Flu season is here. It’s time to check my medicine cabinet. Do I have all my favorite remedies for fever, muscle aches, cough, stuffy nose, sinus pressure, and runny nose?
Here are my “Must Have” medicines that I like to keep on hand for coughs, colds, and flu:
- Delsym® for relief of cough.
Delsym® contains a concentrated form of dextromethorphan (DM), the same active ingredient as in Robitussin DM®. Unlike Robitussin, each concentrated dose of Delsym® lasts for 12 hours, from morning to evening, and is nearly as effective as prescription cough medicines containing codeine. Unlike codeine, DM rarely causes drowsiness, so it is safe to use when driving a car or working around machinery.
- Tylenol® for fever and body aches.
I prefer taking extra-strength 500mg acetaminophen tablets for headache and fever instead of ibuprofen or naproxen. Acetaminophen is less irritating to your stomach, especially when chicken soup is all you feel like eating.
Taking too much Tylenol® is dangerous to your liver. NEVER take more than the maximum recommended daily dose of acetaminophen. This amounts to 8 extra-strength tablets (4 grams) acetaminophen daily for healthy adults. In the elderly, the recommended maximum dose is 3.1 grams or 6 extra-strength Tylenol® 500mg tablets. If you have liver problems, check with your doctor about whether there is a safe dose of Tylenol® for you.
- Aleve® for body aches.
The influenza symptom that puts people flat on their back in bed or curled up on the sofa is severe muscle aches. Sometimes I swear that a ninja must have snuck in and attacked me in my sleep with their fighting sticks.
Naproxen (Aleve®) is my go-to for muscle aches because each dose lasts 8-12 hours, twice as long as ibuprofen (Advil, Motrin-IB). I used to use ibuprofen, but I would wake up at 3:30 in the morning in discomfort when it wore off.
NSAIDs like naproxen and ibuprofen are often more effective for relieving body aches than acetaminophen. Unfortunately, they can cause stomach irritation, stomach bleeding and can harm your kidneys. Drink plenty of fluids when taking any NSAID to avoid kidney damage.
People who take blood thinners like warfarin, Pradaxa®, Xarelto®, Eliquis®, and Plavix® (clopidogrel) need to be especially cautious. To reduce stomach irritation and the risk of developing a bleeding ulcer, you should ALWAYS take any NSAID with a full glass of water or fluid or immediately after eating.
- Sudafed® for sinus and nasal congestion.
I only buy the original formulation of Sudafed®, which contains the decongestant pseudoephedrine. I prefer the red-coated 30mg tablets to the white 60mg tablets, both of which are only available “behind the counter.” It’s worth the hassle of showing your identification to have an effective decongestant. Phenylephrine doesn’t work nearly as well; it is only available at 1/3 of its effective dose because higher doses have caused strokes.
- Actifed® for runny nose and sneezing.
If you were a surgeon with a head cold, you really wouldn’t want your nose to drip or to sneeze on your patient during surgery. As a hospital pharmacist, I would take urgent calls from the surgery department, requesting something to dry up the runny nose of an afflicted surgeon or scrub nurse.
We’d send them a couple of tablets of the original formula of Actifed®, a surprisingly effective combination of antihistamine and decongestant. This Actifed® formula contained pseudoephedrine to relieve nasal congestion plus an older antihistamine called triprolidine. Triprolidine worked great at drying up runny noses and decreasing sneezing.
It also rarely caused drowsiness, so surgeons didn’t have to worry about nodding off in the middle of performing a hip replacement. Today I still rely on the original formula of Actifed®, available only “behind the counter,” requiring a signature and identification.
- Nyquil® Cold and Flu for multi-symptom relief at night.
I prefer using products with one single ingredient to mix and match my specific symptoms. My husband just wants something to “knock me out so I can get some rest.”
Nyquil®’s original formula came in 2 flavors: green and red cherry. It contained acetaminophen for fever and aches, dextromethorphan for cough, pseudoephedrine for stuffy nose and sinus pressure, the antihistamine doxylamine for runny nose and sneezing, plus 10% alcohol to help you sleep.
When pseudoephedrine was restricted in 2006, the original formula of Nyquil® was updated with phenylephrine. Nyquil® Severe Cold and Flu remains closest to its original recipe. I prefer Nyquil® Cold and Flu instead, which doesn’t contain phenylephrine, allowing me to add pseudoephedrine when needed.
