Influenza Hitting Hard: OTC Medications For Symptoms

Influenza is hitting hard this year thanks to a drifted influenza strain (H3N2) causing a more serious illness and one that is not included in our annual vaccine. Because of the hard hit, public health officials are reminding us to get high-risk patients into see physicians early if they have symptoms of “the flu” or influenza infections. Reason being, those at high-risk for complications may benefit from a prescription anti-viral medicine that can lessen the burden of illness and decrease risk for complications. Over-the-counter medicines you buy don’t fight influenza.

What Is “The Flu” And What Is Influenza

In general, in healthcare we use the term “the flu” when discussing an infection with influenza, a virus that causes widespread body aches, high fever, cough/cold symptoms, headache or even leg aches. Some children vomit with influenza infections as well (incidentally many patients with lab-confirmed influenza that I’ve seen this winter have also been vomiting) although in general influenza infections are upper and lower respiratory infections, and not the “stomach flu.” We worry about influenza as it’s in the list of top ten causes of death in the US and because it can cause severe symptoms, even in children. Infants and young children are at particular risk for serious infections as their bodies and their immune systems haven’t fought off influenza before.
High risk patients: 

• Children 2 years & younger (their immune system not as robust and not as much “memory” to fight off severe influenza infections).
• Adults age 65 year & older (their immune system is aging and not as robust fighting off severe influenza infections).
• People with underlying health problems (including asthma) or other lung problems, other chronic health conditions (like diabetes, heart disease).
• Pregnant moms or newly postpartum moms.
• Those people immunosuppressed.

The Numbers So Far

According to the CDC, widespread influenza activity is being reported in 46 states. The most common strain is that drifted virus H3N2, accounting for over 90% of the more than 5,000 reported influenza-positive tests recorded last week (ending January 10). It’s still too soon to tell whether we’ve reached the peak of flu season, however there are early signs that the virus is lessening in parts of the country. So far, this year the influenza vaccine is estimated to be about 23% effective, clearly not as effective as usual but still providing some protection.

What Over-The-Counter Medicines Can Help With Influenza?

It’s important to remember that over-the-counter (OTC) medications cannot cure “the flu” nor shorten your suffering with symptoms. They’re designed simply to help you get through the illness and should be taken within the proper guidelines. In general children under 4 should not be given OTC cough and cold medicines. 
That being said, there are four types of medications that can make getting through the flu a little more bearable.

1. Mucus thinners. Influenza can sometimes cause the body to produce large amounts of mucus that no amount of coughing can clear easily. Look for the ingredient guaifenesin in OTC medication to help make your coughs more productive and clear out thinner, easier-to-move mucus.
2. Fever reducers. Ibuprofen and acetaminophen are two ingredients that can reduce fever and other aches & pain associated with the flu. Use caution when taking ibuprofen if you have a history of heart disease or stomach ulcers. It’s also recommended that pregnant women avoid using ibuprofen as the drug can cause harm to the baby when taken in the third trimester. It’s NOT recommended to take aspirin when influenza concerns or symptoms exist.
3. Cough medicines. While coughing is essentially good for you (it’s the body’s way of removing foreign material or mucus from the lungs), it can be quite annoying when all you want is to sleep. Cough suppressants can help keep the hacking at bay and soothe a worn-out throat. Look for the active ingredient dextromethorphan in cough medications. I don’t typically recommend cough medication in children as there is little data they work. A teaspoon of honey for children age 1 and up is sometimes more effective.
4. Decongestants. A stuffed nose is another unfortunate symptom of the flu. Nasal decongestants (like pseudoephedrine and oxymetazoline) work by reducing the swelling of nasal membranes. When the membranes shrink, you’re potentially able to breathe easier.

Always read OTC medicine labels carefully. Medications are based by weight (not just age) for children. Never take, nor give, more than the recommended dose. Watch out for medicines with multiple ingredients as you don’t want to “double dose” when giving a combination medication along with another OTC cough and cold medicine. If your symptoms aren’t improving or if you have any questions regarding medication your child is taking, get in touch with your child’s pediatrician or family doctor for dosing info and support!
This post was written in partnership with OTC Safety.org. In exchange for our ongoing partnership helping families understand how to use OTC (over-the-counter) meds safely they have made a contribution to Digital Health at Seattle Children’s for our work in innovation. I adore the OTC Safety tagline, “Treat yourself and your family with care all year long.” Follow @OTCSafety #OTCSafety for more info on health and wellness.