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Winter is imminent and with dropping temperatures viruses are bound to be more prevalent, exacerbating health problems among the vulnerable and immunocompromised patients. This can cause serious complications, and therefore, it's important to know the symptoms, methods to manage them and when to refer. A healthy person can usually manage the illnesses with over-the counter medication. Colds, flu and Covid-19 are caused by different viruses. As some of their symptoms overlap, it may be hard to tell the difference. However, some key differences are shown in the following figure. It is also possible to suffer from cold/flu and Covid-19 simultaneously, which can complicate matters. As per NHS guidelines, anyone with fever, cough, loss/change in sense of taste and/or smell has to self-isolate and request a Covid test. Pharmacy Advice The pharmacy team should advise patients with symptoms to take rest, ensure adequate hydration and take balanced nutrition. Supplements such as Vitamin C, Vitamin D and zinc can also help to boost the immune system and can be recommended.

The Department of Health and Social Care (DHSC) has issued a medicine supply notification for Dioralyte oral rehydration sachets. "Dioralyte oral rehydration sachets are expected to be in limited supply until late December 2022. St Mark's solution is available as an unlicensed special and can support an uplift in demand," said DHSC. "Kidderminster formula is available as an unlicensed special and can support a partial uplift in demand. As an alternative to the unlicensed specials, the individual components can be purchased from community pharmacies and supermarkets or prescribed, but there have been intermittent supply issues with glucose powder." Diluted apple juice has been reported to be a potential alternative to electrolyte maintenance fluids in children with mild gastroenteritis and minimal dehydration. If there is currently no listing on dm+d for the imported product for prescribers to select using their prescribing systems an EPS prescription for unlicensed St Mark's solution cannot be issued.

Department of Health and Social Care (DHSC) has issued a medicine supply notification for Clomifene (Clomid) 50mg tablets on Monday (5 June). It said: "Sanofi will be out of stock of clomifene (Clomid) 50mg tablets from w/c 12 June 2023 until w/c 18 September 2023." "Generic clomifene 50mg tablets remain available from Wockhardt who are able to partially uplift supplies until the end of July 2023. Unlicensed supplies of clomifene 50mg tablets may be sourced, lead times vary. Alternative medicines for use in infertility remain available," it added. The specialist importers- Orifam and Target Healthcare have confirmed to DHSC they can source unlicensed clomifene 50mg tablets. "If there is currently no listing on dm+d for the imported product for prescribers to select using their prescribing systems an EPS prescription for unlicensed clomifene 50mg tablets cannot be issued," said Community Pharmacy England.

The Department of Health and Social Care (DHSC) has issued a medicine supply notification for Temazepam 10mg and 20mg tablets. "Temazepam 10mg and 20mg tablets are in limited supply until w/c 5th December 2022. Alternative benzodiazepines and non-benzodiazepine hypnotics remain available and will be able to support increased demand," said DHSC. Temazepam 10mg/5ml oral solution remains available but cannot support an uplift in demand. DHSC suggested: "Where the above options are not suitable, unlicensed supplies of temazepam 10mg tablets may be sourced, lead times vary." The department confirmed that Target Healthcare, a specialist importers, have confirmed they can source unlicensed Temazepam 10mg tablets. "If there is currently no listing on dm+d for the imported product for prescribers to select using their prescribing systems an EPS prescription for unlicensed Temazepam 10mg tablets cannot be issued."