For headache, aching muscles or fever, paracetamol or ibuprofen can be used, assuming the customer has no reason not to take them. Both can be taken simultaneously if symptoms are severe.

However, they should be combined rather than alternated to reduce the risk of confusion and accidental overdose. Aspirin and other NSAIDs are not recommended. Steam inhalations can be effective at loosening mucus and relieving congestion, and there is no harm in adding products such as menthol crystals or eucalyptus.

Care needs to be taken to reduce the risk of scalding, particularly with children, so sitting in a bathroom with the shower running on the maximum temperature may be a safer option. Saline nasal drops and irrigation products can also ease congestion, although some customers find them unpleasant to use.

Topical decongestants, such as ephedrine and xylometazoline, have been shown to be more effective than systemic products such as pseudoephedrine and phenylephrine, but they should only be used for a maximum of five to seven days because of the risk of rebound congestion. Due to their mode of action, decongestants are not suitable for everybody, so read the patient information leaflets carefully and ask whether the patient takes any other medication or suffers from any other conditions before making a recommendation. Pharmacy teams also need to be mindful of the sales restrictions that apply to products containing ephedrine or pseudoephedrine: only one pack of either may be sold per transaction.

Antihistamines are included in some cold and flu remedies to help dry up nasal secretions. There is also some evidence supporting the use of sedating antihistamines (e.g. chlorphenamine) in combination with a decongestant. However, side effects can be a problem. Non-sedating antihistamines such as loratadine are generally not thought of as useful for relieving colds and flu.

Many people rely on cough medicines, although there is actually very little evidence either for or against their use. The most common ingredients of chesty cough medicines are expectorants such as ipecacuanha, guaifenesin and squill. Cough suppressants (opioids such as pholcodine, codeine and dextromethorphan) form the mainstay of products for dry coughs.

Alternatively, some products include sedating anthistamines, which are thought to work by inducing drowsiness. Many cough medicines contain a demulcent, such as glycerol, honey or syrup to soothe the throat. These are generally inexpensive and do not cause adverse reactions.

However, their high sugar content should be taken into consideration for patients with diabetes. OTC cough and cold products containing cough suppressants or expectorants, antihistamines or decongestants are not suitable for children under six years of age. And they should only be considered for children aged six to 12 years if other measures have been tried unsuccessfully.

In this case, dosing should be kept low and treatment should not exceed five days. Codeine-containing cough medicines are an exception €“ they should not be used by anyone aged under 18 years of age. Many winter remedies contain more than one ingredient. It is necessary to note the product's active ingredients and reinforce the correct dosage to the customer in order to highlight the risk of adverse reactions and accidental overdose.