not only worsen over the course of the illness, but also change from night to day due to changes in circadian rhythms.2, When a patient suffers from cold for three days, he comes to you in a helpless state. It’s not just nasal congestion, runny nose and pain, but also the fact that you haven’t slept for three days because it gets worse at night, you cough more, you have more nasal congestion.1…This is where we can help patients. As? Adding some more products,” says Pablo Garcia (@medicadoo).

In this context, Irene González Ortes (@boticonsejo) is clear: “Here the treatment can be complemented with something like Vaporub ointment.”

Vaporub Ointment provides relief from nasal congestion and cough with its 2-in-1 action3So that the patient suffering from cold sleeps like a baby, thanks to the relief from the above symptoms.

Regarding the patient’s perspective on this recommendation of Vaporub Pomada, Pablo García (@medicadoo) explains: “If we as pharmacists think that the best recommendation is two products, then we have to recommend two products. Depending on the circumstances, the patient may or may not take it, but it should be a full recommendation (…) from our end. In the case of Vaporub ointment, experience and studies show that most patients see improvement when products like Vaporub are added to their treatment. 86% will feel improvement in symptoms4,

Vaporub Ointment
Vaporub Ointment

What problems does a pharmacist face in following complete recommendations?

According to Irene González and Pablo García in the Round Table of cold, found outFrom Diario Medico, some of the main problems that a pharmacist faces during the flu and cold season are the endless lists of anti-flu drugs, in addition to the fact that the patient comes with a preconceived idea that this product does. Not compatible with their symptoms. Again, in this situation, the pharmacy staff should ask the patient to understand their symptoms and recommend the anti-flu that best suits their needs.

“As pharmacy staff we need to know how to identify based on symptoms what is the ideal anti-flu, anti-cold for that patient. Not everyone is the same and you have to ask, you have to be very curious, you have to chat a lot in that sense and try to get every possible information from the patient to make the right recommendation,” Pablo. Garcia (@says Medicado).

According to Pablo and Irene, one of the questions that can’t be ignored during a flu referral is, “Do you have a cough?”

Irene (@boticonsejo) adds: “They always come to me and tell me ‘give me anything, No, nothing, no. What’s the matter with you? Do you have cough? You have to start from there. Nothing works for every situation. Because I probably won’t cough. In fact, only 3 out of 10 cold patients have a cough associated with the infection.5*,

“And yet, 60% of cold medications prescribed are accompanied by a cough suppressant.”,, Why give a cough suppressant along with flu medicine when the patient does not have a cough? If you don’t have a cough, I would take a cold-preventive medicine including an analgesic for pain and fever and some medicine for a runny nose, such as Ilvico6. Paracetamol, brompheniramine maleate and caffeine, which will help to enhance these effects of paracetamol7,


And what about patients who have them?

It is important to understand what type of cough they have. 89% of cough patients claim that their cough is productive5*, It is very important not to suppress it because this cough is beneficial for health, promoting mucus. Dextromethorphan suppresses cough, so its use is contraindicated in patients with productive cough., In this context, Pablo (@medicadoo) recommends products such as Ilvigrip Expectorante, which has an expectorant effect due to guaifenesin. Additionally, it relieves fever, mild or moderate pain and nasal congestion due to paracetamol and phenylephrine hydrochloride.8,

For patients with dry cough, Irene (@boticonsejo) is clear: “Cough is the symptom that worsens most at night1. (…) For patients who have a cough at night, that dry, irritating cough that prevents them from resting, Ilvigripp is the solution, because it contains doxylamine9“It helps sleep.” Ilvigrip Night also contains dextromethorphan, which relieves cough, and paracetamol for mild or moderate pain and fever.9,


Pablo García (@medicadoo) and Irene GonzálezOrtes (@boticonsejo) agree on their final advice for all pharmacy staff during flu and cold season: “There are two key questions that should not be ignored in case of flu and cold: Do your symptoms get worse at night? Do you have a cough?”

1. Phillipson, G., Aspley, S. and Fietz, I. Perceptions of the importance of sleep in the common cold—two online questionnaire-based surveys. SN Comp. Clin. Med. 2, 596-605 (2020). https://doi.org/10.1007/s42399-020-00265-5
2. Geiger SS, Fagundes CT, Siegel RM. Chrono-immunology: Progress and challenges in understanding the relationship between the circadian and immune systems. Immunology. 2015 Nov;146(3):349-58. doi:10.1111/imm.12525.
3. Vaporub Ointment Technical Sheet. https://cima.aemps.es/cima/pdfs/es/ft/22051/FT_22051.html.pdf
4. WhitefordD, Rios J, Henzhold D, Espley S. (2023) Multi-Symptom Relief for Cough and Cold: Benefits of Including Vicks VapoRub in the Treatment Regimen. The Open Journal of Respiratory Diseases, 13, 9-27.
5. Ron Eccles, Peter Dikpinigaitis, Ronald B. Turner, Howard M. Druce, Maryanne Adeleke, and Ashley L. Mann (2016) Characterizing the urgency of cough and cough symptoms associated with the common cold: results of a US Internet survey, Postgraduate Medicine, 128:5,485-491, DOI: 10.1080/00325481.2016.1185376
6. Ilvico Tablet Technical Sheet. https://cima.aemps.es/cima/dochtml/ft/33844/FT_33844.html
7. Laska EM, Sunshine A, Mueller F, Alvers WB, Siegel C, Rubin A. Caffeine as an analgesic adjunct. Jama. 1984 Apr 6;251(13):1711-8. PMID: 6366275.
8. IlviGrip Expectorant Technical Sheet https://cima.aemps.es/cima/dochtml/ft/73271/FT_73271.html
9. IlviGrip Knight Technical Sheet https://cima.aemps.es/cima/pdfs/ft/80647/FT_80647.pdf
* Total participants: 8011 people who had a cold in the last 3 months, excluding those who did not have a cough (1527), those who had a frequent cough not related to a cold (2786) and those who had other diseases (990) were given, and ultimately 2,708 were left who had cough as a symptom of a cold.
** Data extracted from Flu Market’s 2023 Sales Volume (January-June) – IQVIA
¥ Approved technical sheets for all medicines containing dextromethorphan, searched in CIMA (cima.aemps.es) for the month of August 2023
Exclusive content for healthcare professionals. Do not transmit to consumer. Airdate: 01/19/2024.
Medicines are not subject to medical prescription. Unfunded medicine. mat-es-wix-24-000001. Vaporub Ointment 50g (CN.846287.2) RRP: €9.41. From the age of 6 years. Ilvico 20 Tablets (CN 771337) RRP: €11.98. From the age of 12. Ilvigrip Expectorant Powder for oral solution (CN 677204.1) RRP: €11.96. From the age of 12. Ilvigrip Night Syrup 180ml (CN 709958.1) RRP: €11.96. From the age of 12. Wicks Laboratories, SLU

This content is developed by Unidad Editorial’s branded content and content marketing creative firm UE Studio for Wix.

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