What are the treatments for acute cough and influenza?

From the Guidelines

Treatment for Acute Cough and Influenza

The most effective approach for treating acute cough and influenza involves a combination of over-the-counter medications, antiviral drugs, and supportive care.

• Over-the-counter medications: Start with acetaminophen (650-1000 mg every 4-6 hours) or ibuprofen (200-400 mg every 4-6 hours) to alleviate fever, headache, and body aches 1. For cough, dextromethorphan (15-30 mg every 4-6 hours) can be used, but choose a medication that targets the specific type of cough, such as a dry cough or a productive cough.
• Antihistamines and decongestants: Antihistamines like diphenhydramine (25-50 mg every 4-6 hours) or loratadine (10 mg once daily) can help relieve runny nose, sneezing, and itchy eyes 1.
• Antiviral medications: Oseltamivir (75 mg twice daily for 5 days) or zanamivir (10 mg twice daily for 5 days) can be prescribed if the flu is diagnosed within 48 hours of symptom onset, especially for patients at higher risk for complications or with severe symptoms 1.
• Supportive care: Drink plenty of fluids, such as water, clear broths, or electrolyte-rich beverages like sports drinks, to stay hydrated. Resting and avoiding strenuous activities can also help the body recover from the flu.
• Duration of treatment: Most over-the-counter medications should not be taken for more than 7-10 days. If symptoms persist or worsen, consult a healthcare professional for further evaluation and guidance.

Important Considerations

• Timing of antiviral treatment: Initiate antiviral treatment within 48 hours of symptom onset for maximum benefit 1.
• Patient risk factors: Consider the patient's age, underlying medical conditions, and risk factors for complications when deciding on treatment 1.
• Resistance patterns: Be aware of local antiviral resistance patterns and adjust treatment accordingly 1.

From the FDA Drug Label

Oseltamivir phosphate for oral suspension is indicated for the treatment of acute, uncomplicated illness due to influenza A and B infection in patients 2 weeks of age and older who have been symptomatic for no more than 48 hours. In both trials, there was a 1.3-day reduction in the median time to improvement in influenza-infected subjects who received oseltamivir phosphate 75 mg twice a day for 5 days compared to subjects who received placebo.

The treatment for acute cough and influenza is oseltamivir phosphate. Key points about oseltamivir phosphate include:

• It is indicated for the treatment of acute, uncomplicated illness due to influenza A and B infection in patients 2 weeks of age and older who have been symptomatic for no more than 48 hours 2
• It has been shown to reduce the median time to improvement in influenza-infected subjects by 1.3 days compared to placebo 2
• The recommended dose is 75 mg twice a day for 5 days 2
• It is not a substitute for early influenza vaccination on an annual basis as recommended by the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices 2

From the Research

Treatments for Acute Cough

• Over-the-counter (OTC) cough preparations may be used to treat acute cough, but there is no good evidence for or against their effectiveness 3
• Antitussives, expectorants, mucolytics, antihistamine-decongestant combinations, and other drug combinations have been studied, but the results are inconsistent and often conflicting 3
• In children, OTC cough and cold medications are not effective in treating the common cold and may cause serious side effects, including death 4

Treatments for Influenza

• Diclofenac-K and ibuprofen have been shown to be effective in relieving influenza-like symptoms, such as fever, headache, and muscle/joint aches and pains 5
• A flexible dosing regimen of diclofenac-K 12.5 mg or ibuprofen 200 mg may be used to treat influenza-like symptoms, with comparable tolerability 5
• Aspirin, paracetamol, and ibuprofen are safe and effective for the treatment of colds and flu, except in certain cases such as the use of aspirin in feverish children 6

Use of OTC Medications

• OTC medications for cough associated with acute pneumonia may be beneficial, but there is insufficient evidence to recommend them as an adjunctive treatment 7
• Mucolytics may be beneficial in reducing cough severity, but there is insufficient evidence to recommend them as an adjunctive treatment for acute pneumonia 7
• Antihistamine-decongestant combinations and other drug combinations may be effective in reducing cough symptoms, but the results are inconsistent and often conflicting 3