Drugstore Indecision
Pharmacists' Top Picks
Heartburn
The drug: Prilosec OTC
Why it's No. 1: The top dog here is the first and only OTC option in a breakthrough class of drugs known as proton pump inhibitors (PPIs). This one knocks out heartburn by shutting down the acid-producing cells in your stomach. (Antacids like Tums or Mylanta merely neutralize stomach acid after your body has already made it.) "Plus, antacids work for only one to three hours, but Prilosec can give you relief for up to 24 hours," Engle says.
Generic None. The soonest one could be available is 2008.
Fine print: Prilosec OTC works best if you have frequent heartburn (two or more days a week). If your symptoms are triggered by only certain foods -- like that burrito lunch -- you can also get relief, Engle says, by taking an OTC H2 blocker such as Pepcid AC or Zantac 75 before a meal. If you take it after a meal, when your belly's already in full revolt, you'll have to wait an hour or more before you start feeling better.
See a doc if your heartburn is accompanied by difficult or painful swallowing, vomiting, or bloody or black stools.
Hemorrhoids
The drug: Preparation H Ointment
Why it's No. 1: TV commercials for this product may feature geezers, but hemorrhoids (swollen, painful veins around the anus and rectum) aren't just a late-life affliction. Flare-ups can happen when you're constipated (all that pushing), and they're especially common during and after pregnancy (ditto). This tried-and-true remedy (it's been around for more than 50 years) contains a combination of three lubricants--mineral oil, petrolatum, and shark liver oil--to soften and protect the skin, plus a topical version of phenylephrine HCl, a vasoconstrictor that shrinks tissues and relieves itching.
Generic: Any hemorrhoid treatment that contains the same active ingredients
Fine print: Although the ointment got highest marks in the survey, Doering recommends Preparation H cream with maximum-strength pain relief. "It won't stick to your skin as well as the ointment, so it's messier, but it has a local anesthetic (pramoxine HCl) that reduces pain," he says.
See a doc if bleeding occurs, or if the problem persists for more than a week or worsens.
Motion Sickness
The drug: Dramamine Less Drowsy Formula
Why it's No. 1: If just the thought of getting on a boat makes you want to hurl, the drug to turn to is Dramamine, and this version is less likely than others to make you sleep through your scuba lesson. "The nausea occurs when the part of the brain that detects motion gets mixed signals," Pray says. "The same thing happens when you're reading a book while riding in a car. Your body feels motion but your eyes don't register the movement, which sets you up for what is called a 'sensory conflict.' Dramamine blocks the receptors in the central nervous system that give you those mixed signals." Meclizine hydrochloride, the active ingredient, is just as effective at preventing motion sickness but is less likely to make you nod off than dimenhydrinate, the ingredient in the original form of Dramamine.
Generic: Meclizine
Fine print: The key word in this product name is "less," Mackowiak says. In some cases, "it may still make you feel a bit sleepy," she says. So test-drive it before getting behind the wheel.
See a doc if you have severe, uncontrollable vomiting.
Poison Ivy or Oak
The drug: Cortaid
Why it's No. 1: Last off-the-grid adventure leave you with the itchies? Grab Cortaid, which will decrease the swelling and discomfort of poison ivy faster than anything else. Just read the label before you get in line for the cashier, Doering says. "Several products on the market bear the Cortaid brand, including a kit that gets the poison ivy toxin off your skin, but they don't all contain hydrocortisone, so you'll still feel pretty miserable."
Generic: Hydrocortisone
Fine print: It's not a good idea to use hydrocortisone on large areas (anything bigger than the size of your palm), because too much could be absorbed into your bloodstream, leading to side effects such as inflammation and peeling, itchy, or irritated skin, Doering says.
See a doc if itching remains severe despite use of the product, if symptoms persist for more than seven days, or if the rash covers a large area. You may need an oral steroid instead, Pray says.
Red Itchy Eyes
The drug: Naphcon-A
Why it's No. 1: Unlike drops that simply treat the appearance of red eyes by constricting the blood vessels, Naphcon-A also contains an antihistamine to relieve itchiness caused by allergies.
Generic: Allergy eye drops containing the decongestant naphazoline and the antihistamine pheniramine
Fine print: Using an eye drop containing a decongestant for more than three days in a row can make your eyes redder than they were to start. "A decongestant works by shrinking swollen vessels, which restricts the amount of blood in the area," Pray explains. "But if you use it too often, when it wears off, your body sends a flood of blood back, which causes a rebound effect"--essentially magnifying the original problem.
See a doc if your eyes feel gritty, your vision becomes blurred, or the condition worsens or persists for more than 72 hours.
Stuffy Nose
The drug: Sudafed
Why it's No. 1: You feel stuffier than a debutante ball, not because your head is full of mucus but because your blood vessels are swollen, Engle says. "The active ingredient in Sudafed (pseudoephedrine) is a vasoconstrictor that's very effective at shrinking those vessels." Decongestants that contain the vasoconstrictor phenylephrine don't work as well because most of the drug is broken down in the stomach before it even enters the bloodstream, Doering says. Another perk: Sudafed comes in sustained-release forms. "Some are formulated to last up to 24 hours, but a phenylephrine product will only work for four hours at most," Engle says.
Generic: Pseudoephedrine
Fine print: If Sudafed keeps you up at night, Doering recommends a nose spray or drop containing oxymetazoline, such as Afrin. "Its relief isn't as long-lasting, but you'll be spared the insomnia because the medication is deposited directly into the lining of the nose, rather than being circulated through your bloodstream." (Just don't use it for more than a week, or your body will try to compensate for the effect of the medicine by sending more blood to the area, leaving you even more congested.)
See a doc if your symptoms don't improve within a week or you're also running a fever.
Tension Headache
The drug: Tylenol
Why it's No. 1: Pharmacists are looking after your gut with this medicine cabinet staple. Aspirin and ibuprofen can also kill a headache, but druggists know they can irritate the stomach, causing cramps and sometimes bleeding. "Compared with other headache relievers, Tylenol has the fewest side effects and interactions with other drugs," Doering says.
Generic: Acetaminophen
Fine print: Knock back fewer than three cocktails a day if you're taking Tylenol, Mackowiak says. "Combining large quantities of alcohol and acetaminophen can cause serious liver damage."
See a doc if your headache worsens or lasts for more than 10 days.
Yeast Infections
The drug: Monistat
Why it's No. 1: When you've got an itch you can't scratch in public, reach for a tube of Monistat, which kills the overgrowth of the fungus that causes a yeast infection. "This is the only product that's available in seven-day, three-day, and one-day formulations," Pray says.
Generic: Miconazole
Fine print: While the one-day and three-day formulations can cut down on the number of nights you spend in misery, it can still take up to a week for the infection to disappear, Pray says. "Some women come in on the third day and say they need another package," he says. "I tell them to wait it out another day or two." The shorter formulas keep working even after the last dose, so you might not feel better until after you've emptied the package.
See a doc if your symptoms don't improve or they worsen after treatment.
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