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September 1999

Hiking Medicine: Trail Rx

Got a first-aid kit? Great. Now add these over-the-counter medicines and it'll be perfect.

One trip down the drugstore aisles will convince you: There’s an over-the-counter tube, bottle, or canister of medication for just about any minor ailment a backpacker is likely to encounter. The trick is deciding which one you actually need to lug into the field.

Some first-aid potions are automatic choices. Triple antibiotic ointment, for example, should be in every first-aid kit, as should any medicine that addresses your specific

needs, like recurring gastric distress or athlete’s foot. But beyond the obvious, how do you make sure your health and well-being bases are covered, outside of carrying a pharmacy in your pack?

What follows is a list of likely candidates, with some suggestions about when to use, when to avoid, and which ones work best for what. Remember to look for the smallest container, and repackage when appropriate. Personally, I double-bag each separately and include the box top with the name, lot number, and expiration date. That way I don’t have to play the guessing-by-flashlight game at night. If you’re not familiar with a drug, also include the use and dosage.


Add to your kit: The NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), such as ibuprofen, naproxen, and aspirin. Available as generics or in the common brand names Advil, Motrin, Aleve, Anacin, and others.

When to use: These little pills are good for alleviating pain and inflammation from a host of common ailments likely to strike a backcountry traveler sooner or later, including sore muscles and joints, headache, toothache, fever, and sprains.

Don’t use if: You experience stomach irritation or allergic reactions (hives, rashes, asthma).

In the field: Take according to instructions at the first sign of pain or inflammation. Never mix with each other, or with alcohol. Aspirin’s only advantage is its cost. It has more side effects than the others, and it doesn’t survive dampness well. A strong vinegar smell means it’s outdated. Note that acetaminophen (Tylenol) is an effective painkiller, but does nothing for the inflammation of an overused knee joint or a twisted ankle.


Add to your kit: A tube of triple-antibiotic ointment or cream such as Neosporin, Mycitracin, or one of the many generic brands.

When to use: When a nasty fall or slip of a knife results in an open cut or scrape with redness, pain, swelling, and a honey-colored crust over broken skin, use a triple-antibiotic to prevent and treat bacterial infection.

Don’t use if: Skin is unbroken or if bleeding from broken skin is more than an “ooze.”

In the field: Gently wash crust off wound, then apply just enough cream to cover the area, twice daily. Use cream instead of ointment, which has a petrolatum base that can seal out air. If you see a tender red streak meandering from the wound toward the heart, you have a more advanced infection that needs an oral antibiotic, pronto.

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