We all talk about flu prevention — getting the flu vaccine, handwashing, avoiding people who are already sick. But what if you already have the flu? Allergy & Asthma Network turned to Purvi Parikh, MD, for a Q&A on flu treatment.

Q: What is the primary treatment for flu?

Purvi Parikh, MD: Flu is a virus, so unlike a bacterial infection that can be killed with antibiotics, there’s no medicine that cures it. The main treatments are rest, which gives your immune system a chance to work, and drinking plenty of liquids to help thin mucus and prevent dehydration.

For fever and muscle aches, I usually recommend ibuprofen every 6 hours. Do not give children medicines for adults or try to estimate dosages. Follow exact dosing instructions on the bottle or from the healthcare provider – and use the measuring device that comes with the medication.

Never give aspirin to a child, as it increases the risk for Reye’s Syndrome, a dangerous condition of the nervous system.

Q: Should I take a decongestant or cough medicine?

Dr. Parikh: If a patient is very congested or has a very bad cough, I may recommend a decongestant or cough medicine – but not for young children. The risks for children under 4 using these medications outweigh the benefits – and children ages 4 to 6 should only use them when prescribed by a physician.

Q: What about antivirals?

Dr. Parikh: There are a few antiviral medicines that I prescribe for flu. These medicines won’t kill the virus, but they will slow it down, ease symptoms and possibly reduce the length of time the patient feels sick. 

  • Tamiflu® (oseltamivir) is approved for patients as young as 2 weeks old, and it comes in a liquid or capsules. 
  • Relenza® (zanamivir) is an inhaled medicine approved for people ages 7 and up, but it should not be used by those with asthma.

I don’t give antivirals to all patients with flu, as many will get better by themselves, but I do use them for patients who are very sick, have asthma or COPD, are at risk of complications such as pneumonia, sinus infections or ear infection and women who are pregnant or recently gave birth.

CDC recommends starting antiviral treatment within 48 hours after symptoms begin, but treatment can still be beneficial for some patients up to 4 or 5 days after symptoms begin.

Q: When should I consider going to the hospital if I have the flu?

Dr. Parikh: For children, warning signs include difficulty breathing, chest pain, a fever above 104 degrees, fever that improves but then returns or worsens, bluish lips or face, dehydration, seizures, severe fatigue and worsening of asthma symptoms.

For adults, symptoms that indicate a hospital visit is necessary include difficulty breathing or shortness of breath, chest pain, dizziness or confusion, severe muscle pain, fever or cough that improves but then returns or worsens, seizures, not urinating and worsening of asthma symptoms.

Q: What flu prevention steps should I take?

Dr. Parikh: Getting the flu vaccine early in flu season is vital, but January or February remains an acceptable time to get vaccinated as the season can linger into spring.

Then focus on preventing exposure. Wash your hands often, especially before eating, and teach children to not put their hands in their mouths, nose and eyes. Wipe down surfaces where viruses may linger. Stay away from people who are sick – and stay home if you’re the one who’s ill.

Purvi Parikh, MD, is an allergist and immunologist with Allergy & Asthma Network. She practices in New York City at Allergy and Asthma Associates of Murray Hill and New York University School of Medicine.