Role of Vitamins, Supplements, and Herbal Medicines in Dengue Management
Vitamins, supplements, and herbal medicines have no established role in the management of dengue fever, as current evidence-based guidelines recommend only symptomatic management with fluid resuscitation, acetaminophen for fever control, and close monitoring for complications. 1, 2
Evidence-Based Management Approach
The cornerstone of dengue treatment is symptomatic and supportive care, with no specific antiviral therapy or adjunctive supplements currently approved or recommended by major guideline organizations. 1
Standard Treatment Protocol
Symptomatic management is the only evidence-based approach, focusing on fluid management, fever control with acetaminophen, and monitoring for warning signs of severe disease. 1, 2
Acetaminophen (paracetamol) remains the only recommended medication for pain and fever relief, while aspirin and NSAIDs must be strictly avoided due to bleeding risk. 1, 3
Fluid resuscitation is the critical intervention for patients with dengue shock syndrome, with initial boluses of 20 mL/kg of isotonic crystalloid over 5-10 minutes. 1, 2
Why Supplements Are Not Recommended
The comprehensive dengue management guidelines from the American College of Cardiology, World Health Organization, Centers for Disease Control and Prevention, and other major societies make no mention of vitamins, supplements, or herbal medicines as part of the treatment algorithm. 1, 2, 3
No evidence exists in current clinical guidelines supporting the use of vitamin supplementation, herbal remedies, or dietary supplements to improve outcomes in dengue fever. 1, 2
The focus remains entirely on monitoring hematocrit and platelet counts, recognizing warning signs, and providing appropriate fluid management based on disease severity. 1, 3
Critical Management Priorities
Daily complete blood count monitoring is essential to track platelet counts and hematocrit levels, particularly during the critical phase (days 3-7 of illness) when plasma leakage can rapidly progress to shock. 1, 3
Warning signs requiring immediate attention include high hematocrit with rapidly falling platelet count, severe abdominal pain, persistent vomiting, lethargy or restlessness, and mucosal bleeding. 1, 2
Aggressive oral hydration with a target of 2,500-3,000 mL daily using any locally available fluids (water, oral rehydration solutions, soup, rice water) is recommended for patients without shock. 1, 2
Common Pitfalls to Avoid
Do not prescribe unproven supplements or herbal remedies, as this may delay appropriate supportive care and create false expectations about treatment efficacy. 1
Avoid soft drinks for hydration due to high osmolality, despite their availability. 1
Never use aspirin or NSAIDs when dengue cannot be excluded, as these worsen bleeding tendencies. 1, 2, 3
Clinical Context
While some patients or families may inquire about supplements or traditional remedies, the evidence-based approach requires focusing resources on proven interventions: fluid management, monitoring for complications, and timely escalation of care when warning signs appear. 1, 2 The case fatality rate can be reduced to less than 0.5% with meticulous supportive care alone, without any role for supplementation. 4