Summary

The FDA has proposed phasing out oral phenylephrine, a common decongestant in cold medicines like Sudafed PE and DayQuil, after studies showed it is no more effective than a placebo.

The drug, ineffective when swallowed due to breakdown in the stomach, remains usable in nasal sprays.

Alternatives include pseudoephedrine, nasal sprays, and steroid treatments like Flonase.

The regulatory process to remove phenylephrine could take over a year, but experts argue removing ineffective options will help consumers choose better remedies for congestion. Drugmakers are expected to challenge the proposal.

  • weariedfae@sh.itjust.works
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    1 day ago

    Goddamn pseudoephedrine is the best, hands down. I have allergies that routinely stuff me up and I vehemently hate fucking tweakers for trying to ruin one of the most effective over the counter drugs out there.

  • Dlayknee@lemmy.world
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    1 day ago

    experts argue removing ineffective options will help consumers choose better remedies for congestion

    Homeopathic medicine says what?

  • Rivalarrival@lemmy.today
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    1 day ago

    Phenylephrine sucks via the oral route, but it works pretty damn good via the nasal route. In my experience, phenylephrine nasal sprays (4-Way and generics) work as well as oxymetazoline sprays, with much less rebound congestion.

    Phenylpropanolamine worked better than pseudoephedrine, but slightly increased the risk of stroke, so it had to be banned entirely.

      • Rivalarrival@lemmy.today
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        1 day ago

        Just for clarity, because I am not 100% certain I am grokking your comment properly:

        • In my experience, your comment is true of oxymetazoline nasal sprays.

        • In my experience, your comment is not true of phenylephrine nasal sprays.

        By that, I mean I, personally, have never experienced difficulty weaning myself off of generic PE nasal sprays; I have experienced such difficulties with oxymetazoline.

        That being said, I can’t rule out the possibility or severity of rebound congestion from any decongestant, including both nasal sprays and pills.

        • TheLoneMinon@lemm.ee
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          22 hours ago

          Not the person you’re replying to and have nothing to add to this specific conversation, but I just wanted to commend you on this style of communication. It was so clear and level and I see no way anyone (in good faith) could find anything to misconstrue from your statements. This is som 10/10 internet communication and I will be studying the way you laid this comment out for future use.

  • Jackcooper@lemmy.world
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    2 days ago

    Edit: OP is a cool guy

    Hi, I’m a pharmacist

    Can you please edit your post to say a common decongestant in cold medicines such as Sudafed PE? It’s inaccurate to say it’s in Sudafed.

    Sudafed is the brand name for pseudoephedrine and it very much is effective. Phenylephrine is in the Sudafed PE which only exists because you need to use a driver’s license to get Sudafed from the pharmacy in the US.

    • MicroWave@lemmy.worldOP
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      2 days ago

      Thanks for the tip. The photos in the article also show PE as well. I’ve updated the summary.

  • watson387@sopuli.xyz
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    2 days ago

    Pseudoephedrine. In the US, you have to go to the pharmacy counter and ask for it, but it works.

    • CrayonRosary@lemmy.world
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      2 days ago

      And it works great! I woke up with a ton of sinus pain yesterday. My whole face ached. Two pseudoephedrine and it was gone in an hour.

    • AllNewTypeFace@leminal.space
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      2 days ago

      The problem is that it is legally an evil drug because you can make meth from it, so it remains heavily restricted. There are more effective ways to make meth at commercial scale than by buying and crushing up cold and flu tablets, but it’s a question of moral principle, i.e. not condoning evil.

      • ITeeTechMonkey@lemmy.world
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        2 days ago

        This is some dumb pearl clutching bullshit.

        With this asinine logic, buying apples are condoning evil because their seeds contain cyanide and though there are more effective ways to create cyanide at commercial scale than buying apples and extracting the small amount of cyanide from the seeds it’s still a question of moral principle i.e not condoning evil.

        • Psythik@lemmy.world
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          1 day ago

          What’s even bigger bullshit is that you can simply buy Benzedrine from the nasal decongestant aisle instead, remove the cotton wick and soak it in an acid (like lemon juice), and in 24 hours you have the same kind of meth they gave the Nazis. For four dollars. It’s literally just sitting there on the shelf for anyone to buy.

          Everything in life is made up and none of the points matter.

        • shalafi@lemmy.world
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          2 days ago

          Yeah, but people are actually making meth from pseudoephedrine and no one is making cyanide from apples.

          And yes, I hate having to go inside to buy it as I use it nearly every day.

      • chiliedogg@lemmy.world
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        1 day ago

        It’s not that hard. The only real issue is when the pharmacy is closed and you’re trying to buy one a holiday or after-hours. I just keep some spare pseudoephedrine in the medicine cabinet to hold me over until the pharmacy opens.

      • Hugin@lemmy.world
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        2 days ago

        They spend more money and chemistry making pseudoephedrine hard to make into meth then they do on the everything else in the medicine. It’s also why meth labs tend to blow up when they didn’t with with standard pseudoephedrine.

  • adarza@lemmy.ca
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    2 days ago

    phenylephrine is effective as a nasal spray, not in tablet or liquid (i.e. taken orally).

    drug makers were all in a panic over lost sales due to pseudoephedrine getting put behind the counter. they basically lied to everyone about phenylephrine’s effectiveness when they put it in all the stuff sold on retail shelves just to protect their fucking profits.

    • crozilla@lemmy.world
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      1 day ago

      F these soulless business associations:

      For now, the Consumer Healthcare Products Association — which represents medicine makers — wants the products to stay available, saying Americans deserve “the option to choose the products they prefer for self-care.”

      Hatton says he and his colleagues disagree: “Our position is that choosing from something that doesn’t work isn’t really a choice.”

  • bluGill@fedia.io
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    2 days ago

    Just stay home when you are sick. being miserable in bed stops the spread.

    • militaryintelligence@lemmy.world
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      1 day ago

      My work won’t allow it. I’m just getting over a horrible sickness after I spread it to everyone at work. Boss didn’t come in for a week, but we had to be there. There needs to be laws.

    • jagged_circle@feddit.nl
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      1 day ago

      This, but if you can’t sleep then its a good idea to take something. Your body can’t heal if you can’t sleep.

  • Schal330@lemmy.world
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    2 days ago

    This stuff is a miracle here in the UK:Image of Sinex Micromist nasal spray

    First time I tried the Micromist nasal spray I was 100% blocked up and had no expectations of it working. After a couple of minutes my nose was completely unblocked.

    I still use it now and then as my nostrils alternate being blocked and some days I just can’t put up with it or struggle to sleep. But you have to take long breaks from using it as you get “blowback” where symptoms come back hard if you use it for too long and then stop.

    • Rivalarrival@lemmy.today
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      1 day ago

      Oxymetazoline reduces congestion in seconds, but causes terrible rebound congestion.

      Phenylephrine doesn’t work when taken orally, but it is extremely effective nasally, with far less rebound congestion than oxymetazoline nasal sprays.

    • MelodiousFunk@slrpnk.net
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      2 days ago

      This is sold as Afrin in the US. Can confirm it works amazingly well. Can also confirm that long term use (more than a few days) will mess you up pretty badly due to rebound congestion.

      • ComradeSharkfucker@lemmy.ml
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        2 days ago

        Yeah I know people essentially addicted to affrin because of that rebound congestion. Its best used only when absolutely necessary

          • Rivalarrival@lemmy.today
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            1 day ago

            Try (the generic versions of) 4-Way. Oral phenylephrine doesn’t work at all, but nasal PE is about as good as oxymetazoline, with much, much less rebound congestion.

    • morbidcactus@lemmy.ca
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      2 days ago

      Yeah, the Pseudoephedrine does what it says it does, I was using Tylenol cold/Flu (daytime meds have that on it) years ago when I came down with something nasty, made me not feel like death. It’s an amphetamine so those on stim meds (like myself since then) should talk to your pharmacist first, mixing stims isn’t a great idea.