How to treat influenza symptoms without antiviral (flu) medication?

Symptomatic Treatment of Influenza Without Antiviral Medications

For influenza symptom management without antiviral medications, acetaminophen (650-1000 mg every 4-6 hours, maximum 4000 mg/day for adults) is recommended as the first-line treatment for fever and pain relief, along with adequate hydration, rest, and targeted symptomatic therapies for specific symptoms. 1

Core Symptomatic Treatment Approach

Fever and Pain Management

• Acetaminophen (Paracetamol):
  • Adults: 650-1000 mg every 4-6 hours (maximum 4000 mg/day)
  • Children: 10-15 mg/kg/dose every 4-6 hours 1
  • Discontinue if fever persists beyond 3 days or pain beyond 10 days 2
• Hydration: Increase fluid intake to prevent dehydration and help thin mucus secretions

Cough Management

• For dry, non-productive cough: Dextromethorphan 10-30 mg every 4-8 hours (maximum 120 mg/day) 1
• For productive cough: Guaifenesin 200-400 mg every 4 hours (maximum 2400 mg/day) to help thin secretions 1

Nasal Congestion

• Pseudoephedrine: 60 mg every 4-6 hours (maximum 240 mg/day) 1
  • Use with caution in patients with hypertension, cardiovascular disease, or glaucoma
• Saline nasal sprays/rinses: Can help clear nasal passages without medication

Monitoring and Red Flags

When to Seek Medical Care

Monitor for signs that may indicate worsening condition or complications:

• Fever persisting beyond 3 days 2
• Difficulty breathing or shortness of breath
• Pain or pressure in chest or abdomen
• Sudden dizziness or confusion
• Severe or persistent vomiting
• Flu-like symptoms improving but then returning with fever and worse cough

High-Risk Patients

The following groups should be monitored more closely as they are at higher risk for complications:

• Adults ≥65 years
• Children <5 years (especially <2 years)
• Pregnant women
• People with chronic medical conditions
• Immunocompromised individuals 1

Additional Supportive Measures

• Rest: Adequate rest helps the body fight infection
• Humidity: Using a humidifier can help relieve congestion and cough
• Warm liquids: Soups, broths, and teas can soothe throat irritation and help with hydration
• Gargling with salt water: May relieve sore throat discomfort
• Avoiding smoke and other respiratory irritants

Important Considerations

1. Avoid aspirin in children and teenagers due to risk of Reye's syndrome 1

2. Early Warning Signs requiring medical attention include:

   • Temperature >37.8°C beyond 3 days
   • Heart rate >100/min
   • Respiratory rate >24/min
   • Oxygen saturation <90%
   • Altered mental status 1

3. Prevention measures during illness:

   • Cover coughs and sneezes
   • Frequent handwashing
   • Limit contact with others to prevent spread

While antiviral medications like oseltamivir are the standard medical treatment for influenza, especially within 48 hours of symptom onset 1, the symptomatic approach outlined above can effectively manage symptoms when antivirals are unavailable, contraindicated, or when treatment is initiated beyond the 48-hour window when antivirals are most effective.