Tuesday, December 18, 2018

Traditional Medicine: Acquiring Antibiotics

Disclaimer:  The following is for educational and informational purposes only.  No medication, prescription or over-the-counter, should be taken without consulting a licensed physician.

Sooner or later, those who choose to prepare for interesting times ahead wish to acquire some antibiotics.  We've all taken them at some point in our lives, and we know what a difference they make.  These wonder-drugs, some of the greatest medical advances ever, are often taken for granted and may someday become ineffective due to overuse and misuse.

But still, we want to have them on hand, so that a physician can treat us or our loved ones when the time comes.  The problem is, most people don't know what they want, or where to get it.

Dr Cynthia Koelker, author of Armageddon Medicine, recommends storing the following quantities of these antibiotics for a family for a year.1

Amoxicillin, 500 mg, 100
Amoxicillin-clavulanate (Augmentin), 500 mg, 100
Cephalexin, 500 mg, 100
Ciprofloxacin, 500 mg, 100
Doxycycline, 100 mg, 100
Erythromycin, 400-500 mg, 100
Metronidazole, 500 mg, 100
Penicillin, 500 mg, 100
Tetracycline, 500 mg, 100
Trimethoprim-Sulfa (Septra), 100

No, we should not need all these within a year, especially if we have stored good quality food and have good sanitation and hygiene practices in place.  But when you need a specific antibiotic, you might need a few courses of it for a few family members.  Also, while some antibiotics can be substituted for another, many cannot.  Don't just get one and plan on using it for everything. It won't work.  You are getting these antibiotics to have on hand for a licensed physician to administer appropriately.

So now, how do you go about acquiring antibiotics?

Ideally, you have a family physician with whom you have a good relationship and who understands the need to prepare.  These are getting harder and harder to find.  If you're looking for a new physician who will share your ideas about preparing and be willing to help you (after you have established a good relationship with him/her), you are going to have your best chances with an older physician who maintains paper, not electronic, records.  Good luck.

Sometimes you can get your physician to prescribe an antibiotic for just in case.  Like you take your child in to see him with what is probably only a bad sore throat, but it could be strep.  If the child is not feeling better in a day or two, he gives you a prescription to fill.  (Make sure you get pills instead of syrups--pills have a much longer shelf life.)  Or you are planning to travel and ask for a prescription or two to deal with diseases you might encounter and wish to avoid ruining your trip with a case of traveler's diarrhea. 

Do not try to build your antibiotic supply by not taking the full course of antibiotic therapy when it is prescribed.  One reason for the rise in antibiotic resistance is that people do not finish the course of treatment, the bad bacteria making you sick are not wiped out, and superbugs develop resistance and emerge.

Most readers have heard of fish antibiotics.  These are not made out of fish and they are not fed to fish, especially in the same dosages that are used for people.  They are designed to be added to aquariums to treat specific bacterial infections in fish.  Although you cannot purchase antibiotics for people or non-aquarian pets in the US without a prescription, for some reason we still have a loophole in this country that allows these very same antibiotics to be sold over-the-counter for aquarium use.  Most of these fish antibiotics are of the same quality and dosage as antibiotics for people.  It is illegal to sell these medications to treat infections in people or pets.  The FDA has been cracking down on retailers, especially those marketing these products to people who clearly are not obtaining them to keep their pet fish healthy.

There are still a few aquarium and survival supply stores that sell these fish antibiotics online.  Amazon and Walmart did until a few years ago, but certainly not now.  Another place to obtain fish antibiotics is at your local ranch and feed store.  They cost a bit more at the feed store, but you can pay with cash, so there's no paper trail for anyone to follow.

If you're uncomfortable with the idea of using fish antibiotics, you can make a trip across the border, north or south.  I've never done this, so I have no experience and can't comment on the process.  Your other option, and, unless you live right near the border, a lot easier, is to order from an overseas pharmacy.  I've used All Day Chemist ( several times.  Their medications are all for use in people.  And their prices are extremely reasonable, unlike many other overseas pharmacies.  While the website indicates that you need a prescription, the people there tend to be flexible, especially if you use an e-check as opposed to a credit card.  There is a downside, unfortunately.  Once you place an order, your phone number is on their list and they want to make sure you are getting all your meds in a timely manner.  So they will call you frequently. If possible, use a burner phone or find someone in the family who doesn't use their phone a lot and won't be bothered by their sales calls.
Regardless of what method you choose to obtain your antibiotics, you probably want to do it soon.  Our government has shown a certain propensity for making responsible self-reliance difficult for people.  You never know what they'll do next.

1.  Dr. Cynthia Koelker, Armageddon Medicine, 549-550.

For more information:

Copyright 2018, Jennifer Rader,

Monday, December 17, 2018

Herbal Medicine: Thyme

Disclaimer: Again, this article is for entertainment purposes only.  It is not medical advice, I am not a doctor, and you should always consult a physician before beginning any herbal therapy, etc.

The use of herbs is gradually becoming more accepted, and that's great.  Herbs are generally gentler, have fewer side effects, less expensive, sustainable.  But some still prefer modern meds and traditional approaches to disease treatment and pain management.  Theoretically, herbal medicine sounds great, but if you know you (or your child) has strep throat, are you wanting that cephalexin right now, or are you saying, "Gee, doc, herbal remedies sound cool and let's see if one will work instead of this antibiotic"? 

Be honest.  Remember the extreme pain of that strep throat. 

Now, even if you are open to herbal treatments, what about your loved ones and friends?  Perhaps they've even stockpiled their own antibiotics and aren't asking to use yours.  Maybe they are not so open to herbal medicine, whatever the reason.  If you or they have access to antibiotics, why should you even care about herbal approaches?

Well, we've got a few reasons.  Pretty much everyone should be aware by now of the very real threat of antibiotic resistance.  We're all cautioned about using the entire bottle of prescribed antibiotics every time to make sure that the bug is wiped out completely and that we don't encourage the development of resistance by failing to finish our supply.  Most who store antibiotics recognize that eventually, that supply is going to be exhausted.  Some people are allergic to one or more antibiotics.  Most physicians, trusted people in the community with loads of very expensive education behind them, are not comfortable with herbal approaches and are not going to recommend them.  The list goes on.

It's nice to come across articles that have researched the combined use of herbs and regular pharmaceuticals for a couple of reasons.  (The abstract of one such article and link to it are provided below.) For one, it seems a reasoned, balanced approach to medicine.  Secondly, in most cases, herbs are potentiating the pharmaceuticals--making them more effective.  Third, with exposure to herbs, people who are more in the pharmaceutical camp can become more comfortable with herbs.  Fourth, people who fear that herbs won't be effective can have the rapid relief found with pharmaceuticals.  Fifth, your pharmaceutical supply can be preserved because you won't have to use as much of it to treat an illness. 

All these reasons combined should really pique the interest of a prepper.  One of the herbs tested in the article cited below is thyme, which is gaining wider recognition for its substantial antibiotic properties, and that's what we're going to review today.

The thyme that is used medicinally is just regular, garden variety thyme, Thymus vulgaris.  The blooming ends of the herb are best harvested for medicinal use from June through September. 

Medicinal uses:  Thyme is used to treat acne (one study showed it worked better than anti-acne products, including those with benzoyl peroxide), bronchitis, high blood pressure, rheumatism, influenza, athlete's foot, and intestinal cramping.  It is also active against enterovirus 71, herpes simplex 1 & 2, Stenotrophomonas maltophilia, MRSA, and Gram-negative bacteria.  Recent studies have shown that thyme can reduce bacterial resistance to penicillin and that it is effective against resistant strains of Staphylococcus, Enterococcus, Escherichia, Pseudomonas, and Candida albicans. 

Tincture:  Fresh herb, 1:2; dried herb, 1:5, 45 percent alcohol.  Dosage:  20-40 drops up to 3x daily.

Essential oil:  Steam inhalation--a few drops in boiling water and inhaling the steam aids in expectorating phlegm, relaxing muscles of the bronchi and thus relieving asthma, whooping cough, laryngitis, bronchitis, chronic sinus infections, and dry coughs.  Oral infections--make a solution containing 0.1 percent thyme oil (there’s a good reason why thymol, one of thyme’s most active ingredients, is found in Listerine).  One to two drops (under the tongue or added to tea) has shown efficacy in potentiating antibiotics like penicillin.  Aromatherapy--for fatigue and mental stress.  Add a drop to anti-fungal cream to improve outcomes in treating mild to moderate cases of fungal infections.  Bath--add several drops to bath water for treating bruises, swelling, and sprains.

Infusion:  Add one teaspoon of leaves to a cup of boiling water and let steep 10-15 minutes.  Add honey to sweeten, if desired.  As thyme eliminates phlegm and mucus from the respiratory tracts, reduces inflammation, and prevents microbial development that can lead to illness, it is effective against bronchitis, asthma, colds, influenza, congestion, and seasonal allergies.  It is also effective in reducing hypertension and treating menstrual cramps.  A tea can also be used as a wash to disinfect skin and surfaces or as a mouthwash for combating tooth decay and bad breath.

Poultice:  1.   Crush leaves into a paste for use on skin inflammations and sores.  2.  Crush four ounces fresh thyme and add to one pint of vodka or fresh vinegar with the mother.  Let sit 12 hours.  Apply to affected area.  Use for treating athlete's foot, lice, scabies, crabs.

Contraindications:  While thyme consumption as an herb in food seasoning is fine, the use of thyme internally as a tea or essential oil is contraindicated in pregnant women and those with duodenal ulcers.

Use of Natural Antimicrobials to Increase Antibiotic Susceptibility of Drug Resistant Bacteria


Plant-derived antibacterial compounds may be of value as a novel means for controlling antibiotic resistant zoonotic pathogens which contaminate food animals and their products. Individual activity of natural antimicrobials (eugenol, thymol, carvacrol, cinnamaldehyde, allyl isothiocyanate (AIT)) and activity when paired with an antibiotic was studied using broth microdilution and checkerboard methods. In the latter assays, fractional inhibitory concentration (FIC) values were calculated to characterize interactions between the inhibitors. Bacteria tested were chosen because of their resistance to at least one antibiotic which had a known genetic basis. Substantial susceptibility of these bacteria toward the natural antimicrobials and a considerable reduction in the minimum inhibitory concentrations (MIC's) of the antibiotics were noted when paired combinations of antimicrobial and antibiotic were used. In the interaction study, thymol and carvacrol were found to be highly effective in reducing the resistance of Salmonella Typhimurium SGI 1 (tet A) to ampicillin, tetracycline, penicillin, bacitracin, erythromycin and novobiocin (FIC < 0.4) and resistance of Streptococcus pyogenes ermB to erythromycin (FIC < 0.5). With Escherichia coli N00 666, thymol and cinnamaldehyde were found to have a similar effect (FIC < 0.4) in reducing the MIC's of ampicillin, tetracycline, penicillin, erythromycin and novobiocin. Carvacrol, thymol (FIC < 0.3) and cinnamaldehyde (FIC < 0.4) were effective against Staphylococcus aureus blaZ and in reducing the MIC's of ampicillin, penicillin and bacitracin. Allyl isothiocyanate (AIT) was effective in reducing the MIC of erythromycin (FIC < 0.3) when tested against S. pyogenes. Fewer combinations were found to be synergistic when the decrease in viable population (log DP) was calculated. Together, fractional inhibitory concentrations ≤ 0.5 and log DP < − 1 indicated synergistic action between four natural antimicrobials and as many as three antibiotics to which these bacteria were normally resistant.

Copyright 2018, Jennifer Rader,

Saturday, December 15, 2018

Expanded Food Storage: Ketchup

I looked at several recipes for making ketchup that were not canning recipes.  I tried a few of those when I had a massive garden and bushels and bushels of tomatoes.  They were total flops.

But ketchup is kinda important, especially for hamburgers and French fries and going with the current 1950's diner food theme.  The recipes I came across were pretty much the same as far as sugar, vinegar, and most common seasoning ratios.  Some added allspice, cinnamon, and/or cloves. Some started with tomato sauce and cooked it down.  I wasn't fond of that idea.  Grid-down, I don't want to use any more fuel than I have to.  Some started with tomato paste and then added water, which is a bit better.  However, there's still the problem that canned tomato products don't have a long shelf life.  I've had cans bulge in as little as two years past the use by date.   So I went with a recipe that used tomato powder as the base.

Because all the recipes made a large quantity of ketchup, and again, that is something I don't want when the grid goes down since there may not be adequate refrigeration, I scaled the recipe down.

Here's what I used:

1/4 cup tomato powder

1 tablespoon sugar (or honey, molasses, or maple syrup)
2 tablespoons white distilled vinegar (or apple cider vinegar)
1/4 teaspoon salt
1/4 teaspoon onion powder
1/8 teaspoon garlic powder
1/8 teaspoon dry mustard
3/4 - 1 cup water (start with 3/4 cup and add until you get the desired consistency)

Combine the dry ingredients first.  (If using honey, molasses, or maple syrup, combine that with water.)  If you don't the spices may clump up and be difficult to mix in.  Whisk in the vinegar and water until you achieve the desired consistency.

Makes about 10 ounces.

I made the above recipe using commercial tomato powder as well as powder from home grown and dehydrated and powdered tomatoes.  I had five taste testers, including The King and The Queen of the Picky Eaters.   All agreed that the ketchup made with the store-bought tomato powder was good and they would be happy to eat it.  But all also agreed that it was a bit tomato-ey and needed a little more sweetener or spice.  However, since everybody's ideas on what ketchup should taste like differ, I'm not going to worry about that.  I'll leave it up to the readers to do their own tweaking.  For my family, I'm going with maple syrup next time.

I also want to add that the tomato powders I used were old.  The commercial stuff was purchased in 2008, and the home stuff was dehydrated in 2009.  The commercial powder is still a very bright red and the ketchup is also nice and bright.  The homemade powder is the dark reddish orangish brown that is typical for home dehydrated tomato powder and it does not have the smooth consistency of the commercial powder.  While some might be a little disturbed at the idea of using food so old, I think it is a huge advantage.  There is no way canned tomato products would have that kind of shelf life. I have a few bottles of Trader Joe's ketchup here; the older bottles are substantially darker than the newer ones.  While the ketchup might still be safe to eat a few years out of date, it definitely isn't going to be as appealing if it is dark.

All in all, I liked making my own ketchup so much that I think I won't be buying ketchup again.

Copyright 2018, Jennifer Rader,

Friday, December 14, 2018

Basic Food Storage: Wheat--Using the Whole Berries

About fifteen years ago, my family and I attended a church barbecue at the little park out our back gate.  And you know, those church potlucks are one of the best places to discover delicious food to feed your family.  Clearly, this barbecue was no exception, and I'm sure I remember it so well just because it is where I tried the most phenomenal salad, which just happened to be made with wheat berries.  It was the first time I had ever even heard of using whole wheat berries in cooking, and I was impressed.  I finally tracked down the person who brought it, because I simply had to have the recipe.  And Carol just rattled off the list of ingredients, and with only six, it was super easy as well.  However, Carol just eyeballed the amounts needed.  Ugh.  (That's a totally acceptable way to work when it's my recipe, but when it's somebody else's, I need exact amounts!)  But as Carol noted at the time, it's got wheat, bacon, and brown sugar, three of the best things in the world.  How could it not be fabulous?

Carol provided a rough idea of the amounts I needed for the recipe, and with a little trial and error, I was able to work out measurements.  After all, I'm not the only one in the family to make this salad; the kids definitely need exact measurements.  So without further adieu, here's Carol's Wheat-Broccoli-Bacon Salad.

Wheat-Broccoli-Bacon Salad

2 cups wheat, boiled for about an hour (or until soft), drained and rinsed
2 cups finely chopped fresh broccoli florets
1 pound bacon, cooked and crumbled
1 cup mayonnaise
2 tablespoons cider vinegar
1/2 teaspoon garlic powder

Combine cooked wheat, broccoli, and bacon in a serving bowl and set aside.  Combine mayonnaise, vinegar, and garlic powder in a small bowl and mix until smooth.  Pour over salad and stir well to distribute the  dressing.  If possible, chill at least two hours before serving. 

Now, I'm guessing a at least a few readers are thinking something along the lines, "Bacon? Fresh broccoli?  Mayo?  This salad may be fine for making now, but it doesn't look like something that's going to work post-collapse."

Yes, it will.  While I may be buying fresh broccoli right now, because it's almost winter here and the garden's been dead for awhile, post-collapse we will have broccoli in the garden in the spring and fall.  Making mayonnaise was actually covered in a post a few weeks ago  (11 November 2018).  And canning bacon will be covered in a future post (22 December 2018). 

Here's a recipe I shared with my food storage class years ago.  It calls for fresh peppers and cilantro, and a red onion.  So it would primarily be made in the summer using garden produce, but you could also substitute freeze-dried peppers if you have them.

Fiesta Bean and Wheat Salad

1 orange or red pepper, diced
1 green pepper, diced
1 small red onion, diced
1 bunch fresh cilantro leaves, chopped
1 small jalapeno pepper, cored and diced
juice of one lime (substitute True Lime packets)
1 cup wheat berries, boiled, drained, and rinsed
1 15 oz can corn, drained
1 15 oz can black beans, drained
2 teaspoons chili powder
2 teaspoons ground cumin
1/4 cup cider vinegar
1 tablespoon sugar
1/2 cup vegetable oil
1 teaspoon salt

Combine all ingredients in a bowl and toss well.  Chill for at least 1 hour before serving.

And lastly, while searching about to see if there were any new recipes for using wheat berries, I came across this gem.  We had it last night for dinner (minus the mint, which I forgot to pick and I was in a rush to get dinner on so we had to do without). 

Wheat Berry Salad with Apples and Cashews

1 cup wheat berries, boiled, drained, and rinsed
3 tablespoons vegetable oil
½ cup orange juice
2 tablespoons red wine vinegar
2 teaspoons ground coriander
½ teaspoon ground cinnamon
2 Granny Smith apples, cored, diced (or substitute 1 cup dehydrated apples, re-hydrated in 2 cups warm water and diced)
2 tablespoons fresh mint, finely chopped
½ cup cashews, toasted, coarsely chopped
2 green onions, chopped
1 cup dried cranberries
feta cheese (optional)

In a small bowl, mix the vegetable oil, orange juice, vinegar, coriander, and cinnamon. Set aside.
To the wheat berries, add apples, mint, onions, and cranberries. Toss with the dressing to coat. Prior to serving, add the toasted cashews and feta cheese.

As you search for other ways of utilizing wheat berries, bear in mind that boiled whole wheat berries can be successfully substituted into most any recipe that calls for brown rice.  And that is quite fortunate, since brown rice has a very short shelf life, whereas wheat stores forever.

Copyright 2018, Jennifer Rader,

Thursday, December 13, 2018

Tips and Tricks--DIY Instant Rice

OK, a post on rice should probably be over in the Basic Food Storage section, but today's little DIY is something too many people are totally unaware of.

Instant rice is totally a DIY thing.  You need never spend too much money on too little rice with way too little flavor ever again.  Here's how:

Cook your rice per instructions on the package.  Use any kind of rice you want.  A rice cooker will produce perfectly cooked rice that dehydrates perfectly as well.  It's been my experience that using the minimum amount of water advised by the rice cooker instructions results in the best final product without any clumping. 

Spread the rice on your dehydrating racks and set temperature to 135 degrees.  Or spread the rice on cookie sheets and dehydrate in a warm oven.  Some ovens actually have a setting for dehydrating.  You may need to prop the door open a crack to let water vapor escape.  Dehydration will take from four to twelve hours, depending on the temperature setting, fan, and humidity.  Dehydrate until the rice is brittle and there is absolutely no water left.  Let cool. 

Vacuum seal in canning jars or bags, or if you make a lot, in a plastic bucket with oxygen absorbers.

Reconstitute in a 1:1 ratio like any other instant rice, i.e., bring two cups of water to a boil, add two cups of rice, cover with lid, let stand five minutes, fluff with fork and eat.  Perfect for quick meals.

Copyright 2018, Jennifer Rader,

Wednesday, December 12, 2018

Reviews: Prescription for Herbal Healing, Backyard Medicine for All, Rosemary Gladstar's Medicinal Herbs

Over the past few years, I've acquired at least a dozen books on herbal medicine.  A couple are what I consider must-haves (like Herbal Antibiotics which I reviewed last month), some that are okay, and three that I really wish I hadn't gotten.  It is those three that I will review today, and the reasons why, so that when you select your herbal medicine books, you can buy with confidence.

First off, I'd like to communicate that I'm not saying any of these books are bad, or poorly written, or authored by quacks.  However, from a prepper or survivalist point of view, which most of this blog's readers are, to some extent, they are not the best use of our resources.

Phyllis Balch, author of Prescription for Herbal Healing, according to the back cover of this book, "...has been a leading nutritional consultant for more than two decades, and has spent more than twenty-five years researching natural approaches to health and healing...."  Her book appears meticulously researched and includes coverage of Chinese and ayurvedic (traditional medicine from India) herbs and therapies to treat over 150 common disorders.  However, with 544 8.5 x 11" pages, it's quite large and focuses heavily on herbs that are only going to be found in herb stores or online, neither of which are going to be an option when society collapses.

Backyard Medicine for All, by Julie Bruton-Seal and Matthew Seal, is a sequel to their first book, Hedgerow Medicine.  Had I done a little more research, I would have clued into the fact that the authors live in the United Kingdom.  Sounds a bit bigoted, right?  Well, think about the climate and growing conditions.  Are the plants that grow in Britain and Scotland going to be the same as those that grow in the deserts and mountains of the western US?  That's a big "no, not really."  This book may work very well for those living in New England or the Pacific Northwest areas of the US.  Another strike against this book, were I looking at several side by side in a bookstore, is the layout.  While I appreciate the color photographs, the organization is just too jumbled.  Most pages have three columns of text, a photograph or two, and then text boxes as well.  I think it contributes to sensory overload.

Rosemary Gladstar's Medicinal Herbs:  A Beginner's Guide is an excellent resource.  Rosemary Gladstar, an herbal teacher and practitioner for 35+ years, very clearly introduces the medicinal uses of thirty-three common herbs.  Unlike many herbal medicine writers, she explains terms that the others just throw around, provides detailed instructions for making her healing formulas, and offers helpful suggestions for growing these herbs in the garden.  She includes photographs of the plants and the text is well-organized.  It's an excellent resource for a beginner.  I appreciate the author's work; however, I'm not sure I will keep this book.  Being able to treat coughs, colds, fevers, and minor joint pain is nice, but it stops there.  Other books cover much more serious medical issues and include information on treating these minor conditions as well, though perhaps lacking the introductory explanations.

In summary, when it comes to purchasing your own herbal medicine books, what factors should you keep in mind?
  • Find books that use herbs that you will actually have access to.  Chinese medicine and Ayurveda have their place, but a lot of the herbs they use grow in the Eastern hemisphere, not here.
  • Along the same lines, the Peterson Field Guide to Western Medicinal Plants and Herbs or Linda Kershaw's Edible and Medicinal Plants of the Rockies aren't going to be of much benefit to folks living on the East Coast.  
  • Decide how far down the herbal medicine rabbit hole you are going to go.  Do you want to learn the basics through free online searches and then spend the money for more comprehensive books that will cover diseases we're likely to encounter after TEOTWAWKI?
 Hope this helps you in making your choices!

Copyright 2018, Jennifer Rader, 

Tuesday, December 11, 2018

Traditional Medicine--OTC Pain Relievers

Disclaimer:  The information below is only for educational purposes to provide a general idea of what medications should be stockpiled and which are indicated for various conditions.  A licensed physician should always be consulted before taking any medication, even those available over-the-counter.

Sometimes we get the idea that over-the-counter pain relievers are all basically the same.  While occasionally any one of two or three choices will work for what ails us at the moment, it really behooves us to gain a better understanding of what works best in any given situation.  So let's review the most common OTC pain relievers.

Advil is the trade name for ibuprofen.  It is taken for reducing pain, fever, inflammation, painful periods, rheumatoid arthritis, osteoarthritis, kidney stones, dental pain, migraines, and even treating patent ductus arteriosis in a premature baby.  Side effects include heartburn and rash, and it may worsen asthma.  It may increase the risk of heart, kidney, and liver failure.  It is not for use during pregnancy.  Advil is on WHO's List of Essential Medicines.  It can interfere with the anti-platelet effect of low-dose aspirin and is a weak photo-sensitizing agent.  Chronic use is associated with an increased risk of heart attack, stroke, and high blood pressure.  If poisoning is suspected, treat with activated charcoal.  Inducing vomiting is not recommended.  One study showed that people who regularly used ibuprofen reported a 38% less risk of developing Parkinson's.  However, the effect of long-term use on the urinary and gastrointestinal tract should be noted. Prescription strength Advil/ibuprofen/Motrin is 800 mg per dose taken at six-hour intervals for a maximum of three doses in a 24-hour period.  Total daily dosage is 2400 mg. 

Aspirin is one of those drugs that would not be approved by the FDA today because it does too many things.  Because it is a blood thinner and can be used to stop a heart attack, chewable baby aspirins should be part of every medical kit.  Aspirin can cause stomach upset and may worsen asthma.  It should not  be used in the last trimester of pregnancy and should not be used for children with infections due to the risk of Reyes syndrome.  Aspirin is on WHO's List of Essential Medicines.  It is generally not as effective against pain as ibuprofen, nor is it very effective for pain due to muscle cramps, bloating, gastric distention, or acute skin irritation.  Aspirin works synergistically with caffeine.  Effervescent formulations work faster than tablets and are more effective for migraines.  Topical aspirin may be effective for some types of neuropathic pain.  Aspirin is more effective for tension headaches and less effective on other types of headaches.  It is most effective at stopping migraines when they are first beginning.  An overdose is treated with activated charcoal and IV saline.

Aleve (naproxen sodium/naprosyn) is similar to Advil and is taken for relieving pain, fever, swelling, and stiffness.  It is generally safe for use by nursing mothers.  It may cause side effects of rash, heartburn, and stomach ulcers.  Aleve is used to treat migraine, osteoarthritis, rheumatoid arthritis, psoriatic arthritis, kidney stones, gout, tendinitis, bursitis, and menstrual cramps.  It is not indicated for diabetic neuropathy.  Aleve may have antiviral activity against influenza.  Aleve may be used to differentiate between infectious fevers and neoplastic (connective tissue) fevers, as in cancer.  Heavy use may cause end stage renal disease and kidney failure.  Aleve should be taken with food.  Aleve may interact with blood thinners and prednisone.  Aleve has been an over-the-counter drug in the US since 1994 in 220 mg tablets, but remains prescription only in much of the rest of the world.    Regular OTC usage is one 220 mg tablet every 8-12 hours.  Prescription dosage should not exceed 1250 mg in the first 24 hours; subsequent daily doses should not exceed 1000 mg.  

Excedrin/Vanquish is a combination of acetaminophen, aspirin, and caffeine used primarily for headaches, but is also used for arthritis, back ache, colds, menstrual cramps, and muscle aches.  This aspirin/acetaminophen/caffeine combination is as effective in treating migraines as lower doses of sumatriptan. Excedrin has more acetaminophen, aspirin, and caffeine per dose than Vanquish.  Excedrin is sold in "extra strength" and "migraine" formulas.  There is no regular strength.  And the "extra strength" and "migraine" dosages and formulas are exactly the same, but if the bottle says "migraine" on it, it costs substantially more.  This is just one example of repackaging as marketing, and the Excedrin manufacturer Novartis was sued over this.  Manufacturers do the same thing with Benadryl/diphenhydramine hydrochloride.  It's one price if sold as an allergy medication and about double if sold as a sleep aid.

Meloxicam is a pain reliever similar to Tylenol but is available by prescription only in the US.  However, I include it here because it has an important advantage over the other OTC pain relievers.  US combat troops are issued this pain reliever for their IFAKs because it does not interfere with platelet function, i.e., blood-clotting, it is more effective at relieving pain than Tylenol, and it is taken only once per day.  Meloxicam is an NSAID most often prescribed for treating arthritis and tendinitis.  It should be taken with food and is better than ibuprofen for moderate to severe pain.  Meloxicam should not be used by individuals with asthma or by pregnant women.  Long-term use may cause liver damage and increase the risk of heart attack and stroke.  It may reduce kidney function and should be used with caution in individuals with heart failure.  Meloxicam may contribute to insomnia, bladder infections, and URIs.  The beginning dose is 7.5 mg/day.  The maximum daily dose is 15 mg, taken once per day.

Motrin.  Exact same thing as Advil/ibuprofen.

Tylenol (acetaminophen in the US, paracetamol in the UK) is most often indicated for treating pain, fever, allergies, cold, cough, flu, and headache.  It reduces the perception of pain, but does little to treat the cause of pain.   Acetaminophen is quite safe, as long as it is used as directed.  Complications arise from overdoses, which are most often unintentional.  These overdoses most often occur because acetaminophen is found in so many OTC medications.  Before July 2011, the maximum daily dose listed on the packaging was 4000 mg, but that year manufacturers reduced that maximum to 3000 mg per day.  This was a liability defense protection move; the FDA still lists the maximum dose as 4000 mg per day.  Acetaminophen tablets come in several strengths:  325 mg regular strength, 500 mg extra strength, and 650 mg arthritis pain (but this last caplet is extended or sustained release over the day and needs to only be taken every twelve hours). Tylenol-3 is 300 mg acetaminophen and 30 mg of codeine, a controlled substance.

Most of the above pain relievers become noticeably effective within 30 to 60 minutes.  Children's chewable--all chewables--enter the bloodstream much more quickly and thus begin acting faster.  This can be especially important when attempting to stop a migraine and stocking some (unfortunately, very expensive) children's chewables may be worthwhile.

Most of the above pain relievers are blood thinners or anti-coagulants and should not be administered when bleeding is or could become an issue.  For this reason, combat troops are not allowed to use anything but acetaminophen or meloxicam.  All of the OTC medications listed above, except meloxicam (which is not OTC in the US) can be purchased very cheaply in large quantities through Amazon and Sam's Club.  For some reason, Amazon Prime Pantry has many of these medications even cheaper.  It may be worthwhile to get a free trial of Amazon Prime Pantry and order all your OTC meds at once. 

Bear in mind that physicians seem to have their own favorites, medications that in their experience work better than others.  And some people also respond better to one medication than another.

One study showed that any use of NSAIDs (even Tylenol) by pregnant women increased the risk of miscarriage 2.4-fold.

As mentioned in the Shelf-Life Extension Program post (6 December 2018), liquid medications diminish in strength soon after their use-by date.  However, tablets and capsules are effective years beyond their stamped use-by dates.  

Combining Tylenol and Advil:  Yes, it is safe.  They have different mechanisms of action.  Tylenol is cleared by the liver; Advil is cleared by the kidneys.  The combination of these two medications has been shown to be more effective than Vicodin or Norco for treating dental pain.  This is most effective when the doses are alternated.  For example, take Tylenol at 6AM, 2PM, 10PM; Advil at 10AM, 6PM, 2AM.  Same idea for goes for combining Tylenol and Aleve. Do not combine Advil and Aleve.

To reiterate the disclaimer above:  a licensed medical provider should be consulted before taking any medication.  The information provided herein is only for education about which drugs are most useful and likely to be suggested by a physician and therefore desirable to keep on hand in a grid-down situation.

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Copyright 2018, Jennifer Rader,