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Harvard Commentaries
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School

Highlight on Drugs Highlight on Drugs

Stocking Your Medicine Cabinet (Part 1)

September 23, 2013

By Harold J. DeMonaco M.S.

Harvard Medical School

A visit to a drugstore or supermarket can be a frustrating and confusing trip if you are trying to find the right over-the-counter medicine. Regardless of what ails you there are likely to be dozens of products to choose from. Finding the right product for you can be a challenge to say the least. Here's my pick of what to have in the medicine cabinet. These recommendations are general and may not be the best for some people with certain medical conditions or taking certain drugs. So, always ask your doctor and make sure you read the label to see if the products are right for you.

First and foremost, if you have small children in the house or are visited by children, keep the telephone number for the Poison Control Hotline (800-222-1222) in plain sight. Poisonings still happen and young children are especially at risk.

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Drugs for Coughs and Colds

There are lots of combination products that are designed to treat a host of different symptoms. The problem with many is that you are taking drugs you perhaps don’t need, and the dose of many of the drugs in the combination products isn't the right dose. Keeping it simple is my advice. It also works out to be a lot less expensive in the long run to buy a pain reliever, something for cough and something for a runny nose separately. You can end up paying 30% more for the combination product than for each of the ingredients separately.

For coughs, my pick is dextromethorphan for adults. It is no longer recommended for young children. Because of potential abuse and incorrect dosing, it is probably safest not to keep this in the house if you have children of any age. Many cough syrups contain a number of different ingredients such as antihistamines and something called guaifenesin. Antihistamines don't work very well for coughs and colds. Guaifenesin is supposed to increase secretions in the lungs and break up thick secretions. It probably doesn't work.

Although recent studies suggest that dextromethorphan is not a potent cough suppressant, it does seem to decrease coughs in older children and adults. It's safe as long as it's taken only as directed on the label. The adult dose is 30 milligrams every four to six hours.

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Drugs for Pain, Inflammation and Fever

For pain and fever, I recommend acetaminophen (also known as Tylenol) for both adults and children. Again, there are lots of combination products, but none work any better. Store-brand products work as well as the brand-name product and are less expensive.

For pain and inflammation in adults (mild arthritis symptoms, for example), I recommend products that contain naproxen (Aleve and others). Once again, the store brand is much less expensive and works every bit as well as the brand-name product. Products that contain ibuprofen are reasonable as well (such as Motrin IB and others). Ibuprofen needs to be taken more often than products containing naproxen.

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Drugs for Diarrhea

Most acute bouts of diarrhea don’t need any treatment. Keeping up with fluids is a good idea in adults and very important in children, especially young children. Pedialyte is perhaps the best available product, especially for children, because it contains water, sugar and minerals that are being lost from the diarrhea.

The two other products I recommend are Pepto Bismol and loperamide. Pepto Bismol is especially useful for traveler's diarrhea. Loperamide (also known as Imodium) works by slowing down activity in the gastrointestinal tract.

In Part 2 of the series, I will talk about basic medicines for heartburn, constipation and first aid. In the final article , I will list a catchall of items you should — and should not — have in your medicine cabinet.

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Harold J. DeMonaco, M.S., is senior clinical associate in the Decision Support and Quality Management Unit at the Massachusetts General Hospital and is currently a Visiting Scholar at the MIT Sloan School of Management. He is author of over 20 publications in the pharmacy and medical literature and routinely reviews manuscript submissions for eight medical journals.

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