Learning scenario
Learning scenario
Jason, 28, comes to your pharmacy for advice. You can see that he looks tired and he keeps yawning. He explains that he is really stressed at work and that he has been struggling to sleep for the last week. He doesn't like taking tablets, but wants something to relieve his sleep issues within a short period of time. He is concerned about becoming addicted to sleep products. He has no known allergies and takes no other medication.
What would you recommend to him?
More than one option may be selected.
Incorrect. This is not the best option for Jason as he is looking for a product to relieve his sleep issues within a short period of time. The effects of Nytol Herbal Simply Sleep & Calm Elixir may not be apparent immediately, and the product should be taken for 2-4 weeks continuously. There are other products more suitable for Jason's needs
Correct. NICE guidelines recommends good sleep hygiene to help short term insomnia. Recommending a sleep aid like Nytol Liquid Caramel Flavour is also appropriate here
Correct. This is a good option as Jason does not like taking tablets. There is often a fear of dependency, but you can educate him on how Nytol Liquid Caramel Flavour works as an antihistamine
Incorrect. Sleep is important for overall wellbeing, so you need to provide appropriate support. You can offer lifestyle advice to help Jason sleep and Nytol Liquid Caramel Flavour is also appropriate.
Product Information
Nytol Liquid Caramel Flavour 10mg/5ml oral solution (P) contains diphenhydramine hydrochloride. An aid to the relief of temporary sleep disturbance. Adults and children 16 years and over: 10 to 25ml at bedtime, or after retiring when sleep is not readily achieved. Children under 16 years: Not recommended. Avoid concomitant use of alcohol or other antihistamine-containing preparations. Do not drive or operate machines. Contraindications: Stenosing peptic ulcer, pyloroduodenal obstruction, known hypersensitivity to ingredients. Special warnings and precautions: The elderly, pregnancy/lactation, myasthenia gravis, epilepsy or seizure disorders, narrow-angle glaucoma, prostatic hypertrophy, urinary retention, asthma, bronchitis and COPD, moderate to severe renal or hepatic impairment, intolerance to some sugars. Interaction with CNS depressants (including alcohol), monoamine-oxidase inhibitors, anticholinergic drugs (e.g. atropine, tricyclic depressants), metoprolol, venlafaxine. Side effects: Fatigue, hypersensitivity reactions, confusion, paradoxical excitation, depression, sleep disturbances, sedation, drowsiness, dizziness, disturbance in attention, unsteadiness, dry mouth, GI disturbances, muscle twitching, headache, blurred vision, tachycardia, palpitations, arrhythmias, paraesthesia, dyskinesias, convulsions, urinary difficulty, urinary retention, thickening of bronchial secretions. PL 02855/0313. MAH: Omega Pharma Limited, 32 Vauxhall Bridge Road, London SW1V 2SA. RRP (ex. VAT): 300ml. £10,99
SPC: https://www.medicines.org.uk/emc/product/10392
Nytol Herbal Tablets (GSL) contains extracts of hops, valerian and passion flower. A traditional herbal medicinal product for use in the relief of temporary sleep disturbances exclusively based upon long-standing use as a traditional remedy. Adults over 18 years: 2 tablets approximately 1 hour before bed. Children under 18 years: Not recommended. Take continuously for 2 - 4 weeks. Seek medical advice if symptoms persist after 4 weeks. Avoid concomitant use of alcohol, hypnotics or synthetic sedatives. Precautions: Caution in glucose-galactose malabsorption, pregnancy/lactation. Side effects: GI disturbances, tachycardia. THR 20894/0073. THR Holder: Brunel Healthcare Manufacturing Ltd, William Nadin Way, Swadlincote, DE11 0BB. RRP (inc. VAT): 30s £5.49
SPC: https://www.medicines.org.uk/emc/medicine/30107
Nytol Herbal Simply Sleep One-A-Night Tablets (GSL) contains Valerian root extract. A traditional herbal medicinal product for use in the relief of temporary sleep disturbances exclusively based upon long-standing use as a traditional remedy. Adults over 18 years: 1 tablet approximately 30-60 minutes before bed. If necessary, 1 additional tablet can be taken earlier during the evening. Children under 18 years: Not recommended. Take continuously for 2 - 4 weeks. Seek medical advice if symptoms persist after 4 weeks. Contraindications: Known hypersensitivity to ingredients. Avoid concomitant use of alcohol, hypnotics or synthetic sedatives. Precautions: Pregnancy/lactation. Side effects: GI disturbances, THR 01074/0002. THR Holder: G. R. Lane Health Products Limited, Sisson Road, Gloucester, GL2 0GR, United Kingdom. RRP (inc. VAT): 21s £5.99
SPC: https://www.medicines.org.uk/emc/medicine/32773
Nytol One-A-Night (P) contains diphenhydramine hydrochloride. An aid to the relief of temporary sleep disturbance. Adults and children 16 years and over: 1 tablet taken 20 minutes before bed. Children under 16 years: Not recommended. Do not use for more than 2 weeks without medical advice. Avoid concomitant use of alcohol or other antihistamine-containing preparations. Do not drive or operate machines. Contraindications: Stenosing peptic ulcer, pyloroduodenal obstruction, known hypersensitivity to ingredients. Caution: The elderly, pregnancy/lactation, myasthenia gravis, epilepsy or seizure disorders, narrow-angle glaucoma, prostatic hypertrophy, urinary retention, asthma, bronchitis and COPD, moderate to severe renal or hepatic impairment, intolerance to some sugars. Interaction with CNS depressants (including alcohol), monoamine-oxidase inhibitors, anticholinergic drugs (e.g. atropine, tricyclic depressants), metoprolol, venlafaxine. Side effects: Fatigue, hypersensitivity reactions, confusion, paradoxical excitation, sedation, drowsiness, dizziness, dry mouth, GI disturbances, muscle twitching, headache, blurred vision, tachycardia, palpitations, convulsions. PL 02855/0070. MAH: Omega Pharma Limited, 32 Vauxhall Bridge Road, London SW1V 2SA. RRP (inc. VAT): 20s £6.89
SPC: https://www.medicines.org.uk/emc/medicine/19778
Nytol Original 25mg Tablets (P) contains diphenhydramine hydrochloride. An aid to the relief of temporary sleep disturbance. Adults and children 16 years and over: 2 tablets taken 20 minutes before bed. Children under 16 years: Not recommended. Do not use for more than 2 weeks without medical advice. Avoid concomitant use of alcohol or other antihistamine-containing preparations. Do not drive or operate machines. Contraindications: Stenosing peptic ulcer, pyloroduodenal obstruction, known hypersensitivity to ingredients. Caution: The elderly, pregnancy/lactation, myasthenia gravis, epilepsy or seizure disorders, narrow-angle glaucoma, prostatic hypertrophy, urinary retention, asthma, bronchitis and COPD, moderate to severe renal or hepatic impairment, intolerance to some sugars. Interaction with CNS depressants (including alcohol), monoamine-oxidase inhibitors, anticholinergic drugs (e.g. atropine, tricyclic depressants), metoprolol, venlafaxine. Side effects: Fatigue, hypersensitivity reactions, confusion, paradoxical excitation, sedation, drowsiness, dizziness, dry mouth, GI disturbances, muscle twitching, headache, blurred vision, tachycardia, palpitations, convulsions. PL 02855/0071. MAH: Omega Pharma Limited, 32 Vauxhall Bridge Road, London SW1V 2SA. RRP (inc. VAT): 20s £4.89
SPC: https://www.medicines.org.uk/emc/medicine/14222
Nytol Herbal Simply Sleep & Calm Elixir (GSL) contains extract of valerian. A traditional herbal medicinal product for use in the temporary relief of symptoms of mild anxiety and to aid sleep, exclusively based upon long-standing use as a traditional remedy. Adults over 18 years: For mild anxiety: two 5ml spoonfuls three times a day with water or fruit juice if desired. To aid sleep: two 5ml spoonfuls 30 minutes before bedtime with an earlier dose during the evening if necessary. Maximum dose: 4 single doses per day. Take continuously for 2 - 4 weeks. Seek medical advice if symptoms persist after 4 weeks. Avoid concomitant use of alcohol, hypnotics or synthetic sedatives. Children under 18 years: Not recommended. Contraindications: known hypersensitivity to ingredients. Precautions: Caution in glucose-galactose malabsorption, pregnancy/lactation. Contains alcohol (up to 2.5g ethanol per dose) which should be taken into account in high-risk groups such as those with liver-disease or epilepsy. Harmful for those suffering from alcoholism. Side effects: GI disturbances. THR 28255/0017. THR Holder: Rutland Biodynamics Ltd, Town Park Farm, Brooke, Rutland, LE15 8DG. RRP (inc. VAT): 100ml £5.99,
SPC: https://www.medicines.org.uk/emc/medicine/30104
References
1. https://www.mentalhealth.org.uk/publications/sleep-report
2. https://www.nhs.uk/medicines/diphenhydramine/
3. U&A Segmentation Study, Hall & Partners 2013
5. https://cks.nice.org.uk/insomnia#!management
6. https://www.sleepfoundation.org/insomnia/what-insomnia
7. https://www.sleephealthfoundation.org.au/insomnia.html
All online references last accessed September 2020