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 Health & Beauty | April 2005 
The 20 Best Medicines for Men
 Ted Spiker - MensHealth.com
| | Hidden somewhere in the endless aisles of over-the-counter drugs are the pills that will put an end to what ails you. In this exclusive report, we name names. |
Talk to any user and he'll say the same thing: If you want the inside dope on drugs, you go to a drug dealer. And there's none more knowledgeable about over-the-counter drugs than a pharmacist. Well, there is actually one source that's smarter: 3,000 pharmacists.
That's how many pill professors the American Pharmacists Association (APhA) contacted for its newest Pharmacist Survey of OTC Products. The APhA survey asked randomly selected pharmacists from across the country to name their picks for "best med" in dozens of different categories, based on both their clinical knowledge and their practical experience. From antihistamines to acid reducers, itch creams to cough medicines, an ace reliever was chosen for every ailment.
What follows is our exclusive look at the best of the best--a selection of the OTC drugs that men need most, plus our own advice on how to get even more out of every medication. And because there's often no need to spend the bucks on a brand name when a generic will do just as well, we've also provided a cheat sheet to cheap health. So go ahead and clip it out--then open your medicine cabinet and clean it out.
ALLERGIES, MULTISYMPTOM
1. Claritin
Why it won: One dose helps halt hay fever and other sinus allergies for up to 24 hours, compared with 4 to 6 hours for other antihistamines. Claritin is also the first OTC antihistamine that's truly nonsedating, which means you can finally operate heavy machinery (or just drive your car). One caution: Claritin-D also contains a decongesting stimulant, so take it at least 4 hours before bedtime, says Paul Doering, an OTC expert at the University of Florida.
Maximize it: Anytime you're anticipating an allergy attack, pop a preemptive Claritin. "This will make your reaction less severe than if you treated it after it began," says Steven Pray, Ph.D., D.P.H., a professor of nonprescription drugs at Southwestern Oklahoma State University.
Generic equivalent: Loratadine, 10 milligrams (mg)
ALLERGIES, SKIN
2. Benadryl
Why it won: Whether it's the burning of a bee sting or the itching of poison ivy, skin reactions involve more histamine--the body's allergy-causing chemical--than sinus flare-ups do. As a result, Claritin may not cut it. "There's some proof that nonsedating antihistamines have an effect on these allergic reactions, but not as great an effect as Benadryl has," says Linda Krypel, Pharm.D., an associate professor of pharmacy at Drake University. But that power comes at a price: Benadryl can make you too drowsy to drive a forklift.
Maximize it: Mix Benadryl with Tagamet, an OTC antacid. Tagamet contains cimetidine, what's known as an H2 histamine blocker. Benadryl uses an H1 blocker. "Take an H1 and an H2 together and you get more relief because they affect different parts of your allergy-response system," says Michael Roizen, M.D., a professor of medicine at SUNY Upstate Medical University.
Generic equivalent: Diphenhydramine, 25 mg
ATHLETE'S FOOT
3. Lamisil AT
Why it won: "Lamisil AT inhibits an essential component of the fungal cell membrane," says Donnie Calhoun, R.Ph., owner of Golden Spring Pharmacy in Alabama. "Without its membrane, the fungus will die." In an Australian study of 217 people with athlete's foot, researchers found that terbinafine, the active ingredient in Lamisil, cleared up the symptoms in 85 percent of people who used it for 1 week, compared with only 56 percent of those applying clotrimazole.
Maximize it: Use Lamisil until your symptoms disappear--and then keep on using it for an addi-tional 2 weeks. "Fungal infections are extremely hard to get rid of," says Dr. Krypel. "Even if you can alleviate the symptoms, the under-lying infection may still be there."
Generic equivalent: None
BURNS
4. Solarcaine
Why it won: It uses the king of the 'caines: benzocaine. In addition to being a powerful painkiller, benzocaine may be safer than other anesthetics, such as lidocaine, which can cause side effects, such as blurry vision and dizziness, says Michael Oszko, Pharm.D., an associate professor at the University of Kansas. Another advantage of Solarcaine is that it's an aerosol; creams can hurt when you rub them in.
Maximize it: Before you reach for the benzocaine fire extinguisher, run your scorched skin under cool water to prevent blistering (don't use cold water, because the drastic temperature change can aggravate your epidermis). "The heat starts breaking down the proteins on the surface of your skin, and that's what results in your blister," says Dr. Pray.
Generic equivalent: Benzocaine, 20 percent
CANKER SORES
5. Zilactin Cold Sore Gel
Why it won: It leads a double life at the drugstore. Though Zilactin is marketed as a cold-sore medication, pharmacists chose it for canker sores because it contains benzyl alcohol. Like a liquid bandage, benzyl alcohol temporarily seals off the sore, protecting it from the irritation caused by eating. Minimize the irritation and you'll maximize the healing.
Maximize it: Apply Zilactin about 10 minutes before dining in order to create the strongest possible seal, says Doering.
Generic equivalent: Benzyl alcohol, 10 percent
CARDIAC CARE
6. Ecotrin
Why it won: It may save your life and your stomach, thanks to a special, slow-disintegration coating. "Ecotrin is dissolved and absorbed in the intestines, so it lessens the risk of stomach irritation that can occur with regular aspirin," says Janet Engle, Pharm.D., a clinical professor of pharmacy practice at the University of Illinois at Chicago college of pharmacy. But use only the low-strength version--81 mg.
A study in the journal Circulation determined that taking less than 100 mg aspirin daily offers the greatest level of cardiovascular protection, and that higher doses may actually increase the risk of heart trouble.
Maximize it: Don't take Ecotrin and drop an antacid at the same time. The antacid will cause the special coating to dissolve too quickly, turning Ecotrin into reg-ular aspirin.
Generic equivalent: Enteric coated aspirin
COLD SORES
7. Abreva
Why it won: Since cold sores are caused by the herpes virus, the only way to knock the disease back into dormancy is with an antiviral medication. Abreva is presently the only topical antiviral treatment available over the counter. A study of 737 people published in the Journal of the American Academy of Dermatology found that docosanol (the active ingredient in Abreva) helped heal cold sores 19 percent faster than a placebo (in 4 days instead of almost 5).
Maximize it: After you apply Abreva, rub on a little Zilactin Cold Sore Gel. The Zilactin will help relieve the pain while the Abreva fights the virus, says Dr. Pray. Otherwise, it's hands off. "The virus will heal faster the less you touch the sore, because when you touch it, you can reinfect it with the virus," says Dr. Roizen.
Generic equivalent: None
CONGESTION, NASAL
8. Sudafed
Why it won: It's like nasal Drano. While most other decongestants only reduce sinus swelling, Sudafed also loosens the mucus, thanks to the inclusion of the expectorant guaifenesin. Pharmacists also point out that when Sudafed is combined with a spray decongestant, such as Afrin, it can prevent a person's ears from clogging up during air travel.
Maximize it: Add ibuprofen to your decongestion regimen. A new study published in the Annals of Allergy, Asthma & Immunology showed that stuffed-up subjects who took ibuprofen with pseudoephedrine--the main ingredient in Sudafed--had 22 percent less congestion than those who took pseudoephedrine by itself.
Generic equivalent: Pseudo-ephedrine hydrochloride, 30 mg, and guaifenesin, 200 mg
COUGH
9. Robitussin
Why it won: This cough remedy edges ahead for what it doesn't contain as much as for what it does. Whether you choose Robitussin Guaifenesin to loosen the mucus in a congested chest or Robitussin DM to also help quiet a cough, neither formula contains alcohol. "Alcohol swells bronchial tissues, which could make the cough worse," says Calhoun.
Maximize it: Take up drinking--water. "If your body's cells are hydrated, it will be easier for the medication to work at the receptor sites and provide relief," Calhoun says. "Proper hydration will help you get better faster."
Generic equivalent: Guaifenesin, 100 mg (Robitussin Guaifenesin); dextromethorphan HBr, 10 mg, and guaifenesin, 100 mg (Robitussin DM)
CUTS AND MINOR WOUNDS
10. Neosporin
Why it won: Three reasons: bacitracin, neomycin, and polymyxin. A recent University of Virginia study showed that ointment containing this antibiotic trio eliminated 96 percent of bacteria in 6 hours, while a salve sans neomycin killed 14 percent. That said, if your gash or rash becomes more inflamed after you apply Neosporin, you may be allergic to neomycin. Instead, go with a double-antibiotic ointment, such as Polysporin.
Maximize it: Even the best bandages can become unstuck, allowing the Neosporin to rub off and the wound to dry out. (Moisture speeds healing time.) If the cut is in an inconspicuous place, Dr. Roizen suggests sealing it with a piece of Saran Wrap and two rubber bands instead. "Saran Wrap really protects the wound because it stays tightly pressed against your skin," he says.
Generic equivalent: Bacitracin zinc, 400 units; neomycin, 3.5 mg; and polymyxin B sulfate, 5,000 units
DIARRHEA
11. Imodium A-D
Why it won: Imodium A-D puts the reins on the runs by slowing down the movement of your intestines, whereas other products focus only on decreasing "fluid production." However, if the cause of your distress is payback from a certain Aztec emperor, reach for a bottle of Pepto-Bismol instead: The active ingredient, bismuth subsalicylate, can help kill off stomach bugs.
Maximize it: Drink a milk chaser. "Calcium increases your body's ability to slow the intestines," Dr. Roizen says. Down one glass of skim milk twice a day for the necessary 600 mg calcium.
Generic equivalent: Loperamide, 2 mg
GAS
12. Gas-X
Why it won: Gas-X contains the ingredient proven to stop explosive gas leaks fast: simethicone. "It breaks the surface tension of small gas bubbles, helping them pass quickly through the body," says Dr. Krypel.
Maximize it: Besides altering what you eat--less soda and beans--change how you eat. Specifically, slow the heck down. You swallow more air when you eat quickly, thus increasing the number of gas-producing air bubbles in your system, says Dr. Pray.
Generic equivalent: Simethicone, 125 mg
HEADACHE
13. Regular Strength Tylenol
Why it won: Tylenol held a slight edge in a clinical cage match with Aleve. Research published in Cephalalgia showed that 37 percent of people who took 1,000 mg acetaminophen saw their headaches disappear after 2 hours, compared with 32 percent of those who popped 375 mg naproxen. However, if the pain is between your eyes, skip both meds and see a doctor. "In almost every case, this is a sinus infection with a sinus headache," says Dr. Pray.
Maximize it: Don't delay. "Most headaches are caused by vascular spasm--a tightening of blood vessels in your head--or the release of that spasm," says Dr. Roizen. "Take medication early and you can stop the spasm from reaching its worst level."
Generic equivalent: Acetaminophen, 325 mg
HEADACHE, MIGRAINE
14. Excedrin Migraine
Why it won: In addition to acetaminophen, it also has the proven pain-busters aspirin and caffeine. In a recent study presented to the International Headache Society, researchers compared the equivalent of two Excedrin Migraine tablets with a prescription headache med. Their finding: Eighty-seven percent of people on the acetaminophen-aspirin-caffeine combination reported complete or partial symptom relief after 2 hours, versus only 75 percent of those given the prescription drug.
Maximize it: Make Excedrin's job easier. Researchers at the University of Miami determined that migraine sufferers who received two weekly 30-minute head massages reported decreases in headache pain.
Generic equivalent: Acetaminophen, 250 mg; aspirin, 250 mg; caffeine, 65 mg
HEARTBURN, ACUTE
15. Mylanta
Why it won: Mylanta combines two balms for the burn: aluminum hydroxide and magnesium hydroxide. "They work immediately, but their duration is short," says Dr. Oszko. Still, it's a longer reprieve than other antacids offer; University of Oklahoma researchers found that Mylanta's ingredients neutralized acid about 22 minutes longer than calcium-based products did.
Maximize it: Stick with liquid Mylanta. "If you take the tablet form, you have to chew it well and drink water to make sure it's absorbed," says Dr. Krypel. "With liquids, you're already there."
Generic equivalent: Aluminum hydroxide, 400 mg, and magnesium hydroxide, 400 mg
HEARTBURN, CHRONIC
16. Prilosec OTC
Why it won: It contains omeprazole, a chemical that can slow your stomach's acid pumps. Just one pill can decrease acid production, but a 2-week course is necessary for lasting relief; a new University of Michigan study showed that 43 percent of people on omeprazole for 2 weeks stayed heartburn-free for 3 months.
Maximize it: As you're popping Prilosec, try dropping pounds. "Weight loss changes the angle of the esophagus," Dr. Roizen says. "A sharp angle makes it harder for the acid to come back up."
Generic equivalent: None
HEMORRHOIDS
17. Preparation H
Why it won: Hemorrhoids are just dilated blood vessels, which are best treated by chemicals called vasoconstrictors. Preparation H contains a vasoconstrictor--phenylephrine--while other brands have only anesthetics. Caution: If your hemorrhoids bleed or last more than a week, see a doctor.
Maximize it: Drink eight 8-ounce glasses of water and down 25 grams of fiber daily. The water and fiber will correct the cause of the hemorrhoids--straining too hard--as well as help promote healing, says Dr. Roizen. "It usually has an effect within a day."
Generic equivalent: Phenylephrine, 0.25 percent
JOCK ITCH
18. Lotrimin AF
Why it won: The fungus in your Fruit of the Looms needs to be treated differently than the type between your toes. The combination of the warm, moist environment in your underwear and the ease with which you can scratch the itch ups the odds of a bacterial infection. Enter Lotrimin AF. In addition to fighting fungus, "the clotrimazole in Lotrimin may help prevent a secondary infection," Dr. Krypel says.
Maximize it: Buy the cream and rub it in well. "The skin protects the fungus, so you need to spend enough time rubbing it into the affected area," Dr. Krypel says.
Generic equivalent: Clotrimazole, 1 percent
JOINT PAIN
19. Advil
Why it won: Advil owes it all to ibuprofen. When French researchers recently studied 222 people with osteoarthritis, they noted that those who took 400 mg ibuprofen had 23 percent more pain relief during the following 6 hours than those who swallowed 1,000 mg acetaminophen. What's more, after 2 weeks of treatment, the people popping ibuprofen still reported less pain and stiffness.
Maximize it: Employ a pincer move: Use Advil to attack the pain from the inside and a heat wrap to hit it from your skin in. Wraps, like those made by ThermaCare, are better than ointments, says Dr. Pray, because they penetrate deeper and last longer (8 hours).
Generic equivalent: Ibuprofen, 200 mg
POISON IVY
20. Cortaid
Why it won: Steroids. Not the Jason Giambi variety, but a topical steroid called hydrocortisone, which helps relieve both the itching and the inflammation that are caused by an ivy attack. Other topical creams, such as Benadryl and Caladryl, work only to soothe the itch.
Maximize it: Soak in oats. Before you rub on the Cortaid, immerse your itch-afflicted area in a mix of warm water and colloidal oatmeal for at least 15 minutes. One Australian study showed that patients who were treated with colloidal oatmeal for minor burns reported less itching and needed less medicine than those treated with another anti-itch ointment.
Generic equivalent: Hydrocortisone, 1 percent |
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