Medications

Some medications can be used to decrease the severity and duration of a flu attack. These are referred to as antiviral drugs. Antiviral medications are often given to those who are very sick, such as those in the hospital and others who are at higher risk of complications.

Those include children under 2 years of age (although 2-  to 4-year-olds are also at increased risk, but not as much as those under 2 years of age) and children or adults with chronic illness such as asthma, chronic lung disease, congestive heart failure, diabetes or HIV, as well as those under 19 years of age on chronic aspirin therapy.

• Amantadine (Symmetrel) and rimantadine (Flumadine) are active only against influenza A. They are not recommended by the CDC during the 2009 flu season as they may not be effective against the H1N1 flu virus.



• Zanamivir (Relenza) and oseltamivir (Tamiflu) are active against both influenza A and B although resistance may develop in some strains of influenza A. These drugs are effective against most 2009 H1N1 flu strains.



• Zanamivir and oseltamivir are most effective when given within 48 hours of the onset of illness. They can decrease the duration of the disease by one day if used within this early time period. They are usually given for a period of about five to seven days. Information is not conclusive whether or not these drugs can prevent complications of the flu.



• Side effects may include nervousness, poor concentration, nausea, and vomiting. Serious effects such as worsening of asthma may occur if you have a history of asthma. Discuss side effects with your doctor.

When the lungs get infected, causing pneumonia, other antiviral drugs such as ribavirin (Copegus, Rebetol) and sometimes antibiotics may be needed.

• For nasal congestion, the doctor may suggest the use of over-the-counter decongestants. Anyone with high blood pressure, heart disease, diabetes, thyroid disease, or glaucoma (high pressure of the eye) should not use these decongestants.

• Phenylephrine (Neo-Synephrine) and oxymetazoline hydrochloride (Neo-Synephrine 12 Hour, Afrin) are available as nasal sprays or drops. Use two to three sprays in each nostril as indicated on the label. Only use these nasal sprays or drops for up to three days. If they are used for more than that, the medication can actually worsen the congestion. These medications are not recommended for children.

• Pseudoephedrine tablets (Sudafed) tablets may help congestion.

Next Steps

Follow-up

Generally, no follow-up is needed for most flu cases unless fever or cough returns along with other new symptoms, which could signal a complication.