How to stock your medicine cabinet for cold and flu season

We can't prevent you from getting sick this year, but we can help you prepare. In this episode, we talk to a doctor and a pharmacist about their medicine cabinet must-haves, how to read medicine labels, and when to treat an illness at home or see a doctor. Follow us on Instagram: @nprlifekit https://www.instagram.com/nprlifekit/?hl=en Sign up for our newsletter here. https://www.npr.org/newsletter/life-kit Have an episode idea or feedback you want to share? Email us at [email protected] mailto:[email protected] Support public media with NPR+ and enjoy perks for over 25 podcasts like this one. This show’s perks include sponsor-free listening and convenient playlists of popular help topics like personal finance, getting healthy, and more. Learn more at plus.npr.org http://plus.npr.org/. See pcm.adswizz.com https://pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences. NPR Privacy Policy https://www.npr.org/about-npr/179878450/privacy-policy

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• 0:24Marielle Segarra?

  So I was on the train today, and this lady started coughing. And, you know, my first thought, of course, is, is she sick?

• 0:33Speaker 05

  Mm-hmm.

• 0:34Marielle Segarra?

  Right? Like, you're hoping she's choking, which sounds actually terrible. But maybe she just choked on her own spit or on some water or something. But then, as she starts coughing more, you're like, trying to diagnose it. Does it sound wet? Is it phlegmy? You know? And like, ugh, do I have to get up? Can the germs travel that far?

• 0:57Speaker 02

  Right. Like, is this a, like, can I just turn away situation? Is this like a move to a different, like, move to a whole different train situation?

• 1:05Marielle Segarra?

  I feel like I notice cold and flu season just by the number of coughs that I hear on the train in October.

• 1:13Speaker 02

  Yeah, yeah, that's a real, that's a real thing.

• 1:15Marielle Segarra?

  Well, you're listening to Life Kit. I'm Marielle Segarra, and I am talking to reporter Andy Tegel. Andy, what is it about this time of year? Why are we so susceptible to getting sick now?

• 1:27Speaker 02

  There's a lot of things working against us at the same time, Marielle. Let me introduce you to Dr. Mona Amin. She's a board-certified pediatrician and the host of the podcast, Peeds Doc Talk.

• 1:37Speaker 09

  There's so many things that are happening in this timeframe. The first one is that different viruses replicate in different climates. And then you add the fact that kids are back in school. And so when you put germs with germy little kids together, it's like a nice little Petri dish that everyone's just sharing the love. Nasty.

• 1:57Marielle Segarra?

  I hate it. So what have you got for us? Would you, you have some tips you can help me not get sick?

• 2:07Speaker 02

  Well, I'm gonna, I'm gonna do my best, Marielle. I'm gonna do my best. In this episode of Life Kit, let's get you prepped for the cold and flu season as best we can. Mona will share all of her must-haves for your medicine cabinet. We'll also talk to a pharmacist about reading labels and how to be smarter in the cold and flu aisle. And then we're gonna wrap up with tips for understanding when to treat a sickness at home and when to go in to see a doctor.

• 2:31Marielle Segarra?

  Here's hoping that this is all just good to know, and you won't need any of it, and you'll be illness-free.

• 2:38Speaker 02

  Crossing all of my fingers, all of my toes.

• 2:41Marielle Segarra?

  That's hard to do.

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• 4:08Speaker 02

  Takeaway one. As the weather turns colder, multiple factors can work against your immune system at once. The very best medicine at your disposal is prevention.

• 4:20Speaker 09

  My goat, my greatest of all time hack, is saline. So like, anytime my nose is feeling dry, even if I'm not sick, I am squirting saline into those nostrils to help keep it moist, almost like the version of washing your hands, but for your nose.

• 4:37Speaker 02

  It's easier for viruses to attach, to stick to you, when your nose is dry.

• 4:43Speaker 09

  Yes. That being said, it's not a full-stop prevention, but it's one layer of that Swiss cheese model, which means adding different layers of the Swiss cheese to reduce the risk of, you know, getting an infection in the first place.

• 4:55Speaker 02

  The idea here, if it's new to you, is that no method of prevention is perfect. They all have holes. But you can reduce your overall risk of getting sick by adding on more layers of protection,

• 5:09Speaker 05

  like... So, I mean, definitely, you want to make sure that you're hand washing.

• 5:14Speaker 02

  This is Alicia Reed, a licensed pharmacist and health educator based in New Orleans.

• 5:19Speaker 05

  So, you know, like, they have a girl's girl. I consider myself a girl's pharmacist, because I, I'm the pharmacist that's gonna tell you whether or not something is worth buying. I don't want you to get fooled by clever marketing. So I consider myself a girl's pharmacist.

• 5:35Speaker 02

  Together, Alicia and Mona are going to tag team to help get you and everyone in your family ready for this cold and flu season. Both say it's pretty simple. Just don't skip the basics.

• 5:46Speaker 09

  Hydration. Fluid helps things move along. And also, fluids help keep our throat moist, so things can't get into our mucus membranes in the throat that can cause viruses. Proper nutrition. Getting fresh air is so healing. Getting sunshine is so healing. Vitamin D. All of this is so good for our immune system.

• 6:08Speaker 02

  And let's not forget about the biggie, sleep.

• 6:11Speaker 09

  The two biggest things that cause illness, it's lack of sleep and stress. When we're very high-stress for a long period of time, viruses love us, because we're considered a good host to replicate in.

• 6:24Speaker 05

  And of course, as a pharmacist, I'm always going to recommend up-to-date vaccinations.

• 6:30Speaker 02

  In particular, for this conversation, your annual flu shot. According to the CDC, the ideal time to get a flu shot, for most people, is before the end of October, so that those antibodies have kicked in by the start of the season. But if this episode is finding you later than that, don't think you're off the hook. And that includes if you've already caught the flu, by the way. In that case, current guidance says wait until you've been symptom-free for two weeks before getting your shot. And yes, it's still worth it to do that, because there are a lot of different strains out there, and a lot of other viruses that can have you running straight to your medicine cabinet. Or...

• 7:13Speaker 02

  Recently online, I saw this idea I really liked, and it's idea prepping a sick box before you start sniffling or you have that tickle in your throat.

• 7:20Speaker 05

  I have actually a bag that has, like, pharmacist survival kit. I definitely think that you should prepare ahead of time for cold and flu season and have things readily available, so that you're not scrambling or depending on someone else to run to the drugstore for you when you become ill. And I do make sure, it's very important to check it, you know, because it may be expired. You may not use it in a while, so you want to go in and make sure that everything is up to date.

• 7:47Speaker 02

  That's a good point.

• 7:48Speaker 05

  What's the general shelf life of over-the-counter medications? Well, they usually give, like, a year or two years, if you're looking at the expiration date. I will say that that's the date that the company can guarantee the stability of the medication, or guarantee that it's gonna work. Anything beyond that, they're unsure of the stability. So, I know some people still keep it and say, well, you know, it's probably still good. I don't want to waste my money. But I typically like to stay within the range of, you know, the expiration date.

• 8:14Speaker 02

  Right. So best practice, you want to take medication that is fresh, that you know is guaranteed. But if you accidentally take a Tylenol that's six months out of date, you're probably gonna, you don't have to panic. Right. So let's get into it. Be it a box, a bag, a shelf, get your shopping list ready. Because takeaway two is prep your sick day supplies before anyone in the house gets sick.

• 8:41Speaker 09

  So the first thing is you want a thermometer, which is very basic.

• 8:45Speaker 02

  For kids three and under, Mona says a rectal thermometer is your most accurate option. For everybody else, oral or digital infrared thermometers work just fine, although the latter may be slightly less accurate.

• 8:59Speaker 09

  Having that nasal saline is wonderful. If your child is younger, a bulb suction or a suctioning tool. But you don't need to go suctioning things out if the saline is allowing everything to drip out.

• 9:12Speaker 05

  I have to have a pain reliever, a fever reducer.

• 9:16Speaker 02

  Let's note, those are separate, standalone meds. So ibuprofen and acetaminophen, for example. And kids' versions of those, too, of course, if needed.

• 9:26Speaker 05

  I also want to make sure I have something for my stomach. Most often, it may be over-the-counter heartburn medication. Something for diarrhea.

• 9:34Speaker 09

  And then the other thing that is for stomach bugs is a vomit bag. And then instead of having to use your baking bowls, you can have this on the go. And then along those lines of vomiting is having something like Pedialyte, which can help with hydration.

• 9:51Speaker 02

  Also on the shortlist, an antihistamine.

• 9:54Speaker 09

  The best one is actually Zyrtec, which is cetirizine, or Claritin, which is loratadine. Benadryl has actually fallen out of favor.

• 10:02Speaker 02

  That's because Benadryl's active ingredient, diphenhydramine hydrochloride, can cause some adverse side effects, like hallucinations, and potential risks for chronic users. And other antihistamines are just as effective. If you just went, wait, what? Isn't an antihistamine the medicine I use for like dust or pollen in the spring? Yes, that's right. Colds and allergies have similar symptoms. Sneeze, runny noses, watery eyes. And antihistamines can help out with all of those things. Some are more effective than others. And as Mona alluded to, providers will favor some over others.

• 10:44Speaker 02

  In the case of Benadryl, it's been shown to cause more side effects than other similar products. So always talk to your doctor or pharmacist if you have questions. Next on the list, a few other good to haves, like chest rub.

• 10:58Speaker 09

  Which is, you know, eucalyptus in it. This is a homeopathic remedy. There's not a lot of research behind it. However, I swear by it. A lot of families love it.

• 11:08Speaker 02

  Another favorite homeopathic remedy, honey.

• 11:11Speaker 09

  What honey does is that it's an anti-inflammatory, which helps with the inflammation that happens from viruses. But it also helps with coating the throat. Honey is the GOAT over the age of one for cough and cold. It's actually been shown to be even better than cough and cold syrups. And the reason we don't give it under one is a risk of botulism toxin. But over one, you can either give it in a syringe. It might be a little thick to pull up. Or just in a tablespoon that they can eat directly. Or you can mix it in warm water or warm milk.

• 11:41Speaker 05

  And then a humidifier. It's something that I definitely make sure that I have invested in for cold and flu season.

• 11:48Speaker 02

  Now, you might have noticed a few exceptions from this list. For one, combination cold and flu meds. That's because those are a little less straightforward. Bringing us to takeaway three. Less is more. Read your labels, opt for simple ingredients, and only take the medications you actually need.

• 12:11Speaker 05

  The number one thing that I tell anyone is when you are looking at an overcounter medication, make sure that it has the ingredient that you are looking for.

• 12:18Speaker 02

  Alicia says, around this time of year, everyone's running to the drugstore for cough syrup. But few stop to read the back of the box. And that's a really important thing to do.

• 12:29Speaker 05

  Because nine times out of 10, it's a lot of things you don't even need.

• 12:32Speaker 02

  Right. And there's 100 different to choose from. I have no idea where to start.

• 12:36Speaker 05

  Right. So first and foremost, you want to know what you're looking for and treat the symptom.

• 12:41Speaker 02

  For instance, if you have a dry cough and only a dry cough.

• 12:44Speaker 05

  You only need a cough suppressant. So you want to look for something with dextromethorphan in it. That's it. That's basically the DM, right? So when you see a DM, but just to turn the box over because there's all types of cough medications. You know, a lot of people, they end up buying more things than they need and they end up taking more than they need. When, you know, you really should just pay attention to the ingredients.

• 13:07Speaker 02

  If you have a wet cough, meaning you have mucus in your chest that needs to be broken up.

• 13:12Speaker 05

  That's where you get guaifenesin. But one very interesting caveat, in fact, is water is actually a natural expectorant. Like you can actually help break up mucus by staying hydrated.

• 13:26Speaker 02

  And this is why it's so important to actually read the ingredients and understand what they do. Alicia referenced this one popular cough syrup, for example, that has both a cough suppressant and an expectorant.

• 13:38Speaker 05

  Some people, you know, end up wanting to buy the guaifenesin and they use that because that's going to break up the mucus. So you're going to cough. And a lot of times people don't realize that if you're taking something to stop the cough and something to break up the mucus, then it's working against each other.

• 13:52Speaker 02

  And the same goes for those combination cold and flu meds.

• 13:55Speaker 05

  So you may be taking a Dayquil and then taking a daytime allergy sinus something, right? You know, you don't want to take too much of something, whether it be a nasal discongestant or an antihistamine. I rarely have a multi-symptom anything at home because I want to treat the actual symptom and not just a combination of things. Because most often it's you don't need all of that. And you also want to make sure that you're not double dipping in terms of pain relievers. There's a lot of cases where someone may be prescribed a liquid pain medication. And then they have Tylenol at home. And then you're telling them, wait a minute, this pain medication already has Tylenol. So you may end up doubling on ingredients.

• 14:39Speaker 02

  Remember, just because a medicine is available over the counter, that doesn't mean it's risk free. OTC meds have different dosage and usage restrictions for good reason.

• 14:52Speaker 05

  A lot of people aren't aware that excessive amounts of Tylenol can lead to liver toxicity. The NSAIDs, which are like the ibuprofens, you can have ulcers. You know, it can affect your kidney function. So that's more of the focus there, just trying to make sure that, you know, if you reach for something, you genuinely, you know, you really need it.

• 15:09Speaker 02

  And this is extra important to be aware of if you have any chronic health conditions, like diabetes or high blood pressure. Not all meds will be safe for all people. After the break, we'll talk about those immunity boosting supplements in the cold and flu aisle.

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• 16:21Speaker 02

  You're listening to Life Kit. Next up, those supplemental cold and flu remedies people love. I'd love to hear your thoughts on things like airborne emergencies, I-CAMS, Inc. I know that people swear by them, but I know they're not regulated in the same way as OTC meds.

• 16:36Speaker 09

  So you said it already that many of them, mostly all of them, are not FDA approved. What that means is they can enter the market as a supplement and they have not had to do official testing. Now, that doesn't mean that they're completely unsafe. It just means that the company does their own testing

• 16:53Speaker 05

  and has deemed it appropriate to put on market. Like zinc actually does have some evidence that it can shorten the duration of a cold, but you have to start it like almost immediately, right? But some people actually take zinc year round, right? As a part of their vitamin supplements, right? In addition to vitamin C.

• 17:09Speaker 02

  But the answer isn't just taking more vitamins.

• 17:12Speaker 05

  Your body can only absorb what it can absorb. And I was like, it's very expensive. You have very expensive urine. So I think that's a takeaway that I have for a lot of people is, you know, make sure you're not overdoing it. Like you just want to make sure that you are doing your best to stay healthy.

• 17:26Speaker 02

  So let's say it again for good measure. Prevention is the very best medicine. But if or when that pesky seasonal bug catches you, let's move on to takeaway four. Learn when it's time to wait it out and when it's time to worry.

• 17:46Speaker 09

  It's really kind of important to know, is this a virus that I can manage at home? Or is this something that I need to go in for?

• 17:53Speaker 02

  According to the CDC, a common cold usually lasts less than a week. Though it's not unusual for some symptoms like a runny nose or wet cough to stick around for 10 to 14 days. A flu, if uncomplicated, can pass through your system in as little as a few days or as long as a few weeks. I know, it's a pretty big window. So when should you worry?

• 18:18Speaker 05

  You always want to make sure that your symptoms are improving. If your symptoms are worsening, that's when you call the doctor.

• 18:25Speaker 09

  If you're finding that you're having to give medication around the clock, that is when it becomes, let me go see a doctor.

• 18:32Speaker 02

  Generally speaking, us grownups know when something is really off, right? When we have new or severe symptoms, especially in localized parts of the body, like sudden fever and a sore throat, difficulty swallowing. It's not hard to make the call that it's probably time to call your doctor. But when the source of your sickness isn't so obvious like that, or for the littlest members of your family, finding that line can be harder, more anxiety inducing, especially when it comes to fevers.

• 19:06Speaker 02

  Monu says she's seen a lot of worried parents come into the ER unnecessarily because...

• 19:12Speaker 09

  Many fevers can be managed at home. When you need to go take a kid for a fever would be if they're under three months of age. And if your child's over three months, you are watching the following: breathing, hydration, and behavior. First up, breathing. If they are breathing comfortably, you don't have to be concerned about that fever.

• 19:30Speaker 02

  Next, hydration.

• 19:31Speaker 09

  If they are drinking their breastmilk formula, the liquids they're normally drinking, making pee, you don't have to be concerned about that fever.

• 19:38Speaker 02

  Finally, behavior.

• 19:40Speaker 09

  If you give them a medicine, super cranky, the fever is not budging, you can't get them comfortable, that's a sign that maybe we should see them.

• 19:48Speaker 02

  Now, for older kids and adults, guidance from the National Library of Medicine recommends to seek treatment if you've had a fever continuously for two to three days, or if you've had fevers come and go for up to a week or more, even if they're low grade.

• 20:03Speaker 09

  In that timeframe of the fever persistence, you are dealing with anything I mentioned: dehydration, difficulty breathing, or you are so uncomfortable and Motrin or Talina are not helping.

• 20:13Speaker 02

  Also of note, if you're really starting to burn up, like according to Harvard Health, if your temperature reaches 104 degrees Fahrenheit or more, it's time to call it in. And remember, that behavior standard can be a really big bucket for adults. Think loss of consciousness or confusion. So if you're experiencing discomfort or you're just unsure about what's going on in your body, it's never a bad idea to talk to your care provider. So as ever, use your best judgment.

• 20:44Speaker 09

  Like if you have a cold and you're having really thick, green mucus and a fever for three days, worth getting checked out. If it's just green mucus but no fever, not needed, right? Because then we're not worried about a sinusitis, which is an infection of the sinuses. Vomiting, if you're not able to keep anything down, right? Like you are vomiting and you vomit, 15 minutes later you take a sip of a liquid, like a little sip, you're not able to keep that down. For your child or yourself, that is a sign that we want to know because we need to make sure that you're not getting dehydrated to the point that you need IV fluids or maybe a medication like Zofran that can help with nausea.

• 21:22Speaker 02

  Final thoughts, anything you wish I asked you? Any other advice for us as we head into cold and flu season?

• 21:27Speaker 09

  One thing I'd like to leave your listeners with is that in life, we want to control everything, but we can't.

• 21:34Speaker 05

  So when your child gets sick, don't blame yourself. And don't be afraid to call your doctor or talk to a pharmacist about what's going on. I think that we're all making through cold and flu season if we just ask the right questions, take care of ourselves, and just listen to our body.

• 21:51Speaker 02

  All right, let's recap. Takeaway one: cold and flu season is coming for you. Prevention is the best medicine, so don't skip the basics. Takeaway two: you want to build that sick box before you need it. We all know just how little fun it is to drag yourself to the pharmacy at 10:00 PM when you've been hit by the flu. Takeaway three: only take the medications you actually need. Keep them simple whenever you can to avoid unnecessarily overmedicating yourself. And that will require reading your labels. Finally, takeaway four: many viruses, many fevers, can be treated at home. But it's important to know when it's time to consult your care provider. So remember Monu's three rules as a starting point:

• 22:36Speaker 02

  breathing, behavior, hydration. When in doubt, just ask.

• 22:43Marielle Segarra?

  All right, that's our show. One more thing before we go. Do you follow Life Kit in your podcast app? Would you do it now? Tap Follow so you never miss an episode. This episode of Life Kit was reported by Andy Tagle and produced by Lennon Sherburne and Claire Marie Schneider. It was edited by Sylvie Douglas. Our digital editor is Malika Gharib and our visuals editor is CJ Riechelmann. Megan Kane is our senior supervising editor and Lauren Gonzalez is our executive producer. Our production team also includes Margaret Serino. Fact checking by Andrea Lopez-Cruzado. I'm Marielle Segarra. Thanks for listening.

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