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Medical Author:

Steven Fine, MD, PhD

Medical Editor:

Mary Nettleman, MD, MS, MACP

Mary Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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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) or adults over 65 years of age. Also at higher risk of complications are children or adults with chronic illness such as asthma, chronic lung disease, congestive heart failure, diabetes, obesity, or HIV, as well as those under 19 years of age on chronic aspirin therapy. American Indians, Alaska natives, people who are morbidly obese (with BMI greater than 40), and residents of chronic care facilities like nursing homes are also considered to be at higher risk for complications of the flu.

• Zanamivir (Relenza) and oseltamivir (Tamiflu) are the only antiviral drugs currently recommended to treat seasonal flu. They are active against both influenza A and B although resistance may develop in some strains of influenza A.
  • 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 may also be able to reduce the incidence of complications from the flu. The drugs are usually given for a period of about five to seven days.
  • These antiviral drugs are safe for children and pregnant women.
  • 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.
  • Antiviral drugs are not a substitute for the flu vaccine. Getting the annual seasonal flu vaccine is still the best way to prevent the flu.

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 without a doctor's advice.
• 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.

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