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    Stocking Your Home Pharmacy: The Ten Items Everyone Needs to Have

    There are tens of thousands of medications out there, and it is nearly impossible for medical providers to have a working knowledge of all of them. Every country has their own formulary, so medicines used in the United States are not necessarily available in other areas of the world. If they are, they are sold by a different name, or are slightly different chemically.

    Medical providers routinely use reference books and the Internet, of course, to familiarize themselves with medicines they to not use on a daily basis. When I have medical students rotating in my office, their evolving brains are literally swimming in the maze of pharmaceuticals. They may see a patient with a simple infection problem and will not have a clue about antibiotic choices, let alone dosages, side-effects, prices, and insurance formularies. How in the world are they going to learn these things? They may not have the time in a busy practice, seeing patients every ten to fifteen minutes, to look up each and every medication. Like learning how to walk, medical students need to start with fewer medicines in their working formulary, and so do people when they stock their home pharmacies.

    I have medical students pretend they are leaving tomorrow for a desert island. They can only take ten different types medicines to take care of the families who will be with them. This little exercise helps them narrow down the important medicines — the ones they are likely to use on a daily basis — from the ones they may need to look up before using them. Of course, medical providers would chose different medications when stocking their desert island formulary than people at home.

    The vast majority of human afflictions are not treated by medical providers, but are treated at home. While different families may have different issues, this exercise — narrowing down your home pharmacy to just ten medicines — will simplify your life and free up some room in those medicine cabinets that may be overflowing. This extra room can now be used for other medicines that you should have at home. Use the KISS rule: Keep it Safe and Simple.

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    First, take out ALL of those medicines and line them up on a table. Look at the expiration dates and dispose of any old ones. If you have any leftover antibiotics from prescriptions you never finished, throw all of those away, too. Medications for conditions that you no longer have, or are unlike to have, can be discarded as well.

    Group your home pharmacy into categories: cold medicines, ointments/creams, pain/fever medications, etc. This will help you find duplicates — medicines of different brand names that do the same thing, such as two different types of hydrocortisone cream, or two different types of acetaminophen.

    The categories of medicines that you should have in your home pharmacy:

    Pain and fever medications: Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) in both adult and child strengths (if you have children). If you have an infant, you may need infant strengths as well. Remember that ibuprofen also has anti-inflammatory properties.

    Antiseptic solutions: Cuts and wounds should be carefully cleansed, so your pharmacy should have hydrogen peroxide, Betadine solution, or equivalent.

    Topical Antibiotics: Your choice. They come in both ointments (greasy, but protective) and creams (rubs in easily) and all are considered equally efficacious for the prevention and treatment of minor skin infections. Some topical antibiotics are better for burns — you should have a burn ointment in your cabinet.

    Hydrocortisone: This topical steroid is also available in creams and ointments. Used for itching, treating mosquito bites, etc.

    Antifungal medications: Use for Athlete’s feet or fungal diaper rashes. If the woman in the house is prone to occasional vaginal yeast infections, some miconazole (Monistat) is nice to have available.

    Stomach and Intestinal Disorders: Include a good stool softener, such as Colace (docusate sodium), or a mild laxative such as Milk of Magnesia. I do not routinely treat minor diarrhea, but having Kaopectate or even Pepto-Bismol at home would be helpful. Over-the-counter Tagamet (cimetidine) or Prilosec (omeprazole) would be appropriate to include, along with Maalox or Mylanta.

    Salt: You can get this from the kitchen, but making your own saline (1/4 tsp of salt to 8 oz of water) can be used for gargling or homemade nasal spray/drops.

    Antihistamines: Drying up a watery nose or controlling itchy allergies. Benadryl (diphenhydramine) is the most common, but it can be sedating. Claritin (loratadine) lasts longer (24 hours) and is considered non-sedating. Both are available in both adult and children formulations.

    Decongestants: Medications containing pseudoephedrine (Sudafed) or phenylephrine are for stuffy/congested noses. They can be stimulating and may interfere with sleep. Decongestants also drain mucous, so taking them at night is going to cause a river of drainage. It is best to do this during the day when you can blow your nose.

    Cough medicines: There are two types: expectorants (makes you cough by loosening mucous), and suppressants (controls or reduces coughing). It is important to know your goal when you select one. Guaifenesen (Mucinex) is a mucous-thinning expectorant. Plain Robitussin is a cough expectorant. Medicines that contain dextromethorphan (DM), such as Delsym, can suppress a cough. Combination medicines, like Robitussin DM, have both an expectorant and a suppressant — sort of makes you cough and tries to stop it at the same time! Coughing is a NORMAL bodily response to clear the airway, so it does not necessarily need to be controlled, but having a quiet, comfortable night is okay.

    Miscellaneous: Band-aids (all types, including finger tip ones), gauze dressings, Telfa (non-stick) pads, paper tape, and other dressings are always needed.

    Of course, depending on your family and individual needs, there may be other medicines or classes of over-the-counter drugs that you would like to have on hand, such as eye drops, nasal sprays, moisturizing lotions, aspirin, vitamins, etc. Each home pharmacy will need to be individualized, and only you can do it. The home pharmacy of someone with children will be totally different than a family without kids. Medicines need to be securely locked if you have kids, or grandchildren visiting.

    Finally, just because you have a well-stocked home pharmacy does not imply that I endorse using over-the-counter medications routinely. Colds are better off left alone, but sometimes it can be helpful to treat annoying symptoms. We should all learn to tolerate minor pain without heading for the ibuprofen for each and every ache. Always use discretion and avoid over-medication. Follow dosage recommendations and avoid the home treatment of things that have not been properly diagnosed — even if you are the one diagnosing them. Use your medical provider as a consultant if you have doubts.

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