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Lemsip First Action Nasal Spray - 20ml

Lemsip First Action Nasal Spray - 20ml

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  • ✔️ Relieves blocked nose caused by colds and flu fast
  • ✔️ Contains xylometazoline 0.1% for targeted nasal decongestion
  • ✔️ Works locally in nasal passages for rapid symptom relief
  • ✔️ Suitable for adults and children aged 12 and over
  • ✔️ Compact 20ml bottle ideal for home or travel use

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What Is a Nasal Spray for Blocked Nose?

 

When a cold or flu strikes, a blocked nose can make even the simplest things — sleeping, eating, concentrating — feel like a real effort. The nasal spray for blocked nose you need should work quickly, be easy to use, and be clinically proven. Lemsip First Action Nasal Spray 20ml does exactly that. It contains xylometazoline hydrochloride 0.1%, a well-established decongestant active ingredient used widely across the UK to relieve nasal congestion caused by colds, flu, sinusitis, and allergic rhinitis. You can browse our full range of cold and flu remedies if you need additional symptom relief alongside this spray.

Nasal congestion happens when the blood vessels inside your nasal passages become inflamed and swollen, usually in response to a viral infection or allergen. This swelling narrows the airway, making it harder to breathe through your nose. Lemsip First Action Nasal Spray targets this directly at the source, offering relief that oral decongestants can sometimes take longer to deliver.

 

How Does Lemsip First Action Nasal Spray Work?

 

The active ingredient, xylometazoline hydrochloride 0.1%, belongs to a class of medicines called sympathomimetic decongestants. When sprayed into the nostril, it acts on alpha-adrenergic receptors in the nasal mucosa. This causes vasoconstriction — essentially, the blood vessels narrow — which reduces swelling of the nasal lining and allows air to pass through more freely.

  • Xylometazoline binds to alpha-1 and alpha-2 adrenergic receptors in nasal blood vessels
  • Vasoconstriction reduces blood flow to the swollen nasal mucosa
  • Swelling decreases, opening the nasal passages
  • Relief typically begins within minutes and can last several hours

Because it acts locally rather than systemically, the risk of cardiovascular side effects is lower compared to oral decongestants — though it is not entirely absent, particularly in people with certain health conditions.

 

Who Should Use Lemsip First Action Nasal Spray?

 

This spray is suitable for adults and children aged 12 and over who are experiencing nasal congestion. It is particularly useful when congestion is making it difficult to sleep, breathe comfortably, or go about daily life. That said, it is not appropriate for everyone.

  • Adults aged 18 and over with cold or flu-related nasal congestion
  • Adolescents aged 12–17 (under adult supervision)
  • People with sinusitis-related blockage seeking short-term relief
  • Those with allergic rhinitis who need temporary nasal decongestion

It is not suitable for children under 12, pregnant or breastfeeding women without medical advice, or people with certain cardiovascular or thyroid conditions. Always check the full list of contraindications before use.

 

How Does Lemsip First Action Nasal Spray Compare to Other Decongestants?

 

Feature Lemsip First Action Nasal Spray Oral Decongestant (e.g. Pseudoephedrine)
Route of administration Intranasal (local action) Oral (systemic action)
Onset of action Within minutes 30–60 minutes
Systemic side effects Lower risk Higher risk (e.g. raised blood pressure)
Maximum duration of use 7 consecutive days Varies by product

 

Is Lemsip First Action Nasal Spray Suitable for Long-Term Storage?

 

Store this product below 25°C, away from direct sunlight and out of reach of children. Do not use after the expiry date printed on the packaging. Once opened, the bottle should be used within the recommended period stated in the patient information leaflet — typically three months. If you are managing multiple cold and flu symptoms, you might also find our ear, nose and throat collection helpful for complementary products.

This product is a medicine. Speak to your doctor or pharmacist before using if you have an underlying medical condition or are taking other medicines.

Lemsip First Action Nasal Spray 20ml specifications
Treatment category Nasal decongestant
Mechanism of action Alpha-adrenergic agonist causing vasoconstriction of nasal mucosa
Effective for Nasal congestion due to colds, flu, sinusitis, allergic rhinitis
Suitable for Adults and children aged 12 and over
Active ingredient Xylometazoline hydrochloride 0.1%
Pack size 20ml
UK classification General Sale List (GSL) / Pharmacy (P) medicine
Drug class Sympathomimetic decongestant
Preparation Nasal spray solution
Route of administration Intranasal

Specifications of Lemsip First Action Nasal Spray 20ml

 

What Is Lemsip First Action Nasal Spray and What Is It Used For?

 

Lemsip First Action Nasal Spray 20ml is an over-the-counter nasal decongestant containing xylometazoline hydrochloride 0.1%. It is used to relieve the symptoms of nasal congestion — that stuffy, blocked feeling — caused by common colds, influenza, sinusitis, and allergic rhinitis. It works locally in the nasal passages, which means it gets to work quickly without needing to be absorbed into the bloodstream first. If you are also dealing with a sore throat or fever alongside your blocked nose, our cold and flu range includes a variety of products to help manage multiple symptoms at once.

 

What Do You Need to Know Before Using Lemsip First Action Nasal Spray?

 

Before using this spray, it is important to check whether it is appropriate for you. There are several conditions and circumstances where use is not recommended.

Do not use this spray if you:

  • Are allergic to xylometazoline hydrochloride or any other ingredient in the product
  • Have narrow-angle glaucoma
  • Have atrophic rhinitis (a condition causing thinning of the nasal lining)
  • Are under 12 years of age
  • Are pregnant or breastfeeding without first speaking to a doctor or pharmacist
  • Have had recent nasal or brain surgery

Use with caution if you have:

  • High blood pressure (hypertension)
  • Heart disease or irregular heartbeat
  • An overactive thyroid (hyperthyroidism)
  • Diabetes mellitus
  • Enlarged prostate (benign prostatic hyperplasia)
  • Phaeochromocytoma

Known drug interactions — do not use alongside:

  • Monoamine oxidase inhibitors (MAOIs) — including those stopped within the last 14 days
  • Tricyclic antidepressants (e.g. amitriptyline)
  • Other sympathomimetic medicines
  • Bromocriptine or other dopamine agonists

 

How Should You Use Lemsip First Action Nasal Spray?

 

Always use this spray exactly as directed on the label or as advised by your pharmacist. Do not exceed the stated dose.

  1. Blow your nose gently to clear the nasal passages before use
  2. Remove the protective cap from the nozzle
  3. Hold the bottle upright and insert the nozzle gently into one nostril
  4. Press the pump once firmly while breathing in gently through your nose
  5. Repeat in the other nostril if needed
  6. Replace the cap after use and wipe the nozzle clean
  7. Do not tilt your head back during or after spraying
Indication Age Group Dose Frequency
Nasal congestion (cold/flu/sinusitis) Adults and children 12+ 1–2 sprays per nostril Up to 3 times daily
Nasal congestion (cold/flu/sinusitis) Under 12 years Not recommended

 

What Are the Possible Side Effects of Lemsip First Action Nasal Spray?

 

Like all medicines, this spray can cause side effects, although not everyone experiences them. Most side effects are mild and related to local irritation in the nasal passages.

Common side effects:

  • Nasal dryness or irritation
  • Burning or stinging sensation in the nose
  • Sneezing immediately after use
  • Temporary increase in nasal discharge

Less common side effects:

  • Headache
  • Nausea
  • Palpitations or increased heart rate
  • Raised blood pressure
  • Rebound congestion (rhinitis medicamentosa) if used for more than 7 days
  • Insomnia or restlessness

If you notice any serious side effects such as chest pain, severe headache, or difficulty breathing, stop using the spray immediately and seek medical attention. You can also report suspected side effects to the MHRA via the Yellow Card scheme.

 

How Should You Store Lemsip First Action Nasal Spray?

 

Correct storage helps maintain the effectiveness and safety of this product. If you are also storing other medicines at home, our pain relief collection includes products that share similar storage requirements.

  • Store below 25°C in a cool, dry place
  • Keep away from direct sunlight and heat sources
  • Keep out of the sight and reach of children
  • Do not use after the expiry date printed on the bottle or carton
  • Do not freeze
  • Once opened, use within 3 months or as directed on the packaging
  • Do not share the spray with other people — this is for hygiene reasons

Written and reviewed by our qualified team

Your safety and success are our highest priorities. Our medical team rigorously evaluates every product and piece of advice we provide, ensuring you receive only the most effective, science-backed solutions available.

Frequently Asked Questions

Where can I buy Lemsip First Action Nasal Spray online in the UK?

You can buy Lemsip First Action Nasal Spray 20ml directly from Cured Pharmacy, a UK GPhC-registered online pharmacy, for just £6.99. No prescription is needed as it is an over-the-counter medicine. Simply add it to your basket and it will be dispatched to your door.

How does Lemsip First Action Nasal Spray work in the body?

The active ingredient, xylometazoline hydrochloride 0.1%, is a sympathomimetic decongestant that acts on alpha-adrenergic receptors in the blood vessels of the nasal lining. This causes vasoconstriction — the vessels narrow — which reduces swelling and opens up the nasal passages. Because it acts locally rather than systemically, it tends to work faster than oral decongestants.

How do I use Lemsip First Action Nasal Spray step by step?

Start by blowing your nose gently, then hold the bottle upright and insert the nozzle into one nostril. Press the pump once while breathing in gently through your nose, then repeat in the other nostril if needed. Replace the cap after use and wipe the nozzle clean — never share the spray with anyone else for hygiene reasons.

How quickly does Lemsip First Action Nasal Spray start to work?

Most people notice relief from nasal congestion within a few minutes of using the spray. The decongestant effect can last for several hours, which makes it useful both during the day and before bedtime when a blocked nose can disrupt sleep. Individual response times may vary slightly.

What is the correct dose of Lemsip First Action Nasal Spray for adults?

Adults and children aged 12 and over should use one to two sprays into each nostril, up to three times daily. Do not exceed this dose and do not use for more than 7 consecutive days without speaking to a pharmacist or doctor. Always read the patient information leaflet supplied with the product.

Can I use Lemsip First Action Nasal Spray for more than 7 days?

No — you should not use this spray for more than 7 consecutive days. Using it for longer can cause rebound congestion, also known as rhinitis medicamentosa, where the nasal passages become more blocked when the spray is stopped. If your symptoms persist beyond a week, speak to your GP or pharmacist.

Who should not use Lemsip First Action Nasal Spray?

This spray is not suitable for children under 12, people with narrow-angle glaucoma, atrophic rhinitis, or those currently taking MAOIs or tricyclic antidepressants. People with high blood pressure, heart disease, hyperthyroidism, or diabetes should seek medical advice before use. Pregnant or breastfeeding women should also consult a healthcare professional first.

What are the side effects of Lemsip First Action Nasal Spray?

Common side effects include nasal dryness, a burning or stinging sensation, and sneezing shortly after use. Less commonly, some people experience headache, nausea, palpitations, or raised blood pressure. If you notice any serious or unexpected symptoms, stop using the spray and contact your pharmacist or GP.

How do I manage side effects of Lemsip First Action Nasal Spray?

Mild nasal dryness or irritation can often be eased by using a saline nasal rinse between doses to keep the nasal passages moist. If you experience palpitations, severe headache, or any cardiovascular symptoms, stop use immediately and seek medical advice. Never exceed the recommended dose in an attempt to get faster relief.

Can I use Lemsip First Action Nasal Spray during pregnancy?

You should not use this spray during pregnancy without first speaking to your doctor or midwife. Xylometazoline is a vasoconstrictor and its safety in pregnancy has not been fully established. Your healthcare provider can recommend a safer alternative if needed.

Is Lemsip First Action Nasal Spray suitable for children?

This particular formulation (0.1% xylometazoline) is not recommended for children under 12 years of age. For younger children, a lower-strength formulation (0.05%) may be appropriate, but only under medical guidance. You can explore our baby and toddler range for age-appropriate products.

What are the alternatives to Lemsip First Action Nasal Spray?

Other xylometazoline-based sprays such as Otrivine Adult Nasal Spray work in a similar way. Oxymetazoline-based products like Sudafed Blocked Nose Spray are another option. For a non-medicated alternative, saline nasal sprays can help rinse and moisturise the nasal passages without the 7-day restriction. You can browse our full ear, nose and throat collection for more options.

Can I use Lemsip First Action Nasal Spray alongside other cold medicines?

You can use it alongside many other cold remedies, but be cautious about combining it with oral decongestants containing pseudoephedrine or phenylephrine, as this may increase the risk of cardiovascular side effects. Always check with your pharmacist before combining medicines, particularly if you take any regular prescription medication.

What happens if I use too much Lemsip First Action Nasal Spray?

Using more than the recommended dose increases the risk of side effects including raised blood pressure, palpitations, and rebound congestion. If you or someone else has used too much, contact NHS 111 or your nearest pharmacist for advice. In cases of accidental ingestion, seek emergency medical attention immediately.

What is the latest research on xylometazoline nasal sprays?

Xylometazoline has been used as a nasal decongestant for decades and its efficacy and safety profile are well established in clinical literature. Current guidance from the NHS and BNF continues to support its short-term use (up to 7 days) for nasal congestion relief. No major new safety concerns have emerged in recent years, though rebound congestion with prolonged use remains a recognised risk.

How Should You Use Lemsip First Action Nasal Spray?

Using this spray correctly makes a real difference to how well it works. Before you start, blow your nose gently to clear any mucus from the nasal passages — this helps the spray reach the nasal lining more effectively.

Follow these steps each time you use the spray:

What Is the Correct Dose of Lemsip First Action Nasal Spray?

Always use the lowest effective dose and never exceed the recommended amount. Using more than directed will not improve relief and increases the risk of side effects.

The table below summarises the recommended dosing by age group:

When Is the Best Time to Use Lemsip First Action Nasal Spray?

You can use this spray at any point during the day when nasal congestion is causing discomfort. Many people find it particularly helpful before meals — when a blocked nose affects taste and appetite — and before bedtime, as congestion can significantly disrupt sleep quality.

Try to space doses evenly throughout the day rather than using them all at once. If you are using it three times daily, morning, afternoon, and evening is a sensible routine to follow.

How Long Can You Use Lemsip First Action Nasal Spray For?

This spray is intended for short-term use only. Do not use it for more than 7 consecutive days. Prolonged use beyond this period can lead to rebound congestion — a condition where the nasal passages become more blocked than before once the spray is stopped, sometimes called rhinitis medicamentosa.

If your symptoms have not improved after 7 days, or if they worsen at any point, stop using the spray and speak to your GP or pharmacist. They can help identify whether an underlying condition such as sinusitis or allergic rhinitis requires a different treatment approach.

Do not exceed the recommended dose. If in doubt, speak to your pharmacist.

How Should You Use Lemsip First Action Nasal Spray?

Using this spray correctly makes a real difference to how well it works. Before you start, blow your nose gently to clear any mucus from the nasal passages — this helps the spray reach the nasal lining more effectively.

Follow these steps each time you use the spray:

What Is the Correct Dose of Lemsip First Action Nasal Spray?

Always use the lowest effective dose and never exceed the recommended amount. Using more than directed will not improve relief and increases the risk of side effects.

The table below summarises the recommended dosing by age group:

When Is the Best Time to Use Lemsip First Action Nasal Spray?

You can use this spray at any point during the day when nasal congestion is causing discomfort. Many people find it particularly helpful before meals — when a blocked nose affects taste and appetite — and before bedtime, as congestion can significantly disrupt sleep quality.

Try to space doses evenly throughout the day rather than using them all at once. If you are using it three times daily, morning, afternoon, and evening is a sensible routine to follow.

How Long Can You Use Lemsip First Action Nasal Spray For?

This spray is intended for short-term use only. Do not use it for more than 7 consecutive days. Prolonged use beyond this period can lead to rebound congestion — a condition where the nasal passages become more blocked than before once the spray is stopped, sometimes called rhinitis medicamentosa.

If your symptoms have not improved after 7 days, or if they worsen at any point, stop using the spray and speak to your GP or pharmacist. They can help identify whether an underlying condition such as sinusitis or allergic rhinitis requires a different treatment approach.

Do not exceed the recommended dose. If in doubt, speak to your pharmacist.

What Are the Most Common Side Effects of Lemsip First Action Nasal Spray?

Most people tolerate this spray well, particularly when used as directed for short periods. However, because xylometazoline acts directly on the nasal lining, some local irritation is possible. These effects are usually mild and tend to settle quickly.

  • Nasal dryness or a dry sensation in the throat
  • Burning or stinging inside the nose after spraying
  • Sneezing immediately after use
  • Temporary increase in nasal discharge or runny nose

What Are the Less Common Side Effects of Lemsip First Action Nasal Spray?

Less frequently, some people experience effects that go beyond local nasal irritation. These are more likely if the spray is used at higher doses or for longer than the recommended 7 days.

  • Headache
  • Nausea
  • Palpitations or a faster-than-normal heartbeat
  • Raised blood pressure
  • Insomnia or difficulty sleeping
  • Restlessness or agitation
  • Rebound congestion (rhinitis medicamentosa) — worsening blockage after stopping the spray

What Are the Serious Side Effects of Lemsip First Action Nasal Spray?

Serious side effects are rare but can occur, particularly in people with pre-existing cardiovascular conditions or those who use the spray more than directed. If you experience any of the following, stop using the spray immediately and seek urgent medical attention.

  • Chest pain or tightness
  • Severe or sudden headache
  • Difficulty breathing
  • Significant rise in blood pressure
  • Allergic reaction — including rash, swelling of the face, lips, or throat, or difficulty swallowing

What Should You Do If You Experience Side Effects of Lemsip First Action Nasal Spray?

For mild side effects such as nasal dryness or sneezing, no specific treatment is usually needed — they often resolve on their own. Using a saline nasal rinse between doses can help keep the nasal passages moist and reduce irritation. If side effects are persistent or troublesome, stop using the spray and speak to your pharmacist.

You can report suspected side effects directly to the MHRA via the Yellow Card scheme at yellowcard.mhra.gov.uk. This helps regulators monitor the safety of medicines used across the UK.

Can Lemsip First Action Nasal Spray Interact With Other Medicines?

Yes. This spray can interact with certain medicines, and some combinations can be dangerous. The most significant interactions are with monoamine oxidase inhibitors (MAOIs) — including those stopped within the previous 14 days — and tricyclic antidepressants such as amitriptyline. Combining xylometazoline with these medicines can cause a dangerous rise in blood pressure.

You should also be cautious about using this spray alongside other sympathomimetic medicines, including oral decongestants containing pseudoephedrine or phenylephrine. Always tell your pharmacist about all medicines you are currently taking, including herbal remedies and supplements, before starting this spray.

If you are concerned about any side effects, contact your pharmacist or GP immediately.

Patient Information Leaflet

Important - Before taking any medication, it is always important to read the Patient Information Leaflet (PIL)

Written and reviewed by our qualified team

GPhC Number: 2233073
Tarun Kumar

Reviewed by:

Tarun Kumar

Superintendent/ Clinical Lead

📖 Find out more about our team of medical content authors and how we ensure the accuracy of our content with our content guidelines.

Content last updated: 31 Mar 2025

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