The 10 Medicines Everyone Should Have At Home

You want to keep your medicine cabinet prepared for minor health issues. Alas, most pharmacies sell hundreds of different pills, sprays, creams, and gels. Which ones should you actually keep stocked at home?

Here, in no particular order, are the 10 medicines everyone should keep handy. All are available over the counter, without a prescription.

1. Acetaminophen

More often known by its brand name, Tylenol, acetaminophen works wonders for muscle aches, headaches, back aches, and fever.

Each pill contains either 325 mg (regular-strength) or 500 mg (extra-strength). You can take approximately 1000mg per dose (three regular pills or two extra-strength pills), repeating the dose every six hours. If you have severe liver disease, you should ask your doctor about a safe dose.

Although acetaminophen is very safe in standard doses, it can cause fatal liver failure in overdose. You should never take more than 4000 mg total per day (twelve regular-strength pills or eight extra strength pills). Be aware that many combination medications, like DayQuil, NyQuil, Percocet, and Vicodin, also contain acetaminophen that must be counted toward your daily total.

2. Diphenhydramine

Diphenhydramine is an antihistamine commonly known by its brand name, Benadryl. It is often used for seasonal allergies or insomnia; however, we don’t recommend taking it for either. Although diphenhydramine does help with allergies, it also causes excessive sleepiness. When used as a sleep aid, it can cause confusion and memory loss, especially in older adults.

So why is diphenhydramine on the list? It’s still a great drug for treating allergic reactions. If you develop the splotchy, raised red rash known as hives, you’re probably having an allergic reaction. It could have been something you ate, and you should track your meals to look for patterns. Hives could also be a reaction to sweating, exercise, or an autoimmune condition.

Regardless of the cause, hives usually improve with diphenhydramine. Take 25 or 50 milligrams and repeat every six hours as needed.

If you develop hives alongside symptoms like shortness of breath, facial swelling, or abdominal pain, you could be experiencing a life-threatening reaction known as anaphylaxis. Get to an emergency room. You will require observation, to ensure your symptoms do not progress further, and may even need an injection of epinephrine (commonly sold as an Epi-Pen).

3. Loratadine

Like diphenhydramine, loratadine (Claritin) is an antihistamine; however, it’s part of the second generation of these drugs, with a modification that prevents entry into the brain. As a result, it doesn’t cause sleepiness and is a better choice for seasonal allergies. Similar drugs include cetirizine (Zyrtec), fexofenadine (Allegra), levocetirizine (Xyzal), and desloratadine (Clarinex).

Take 10mg of loratadine once daily to treat seasonal allergy symptoms like itchy eyes and sneezing. If your allergic symptoms consist primarily of stuffiness and runny nose, a steroid nasal spray may be a better choice.

4. Fluticasone (nasal spray)

Fluticasone (Flonase) is a steroid that can be sprayed into the nose to treat nasal symptoms related to seasonal allergies, like stuffiness and runny nose. It can also reduce cough related to allergies or a recent cold. Similar drugs include Nasonex (mometasone) and Nasacort (triamcinolone).

Apply one or two sprays to each nostril daily. Before spraying, blow your nose so that the medicine actually coats your nasal surfaces rather than just your mucus. Do a few test sprays to make sure medicine is coming out. Aim straight to the back of your nose, rather than toward your septum. As you spray into each nostril, take a deep breath through your nose while pinching the other nostril shut. After spraying, avoid blowing your nose again for at least 15 minutes, or you’ll just blow the medicine right back out.

5. Aluminum hydroxide

Aluminum hydroxide is a popular antacid sold under many different brands, such as Gaviscon and Equate. If you experience mild heartburn (also known as acid reflux), antacids are a fast-acting and effective treatment. Similar agents include calcium carbonate (Tums) and magnesium trisilicate.

Heartburn (acid reflux) occurs when stomach acid creeps up into the esophagus, the tube connecting the mouth to the stomach. Antacids help neutralize the acid.

You likely have heartburn if you note a bitter taste in your mouth, nausea, and stinging pain in your chest and upper abdomen. Reflux most often happens after a large or spicy meal, especially if you lay down soon thereafter. A glass of water often provides momentary relief, since it washes acid back into the stomach.

Note: If you experience more frequent heartburn, you’re better off taking medicines such as ranitidine (Zantac) or omeprazole (Prilosec). These medications actually reduce stomach acid production, rather than just neutralize it. If you need these medications, however, you should speak to your doctor. Frequent acid reflux may be a sign of a more significant problem, like a stomach hernia.

6. Hydrocortisone (cream)

Hydrocortisone is a steroid that can be applied to many different rashes. It works particularly well on eczema, psoriasis, and other minor allergic rashes. It doesn’t work as well for more severe allergic reactions, such as to poison ivy. Steroids can also worsen bacterial skin infections (which are red, tender, raised, and may have areas of pus) and fungus infections (which occur in sweaty areas, like the feet/toes, groin, and skin creases). You should also never apply steroids to open wounds, since they can impede healing.

If you notice a new skin rash, try applying a thin layer of hydrocortisone twice per day for a week. If the rash gets worse after two or three days, or it doesn’t improve after a week, stop applying the steroid and see your doctor. Long-term steroid use without a doctor’s supervision can cause skin thinning and damage, especially in areas like the face.

7. Bacitracin/polymyxin (ointment)

Bacitracin and polymyxin are antibiotics that protect minor skin injuries from infection and accelerate healing. The most popular formulation is Neosporin; however, many pharmacy brands contain the same ingredients and typically cost less. Apply a generous glob to your scrapes and scratches before covering them with bandages.

If an injury becomes swollen, red, and painful despite the use of bacitracin/polymyxin, it’s possible the wound is infected with resistant bacteria, such as MRSA (methicillin-resistant Staphylococcus aureus). Your doctor may prescribe a more powerful antibiotic ointment, such as mupirocin, or antibiotic pills.

8. Bismuth salicylate

Better known as Pepto Bismol, bismuth salicylate offers some relief from the stomach upset and diarrhea associated with gastroenteritis, a common viral infection also known as “stomach flu.”
If you’ve been experiencing nausea, abdominal cramping, and diarrhea for less than a week, you probably have gastroenteritis and can take bismuth salicylate. (Note: The tabs may turn your teeth pink and your stool black.)

Bismuth is unlikely to be effective if you have prolonged diarrhea (more than one week), severe abdominal cramping, or blood in your stool. In these cases, you could have a bacterial infection that requires antibiotics.

Note: Bismuth should never be given to children, since it can lead to the fatal condition known as Reye’s syndrome. (Same goes for aspirin.)

9. Pseudoephedrine

They’re the reason pseudoephedrine is kept behind the counter…Pseudoephedrine is a decongestant found in Sudafed and various cold/flu or allergy combo-pills ending with a “-D” (like Allegra-D and Claritin-D). Pseudoephedrine reduces mucous production and can be particularly handy when you have congestion due to a cold.

Note: Pseudoephedrine can raise your heart rate and blood pressure. If you have hypertension or heart disease, pseudoephedrine is probably fine if your numbers are well-controlled and use is limited to one or two days. If your blood pressure is already high, however, you probably shouldn’t add pseudoephedrine to the mix.

Finally, many years ago some enterprising individuals discovered that pseudoephedrine could be converted into crystal methamphetamine. As a result, pseudoephedrine-containing medicines are kept behind the pharmacy counter and require an ID to purchase. Also, you’re limited to one box per day. Many medications have substituted pseudoephedrine with the phenylephrine, a different decongestant, to get around this issue. Unfortunately, phenylephrine is not nearly as effective.

10. Ibuprofen

Ibuprofen is the active ingredient in many pain relievers, including Advil and Motrin. Though we generally recommend acetaminophen/Tylenol as first-line pain relief, ibuprofen can be added when acetaminophen is inadequate. Ibuprofen may also be more effective for musculoskeletal injuries, like sprained and swollen joints.

A related medication is naproxen, found in Aleve and Naprosyn. Both ibuprofen and naproxen are classified as NSAIDs (non-steroidal anti-inflammatory drugs).

Take 400-600 mg of ibuprofen (usually two or three pills) up to three times per day. If you have heart or kidney disease, or you take aspirin to prevent heart attacks or strokes, avoid NSAIDs and stick with acetaminophen instead. Also, long-term NSAID use increases the risk of stomach ulcers.

Christopher Kelly, M.D., M.S. and Marc Eisenberg, M.D., F.A.C.C. are cardiologists at Columbia University Medical Center and the authors of “AM I DYING?!: A Complete Guide To Your Symptoms and What To Do Next.”