You’ve noticed the early symptoms—a tickle in the throat, a cough, some body aches or chills, fatigue—and you suspect you’re getting sick with the flu. Should you call your doctor?
After all, you have a million things you need to do this week. Maybe there’s a medication that can shorten the time you’ll have to spend in bed.
Flu antiviral medications can reduce the time you’re sick, but that doesn’t mean that everyone who has the flu needs to take one. We spoke to UNC Health family medicine doctor LeRon Jackson, MD, about who is a good candidate for this treatment.
How Flu Antiviral Medications Work
Antiviral medications for influenza slow down the multiplication of the flu virus in your system, shortening the duration of the illness, Dr. Jackson says.
“They don’t directly help with symptoms the way that cough syrup or a throat lozenge helps symptoms, but they do shorten how long you have those symptoms by about two days,” she says.
Typically, symptoms of the flu last five to seven days without medical treatment, with people feeling their worst in the first three days. The optimal window to take an antiviral medication is within the first 48 hours of illness—the sooner the better.
There are several flu antiviral medications your doctor might prescribe:
- Oseltamivir phosphate (available as Tamiflu or a generic version), which is typically taken in pill form, twice daily for five days. This medication can be used by anyone older than 2 weeks old.
- Zanamivir (Relenza), which is delivered by an inhaler, twice daily for five days. This option can be used by anyone older than the age of 7. Because it is inhaled, this medication is not recommended for people with asthma or chronic obstructive pulmonary disease (COPD).
- Baloxavir marboxil (Xofluza), which is a single-dose treatment in pill form, approved for use in those older than 5. This treatment is not recommended for women who are pregnant or breastfeeding.
“The main side effects of these medications are headache, change in taste and nausea,” Dr. Jackson says. “In rare cases, some experience mood changes with these medications, and if that occurs, you should stop taking the drug and consult your physician.”
Note that antibiotics don’t help with the flu, which is caused by a virus; those medications target bacterial infections.
Who Should Take an Antiviral Drug for the Flu?
While no one enjoys having the flu, there are some people who have a harder time recovering or face a higher risk of complications, including pneumonia, breathing difficulties, worsening of chronic conditions and hospitalization.
“I encourage people who are otherwise healthy to allow their body to fight influenza without the aid of a prescription, unless they’re having really challenging symptoms,” Dr. Jackson says, noting that in previous years, there have been shortages of these antiviral medications.
Good candidates for an antiviral include people with chronic conditions such as diabetes, asthma, COPD and heart disease; pregnant women; and people with a compromised immune system. Children younger than 5 and people age 65 and older may also be at increased risk for flu-related complications.
If you are at high risk for complications, you can even take a preventive course of antiviral medications (one dose a day for 10 days) if someone in your household is sick.
Given that these medications need to be administered within two days of the first symptoms, it can be helpful to talk to your doctor about your individual risk for flu-related complications before you get sick, so that you have a plan in place if you do. Your doctor will likely require a flu and COVID-19 test before prescribing. (If you have COVID-19, your doctor may recommend an antiviral drug for that condition.)
“If you’re experiencing flu-like symptoms and have other chronic medical conditions, contact your doctor as soon as possible to be tested and treated with an antiviral if appropriate,” Dr. Jackson says. “If you’re otherwise healthy but you’re not able to manage your symptoms with over-the-counter medications, you should also contact your doctor right away.”
While these antiviral medications are most effective at shortening the duration of illness when taken early, Dr. Jackson says there is still some benefit to prescribing an antiviral medication after the 48-hour mark for people at high risk for complications or hospitalization.
Other Flu Treatments to Try
If you feel sick, Dr. Jackson recommends plenty of rest and lots of fluids. You can use medications such as acetaminophen and ibuprofen for headaches, fever and body aches; over-the-counter cough medicines and decongestants (be sure to read the label or ask your doctor; some of these medications are not approved for children or people on other medications or with certain health conditions); and Dramamine or Imodium for gastrointestinal symptoms such as nausea or diarrhea. Some find relief with ginger for nausea or honey and lemon for cough.
“Symptom management for flu can be challenging because there are so many symptoms, but by day four or five, symptoms do improve in most young, healthy people,” Dr. Jackson says.
And if you’re looking to shorten the amount of time you’re sick during fall and winter, your best protection is a flu shot.
“The influenza vaccine is the strongest tool we have to prevent severe illness and complications,” Dr. Jackson says. “It improves your ability to fight influenza if exposed, and the illness is less severe if you do contract the flu.”
If you’re concerned about flu-related complications, talk to your doctor. If you need a doctor, find one near you.