Minor Ailments Service & Over The Counter Medication

Prescribing of Medicines for Minor Conditions and Self-limiting Illnesses

In line with guidance from the NI Department of Health, this GP practice does not prescribe medicines:

that can be purchased over-the-counter by patients when they are being used to treat minor conditions or self-limiting illnesses, or
where there is no evidence base for their use.

The following points should be noted:

This practice promotes self-care for minor conditions and self-limiting illnesses (see below for examples)
Medicines on the lists below should be purchased by the patient from community pharmacies or supermarkets and not prescribed on HS21
Patients should be advised that their local community pharmacist can provide advice and help to manage minor conditions and self-limiting illnesses

Clinical judgement is used when considering whether to ask a patient to purchase their medication e.g. paracetamol PRN for headaches or teething in babies should be purchased, however regular full dose paracetamol for chronic pain should be prescribed due to the quantities and processes involved in managing an on-going illness.

1. OTC indications and examples of restricted medicines

OTC indication	Examples of restricted medicines
Aches and pains (mild) e.g. headache, occasional migraine, teething	Anti-inflammatory gels or creams e.g. ibuprofen gel, diclofenac gel Oral painkillers e.g. paracetamol, ibuprofen
Athlete’s foot	Antifungal creams e.g. clotrimazole, miconazole, terbinafine
Cold sores	Anti-viral creams e.g. acyclovir 5%
Colic	Colic drops e.g. Infacol®, Dentinox Colic Drops®, Colief® Gripe water
Coughs, colds and sore throats	Cough bottles Lozenges and spays for sore throats Oral painkillers/antipyretics e.g. paracetamol,ibuprofen Nasal decongestant e.g. pseudoephidrine tablets, decongestant sprays and drops
Diarrhoea (occasional) or constipation	Oral rehydration solutions e.g. Dioralyte® Antidiarrhoeal medicines e.g. loperamide Laxatives e.g. ispaghula husk (Fybogel®), bisacodyl, lactulose, senna
Ear wax	Drops for softening ear wax
Fungal nail infections	Amorolfine 5% nail lacquer (mild infections only– max 2 nails affected)
Haemorrhoids (Piles)	Haemorrhoid creams, ointments and suppositories e.g. Anusol®
Hayfever and allergies	Oral antihistamines e.g. cetirizine, loratadine, chlorphenamine Antihistamine creams Steroid nasal sprays e.g. beclometasone, fluticasone
Head lice	Headlice lotions and sprays e.g. dimethicone lotion
Indigestion and heartburn (mild)	Antacids e.g. co-magaldrox (Maalox®, Mucogel®) Alginates e.g. Gaviscon®
Infant feeding	Baby milks e.g. comfort milks, lactose free formulas for colic, reflux milks (Note - some babies may require cow’s milk free formulas on HSC prescription where clinically appropriate)
Nappy rash	Barrier creams and ointments e.g. Metanium®, Sudocrem®, Zinc and Castor oil cream
Oral health	Mouthwashes e.g. chlorhexidine
Sunscreen	Sunscreens unless for ACBS approved conditions i.e. skin protection against UV radiation in abnormal cutaneous photosensitivity resulting from genetic disorders or photodermatoses, including vitiligo and those resulting from radiotherapy, chronic or recurrent herpes simplex labialis
Threadworms	Mebendazole tablets and suspension
Vaginal thrush	Oral antifungal e.g. fluconazole capsule Topical antifungals e.g. clotrimazole cream and pessaries
Vitamins and minerals	All vitamins and minerals unless in line with an ACBS approved indication, i.e. only in the management of actual or potential vitamin or mineral deficiency; they are not to be prescribed as dietary supplements or as a general ‘pick-me-up’