Hypersensitivity is the root cause of almost all types of common cough

As pharmacies launch into winter mode for 2016, Dawn Gay reports on notable developments in the cold and flu category 

The new common cough medicine, Unicough, was launched in independent pharmacies last November and is the first new cough remedy to be licensed in the UK for 30 years. It is a ‘one-stop-shop’ for all types of common cough, which may be useful for customers and pharmacy staff who are baffled by the complex categorisation of coughs – from chesty and throaty to tickly and dry types.

The pharmacy-only medicine contains three active ingredients – the antihistamine diphenhydramine, the expectorant ammonium chloride, and the decongestant and mild local anaesthetic levomenthol
– in a 20 per cent cocoa formulation. Furthermore, the recent Rococo study reports that Unicough is clinically proven to reduce cough frequency and reduce night- time disruption.

The randomised trial of 163 patients addresses the gaps in the 2014 Cochrane review of OTC medicines for acute coughs, which claimed that “there was no good evidence for or against the effectiveness of over-the-counter medicines”.

Professor Alyn Morice, head of cardiovascular and respiratory studies at the University of Hull and founder of the International Society for the Study of Cough, says it is time to abandon the traditional dry and wet classifications that are applied to acute cough.

These are now “arbitrary categories” based on former best practice for tuberculosis treatment, when patients produced large amounts of phlegm. “In the opinion of several international experts, there is little difference between a dry cough and a cough that produces minimal amounts of sputum,” he explains.

Prof Morice argues that hypersensitivity is the root cause of almost all types of common cough. He says: “The goal of therapy should be to reduce this hypersensitivity and to normalise the cough reflex, rather than differentiating between a dry cough and one producing minimal amounts of sputum.”

The cocoa in Unicough both improves the taste and increases the viscosity of the medicine, relieving the hypersensitive nerve endings that create the impulse to cough. Prof Morice claims that theobromine, the alkaloid in cocoa, can suppress the urge to cough more effectively than codeine in cough medicines.

Headache headliners

A survey of 666 members of the Royal Pharmaceutical Society conducted on behalf of RB revealed that only
19 per cent of pharmacists feel confident when recommending children’s headache products and less than a third are confident that they can recognise when to refer. So RB is offering practical support to community pharmacists when recommending treatments for headache symptoms associated with childhood colds and flu this season. It has teamed up Nurofen for Children with the charity Migraine Action and launched training materials for pharmacists in time for the winter rush.

These include a guidance booklet on how to recognise and manage children’s headaches, including the red flags, lifestyle tips, and treatment, that will be distributed to pharmacies by RB’s activation team throughout the fourth quarter of this year. In addition, a consumer leaflet is designed to help parents understand and manage their child’s symptoms.

This training initiative follows the March launch of Nurofen for Children 100mg Chewable Capsules. Targeted at seven to 12 year-olds, the capsules are designed to be taken ‘on the go’ without water or food. They can be recommended for the reduction of fever and the relief of cold and flu symptoms.

Dr Samantha Bradley, head of professional relations for RB UK, explains: “By listening to parents and their children who suffer with headache, understanding the needs of pharmacy staff, and collaborating with leading headache specialists in the UK to develop practical training materials and patient resources, we hope we can make a significant difference to improving the management of childhood headaches in pharmacies, resulting in better patient outcomes.”

The comfort brands

With so many product choices for cold and flu, it is as important as ever to stock familiar and comforting household names. The heritage product Fisherman’s Friend was first developed as menthol and eucalyptus liquid for fishermen in Fleetwood in 1865 by local pharmacist James Lofthouse. Lofthouse then developed the lozenges when the fishermen found swigging from bottles troublesome on high seas.

Market sales data from Ceuta Healthcare report a 12.4 per cent year-to-date increase in volume sales for Fisherman’s Friend. In pharmacy, the brand has already seen 1.6 per cent growth this year. The newest variant, Honey and Lemon, has enjoyed a 134 per cent year-on-year increase before the winter season has even begun.

Martin Stimson, area business manager for Fisherman’s Friend in the UK, explains: “With such strong sales figures over the last few months, we’re excited to see what the coming months hold. Medicated confectionery naturally presents an opportunity for pharmacies as they are in a strong position to sell over-the-counter products, both to patients seeking out relief from cough and cold symptoms, and cautious convenience shoppers alike.

“In terms of in-store position, we’d suggest till-point to catch the eye of shoppers on the lookout for familiar products that they trust to ease their winter ailments. The vibrant, iconic pack design of Fisherman’s Friend stands out to capture the attention of new buyers, too.”

Fisherman’s Friend will run a national TV advertising and media campaign to coincide with the cold and flu season. In addition, its biggest sampling campaign for 20 years will target consumers at point of purchase and at key shows and events.

“Following a run of television advertising in early 2016, we’ve seen strong sales figures that have continued throughout the spring and summer months, so we’re pleased to say that we’ll be returning to screens again in January 2017. Adverts will once again feature world-renowned tenor Alfie Boe and convey the benefits
of our range of lozenges, that contain more menthol than any other brand in the medicated confectionery category.”

Olbas gains strength

From November to January, LanesHealth will be supporting its Olbas range with a national TV campaign featuring the well- known Olbas Nose family caricatures. The campaign will include a bolt-on to specifically support the Olbas Max Strength Cold and Flu Capsules, plus a consumer- driven PR campaign.

Olbas Max Strength Cold and Flu Capsules were launched in August 2015 and are the first ‘chemical’ products to be introduced to the Olbas range. The UK’s number one decongestant oil range also includes traditional Olbas Oil, Olbas for Children and an inhaler stick – all containing plant essential oils such as eucalyptus, mint, clove, juniper berry and cajuput.

Samantha George, Olbas brand manager, says: “Olbas Max Strength Cold and Flu Capsules contain three active ingredients – paracetamol, phenylephrine and guaifenesin – to effectively target the main symptoms of colds and flu, helping to manage the pain and congestion of sinusitis, blocked nose and sore throat, aches and pains, headache, chills and a high temperature.”