In the cough and cold aisle of a CVS in South Philadelphia this week, Samantha Romano searched the bookshelves for medication for her boyfriend, who had a bad cold and sore throat.
The couple had a half-used box of DayQuil at home, but Romano recalled hearing recently about the government's warning that it might not work. She instead opted for her throat spray to relieve his symptoms.
Like Romano, many consumers are looking for the industry's most popular non-pharmaceutical cold remedies this winter. This fall, be federal advisory committee Phenylephrine, an anticongestive ingredient widely used in treatments such as DayQuil and Advil Cold and Sinus, was found to be ineffective when taken orally.
Now, doctors and pharmacists are working to help patients find options beyond the best-selling brand-name drugs they may have relied on in previous flu seasons.
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Phenylephrine is intended to fight Nasal congestion or nasal pain due to colds or allergies Reduces swelling of nasal vessels.
It can be dangerous for children under 4 years of age and can cause side effects such as nervousness, dizziness, and insomnia. But the Food and Drug Administration, which convened an advisory committee on phenylephrine this fall, says there are no concerns about the drug's safety.
Ineffectiveness of phenylephrine when taken orally Ian Paul, a professor of pediatrics at Penn State Health who has consulted with drug companies on cold and cough treatments, said the suspicions have been around for years. In 2007 he I wrote an article The American Academy of Pediatrics has warned that there is a lack of evidence to support the use of phenylephrine to treat colds.
Research suggests that another drug, pseudoephedrine (sold under the brand name Sudafed), may be able to effectively combat congestion, Paul wrote. But since 2005, the federal government has mandated that drugs be dispensed from behind the counter at pharmacies because they can be used to make illegal methamphetamine.
Instead, phenylephrine products are now on pharmacy shelves and more readily available. The manufacturer of Sudafed has begun selling a version containing phenylephrine called Sudafed PE.
Some pharmacists, like Mayank Amin, were cautious about stocking phenylephrine drugs. At an independent Skip Pack pharmacy in Montgomery County, Amin worried people would confuse it with pseudoephedrine, which you have to see a pharmacist to get.
Amin wasn't surprised when an FDA advisory committee found in September that phenylephrine was ineffective when taken as an over-the-counter pill.Phenylephrine May also be effective in nasal spray formDoctors say this is because it interacts directly with nasal tissues, as opposed to being metabolized in the liver.
He hopes the ruling will encourage more patients to read labels carefully and consult pharmacists when purchasing over-the-counter drugs.
“Pharmacists are the most accessible health care professionals, and people still come to us for additional care. They say, 'Hey, Dr. Mac, what are you going to drink today? Would you recommend it?'' he said. “If the drug is being sold behind the counter, we can make better recommendations. You can ask if there is another disease that has.”
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The commission's findings have prompted some consumers and advocates to avoid phenylephrine. CVS has already removed products containing only phenylephrine from its shelves, but products like DayQuil that contain other active ingredients to treat colds are still available.
Sue Robotti, another FDA drug safety panel consumer representative, said she hopes the FDA will eventually remove phenylephrine drugs from shelves completely.
“People aren't getting the care they need and they're wasting time and money,” said Robotti, founder of MedShadow, a nonprofit that publishes articles about drug side effects.
The FDA says: will consider the decision of the advisory committee before taking the final action of the drug.
How to treat a cold
Romano, a South Philadelphia woman looking to treat her boyfriend's cold, avoids most cold medicines because he has a health condition that can be exacerbated by side effects. She and her boyfriend were also considering treating his symptoms with home remedies.
According to Paul's own research and review of scientific evidence, some home remedies, such as using honey to soothe a sore throat, are more effective than cold medicine. Patients may also find relief from symptoms by rinsing their nose with saline, staying hydrated and using topical steam rubs, he said.
“Chicken soup, steam baths, and plenty of hydration. There's not a lot of hard evidence from well-conducted clinical trials that these are effective, but Grandma's Chicken Soup won't harm you. No,” he said. “All you really need is the patience and time to endure the common cold.”
To relieve nasal congestion, patients can consult their pharmacist to find a more effective pseudoephedrine or choose phenylephrine nasal spray.
Ibuprofen and acetaminophen can help reduce fever. Products like DayQuil and Advil Cold and Sinus also contain acetaminophen and ibuprofen, which may provide some relief to people who suffer from colds. It's not just phenylephrine's fault.
“DayQuil is like throwing a concoction at someone. If someone is sick with a cough, cold, fever, etc., DayQuil or NyQuil can help. [active ingredients]” said Amin.
