Summary
SUMMARY
Customers suffering with sleep and stress issues, particularly for long periods of time, are at serious risk of both physical and mental health complications
Your pharmacy team should feel empowered to lead sleep and stress-related conversations in their day-to-day OTC interactions – completing their training can help to achieve this
Customers at high risk of addiction, dependence or tolerance should be appropriately identified and supported to help reduce the risk of complications
Poor sleep and stress can be the cause of many medical conditions; however, many medicines and medical conditions can affect sleep and stress negatively themselves. By recognising them, you can appropriately support your customer
Communicating well with other HCPs will ensure patients receive the care they need. This can include making medicine interventions, improving adherence, reducing polypharmacy and improving overall patient outcomes, thus fulfilling your role in medicines optimisation
MERCHANDISING ADVICE
Sleep & stress is a growing category, with sales increasing by 8% sales over the past year (April 2023 vs April 2024) to create a category now worth £92m (2023 sales value). In order to maximise the success of your sleep and stress category in the pharmacy, this planogram highlights Perrigo's suggested minimum credible P-med range, based on how shoppers shop the category
INCREASED CONSUMER CHOICE:
Both branded
and generic options
available
Liquid option
available
Branded alternative
active available
ADVISE, MANAGE AND RECOMMEND
INCREASING SEVERITY AND DURATION OF SYMPTOMS
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Available at: https://www.mind.org.uk/information-support/types-of-mental-health-problems/sleep-problems/tips-to-improve-your-sleep/
5. NHS. Insomnia. 2024 Available at: https://www.nhs.uk/conditions/insomnia/
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7. National Institutes of Health (NIH). Valerian Fact Sheet for Health Professionals. 2013 Available at: https://ods.od.nih.gov/factsheets/Valerian-HealthProfessional/
8. Janda K, et al. Passiflora incarnata in Neuropsychiatric Disorders-A Systematic Review. Nutrients. 2020;12(12):3894.
9. Butterweck V, et al. Hypothermic effects of hops are antagonized with the competitive melatonin receptor antagonist luzindole in mice.
J Pharm Pharmacol.2007;59(4):549-52
10. NHS. Diphenhydramine. 2021. Available at: https://www.nhs.uk/medicines/diphenhydramine/
11. Pacheco. D et al. Pregnancy insomnia: causes and treatment. Sleep foundation 2024.
Available at: https://www.sleepfoundation.org/pregnancy/pregnancy-insomnia
12. Sleep charity. Teen Sleep hub. You and your sleep, a guide to better sleep for teenagers. 2020.
Available at: https://thesleepcharity.org.uk/wp-content/uploads/The-Teen-Sleep-Hub-eBook.pdf
13. Henderson R. 10 medicines that cause sleep problems and how to deal with them. Healthily. 2022.
Available at: https://www.livehealthily.com/self-care/medicines-that-cause-sleep-problems-and-how-to-deal-with-them
14. Breus. M. Medications that can cause insomnia. Sleep doctor. 2024. Available at: https://sleepdoctor.com/insomnia/medications-that-cause-insomnia/
15. The Science of Drug Use and Addiction: The Basics. NIDA. 2024.
Available at: https://archives.nida.nih.gov/publications/media-guide/science-drug-use-addiction-basics
Online sources last accessed September 2024
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 on 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. Contraindications: Known hypersensitivity to ingredients. Precautions: Avoid concomitant use of alcohol, hypnotics or synthetic sedatives. Use with caution during pregnancy/lactation. Side effects: GI disturbances, hypersensitivity, tachycardia, dizziness, headaches, nightmares or vivid dreams. THR 20894/0073. THR Holder: Brunel Healthcare Manufacturing Ltd, William Nadin Way, Swadlincote, Derbyshire, DE11 0BB. Revision date: 12/2023. RRP (Inc. VAT): 30s £6.89
SPC: https://mhraproducts4853.blob.core.windows.net/docs/b40f9c34c2993f999bba7235d601a41590809067
Nytol® Herbal Simply Sleep One-A-Night Tablets (GSL) contains valerian root extract. A traditional herbal medicinal product for use in the temporary relief of sleep disturbances exclusively based on 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. Precautions: Avoid concomitant use of alcohol, hypnotics or other sedatives. Use with caution during pregnancy/lactation. Side effects: GI disturbances, dizziness, headaches, nightmares or vivid dreams. THR 01074/0002. THR Holder: G. R. Lane Health Products Limited, Sisson Road, Gloucester, GL2 0GR, United Kingdom. Revision date: 12/2023. RRP (Inc. VAT): 21s £7.49
SPC: https://mhraproducts4853.blob.core.windows.net/docs/16d4a91fd3b358effd469ab3c08c15d7d2e8412f
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 on long-standing use as a traditional remedy. Adults over 18 years: For mild anxiety: two 5ml spoonful’s three times a day with water or fruit juice if desired. To aid sleep: two 5ml spoonful’s 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. Children under 18 years: Not recommended. Contraindications: known hypersensitivity to ingredients. Precautions: Avoid concomitant use of alcohol, hypnotics or other sedatives. Contains sucrose. Use during pregnancy/lactation not recommended. Contains alcohol (1300mg ethanol in each 5ml) 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, dizziness, headaches, nightmares or vivid dreams. THR 28255/0017. THR Holder: Rutland Biodynamics Ltd, Town Park Farm, Brooke, Rutland, LE15 8DG, United Kingdom. Revision date: 12/2023. RRP (Inc. VAT): 100ml £7.49 SPC: https://mhraproducts4853.blob.core.windows.net/docs/d2ae5949f3e9cadfc13024a067d41b6b5f93228f
Nytol® One-A-Night 50mg Tablets (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. Contraindications: Stenosing peptic ulcer, pyloroduodenal obstruction, known hypersensitivity to ingredients. Precautions: Use with caution with the elderly, during pregnancy/lactation, myasthenia gravis, epilepsy or seizure disorders, narrowangle 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 antidepressants), metoprolol, venlafaxine. Side effects: Fatigue, sedation, drowsiness, dizziness, dry mouth, tachycardia, palpitations, convulsions. PL 02855/0070. MAH: Omega Pharma Limited, Wrafton, Braunton, Devon, EX33 2DL, United Kingdom. Revision date: 01/2024. RRP (Inc. VAT): 20s £7.89
SPC: https://mhraproducts4853.blob.core.windows.net/docs/632e57fa716c861dd120dad8103e7f30255e113b
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. Contraindications: Stenosing peptic ulcer, pyloroduodenal obstruction, known hypersensitivity to ingredients. Precautions: Use with caution with the elderly, during pregnancy/lactation, myasthenia gravis, epilepsy or seizure disorders, narrowangle 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 antidepressants), metoprolol, venlafaxine. Side effects: Fatigue, sedation, drowsiness, dizziness, dry mouth, tachycardia, palpitations. PL 02855/0071. MAH: Omega Pharma Limited, Wrafton, Braunton, Devon, EX33 2DL, United Kingdom. Revision date: 12/2023. RRP (Inc. VAT): 20s £5.69
SPC: https://mhraproducts4853.blob.core.windows.net/docs/5af8576b8d5c2bc3a2f83e05d1b8d66d8b7ad864
Nytol® Liquid Caramel Flavour 10mg/5ml oral solution (P) contains diphenhydramine hydrochloride. As a sleep aid: as a short-term mild hypnotic. 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. Contraindications: Stenosing peptic ulcer, pyloroduodenal obstruction, known hypersensitivity to ingredients. Precautions: Use with caution with the elderly, during pregnancy/lactation, myasthenia gravis, epilepsy or seizure disorders, narrowangle 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 antidepressants), metoprolol, venlafaxine. Side effects: Fatigue, sedation, drowsiness, dizziness, disturbance in attention, unsteadiness, dry mouth, tachycardia, palpitations, arrhythmias. PL 02855/0313. MAH: Omega Pharma Limited, Wrafton, Braunton, Devon, EX33 2DL, United Kingdom. Revision date: 12/2023. RRP (Inc. VAT): 300ml. £10.99
SPC: https://mhraproducts4853.blob.core.windows. net/docs/cd69bea27da870ac4326ca5bce2f7bd6ba4000ff
If users experience any side effects, they should discontinue use and seek pr ofessional medical advice.
To report any potential side effects, contact us or use the MHRA’s Yellow Card Scheme available at https://yellowcard.mhra.gov.uk/ or search for MHRA Yellow Card in the Google Play or Apple App Store.