Nasal congestion (viral rhinitis, rhinosinusitis)
Ontario assessment · Screening, treatment, documentation and follow-up
Clinical evidence & sources
Clinical basis & sources
- Primary source
- OCP Expanding Scope of Practice
Sources used
- Sinus Infection BasicsUS Centers for Disease Control and Prevention · 2024-04-17
- Sinusitis (acute): antimicrobial prescribing, NG79National Institute for Health and Care Excellence · 2017-10-27
- Sinusitis (sinus infection)National Health Service · Accessed 2026-10-13
- Symptoms of nasal and sinus cancerNational Health Service · Accessed 2026-10-13
- Rhinosinusitis commissioning guideNHS Essex Integrated Care Board · 2026-03
- Shortness of breathNational Health Service · Accessed 2026-10-13
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 (ScopeUp pathway preference)
- Post-nasal drip or facial pressure that worsens bending forward
- Reduced sense of smell
Red flags — any positive means refer
- Symptoms beyond 10 days without improvement, 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 difficulty breathing, including gasping or inability to speak
- Severe or persistent symptoms in a young child
- Recurrent or chronic symptoms lasting more than 12 weeks
Sign in to run this assessment
The interactive consult — guided screening, one-click treatment fills, printable assessment, prescription, and physician-notice documents — is free with a ScopeUp account. Enter your email, type the one-time code we send, and every assessment unlocks.