Nasal congestion (viral rhinitis, rhinosinusitis)
Clinical basis & sources
- Primary source
- OCP Expanding Scope of Practice
Allowable drugs under Schedule 4 (7)
Drugs an Ontario pharmacist may prescribe for Nasal congestion (viral rhinitis, rhinosinusitis) under O. Reg. 256/24, Schedule 4. Choice still depends on the assessment, contraindications, allergies, and product availability — this is the eligible list, not a recommendation.
- Ipratropium bromide
- Mometasone
- Oxymetazoline
- Pheniramine
- Phenylephrine
- Pseudoephedrine
- Xylometazoline
Symptoms this assessment screens
- Blocked or stuffy nose
- Part of a viral cold (runny nose, sneezing, mild sore throat)
- Symptoms present only a few days
- Post-nasal drip or facial pressure that worsens bending forward
- Reduced sense of smell
Red flags — any positive means refer
- Symptoms beyond 10 days or worsening after initial improvement
- High or persistent fever
- Severe facial pain, swelling, or one-sided symptoms
- Persistent one-sided bloody discharge
- Immunocompromised
- Eye/periorbital swelling, severe headache, vision change, neck stiffness, or confusion
- Severe shortness of breath, wheeze, or stridor
- Severe or persistent symptoms in a very young child
- Recurrent or chronic symptoms lasting more than 12 weeks
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