A committee advising the U.S. Food and Drug Administration found in September that phenylephrine, a popular decongestant ingredient, is not actually effective at decongesting or “unclogging” the nose when taken orally. discovered.
Phenylephrine has no safety issues, and the FDA itself has not yet issued new rules regarding its ingredients or how it is marketed. It’s in many popular medications, including some His NyQuil, Mucinex and other well-known store brand oral medications, but they contain more than just phenylephrine that may relieve symptoms. Contains other ingredients.
Prior to the public agency’s action, CVS last month withdrew a “small number” of medications containing phenylephrine. only Active ingredients (think Sudafed PE). The company said it “will continue to offer many other oral cough and cold products to meet consumer needs.”
Many people use over-the-counter nasal decongestants to treat mild viral symptoms or seasonal allergies. This facilitates first-line treatment. And according to Dr. Jeffrey Rutledge, chief medical officer and co-founder of the telemedicine site, health tapHaving options when you feel miserable can be one of the most important parts of your treatment.
But you don’t have to settle for just one option.
“As a practicing physician, I have never recommended the use of phenylephrine products to my patients,” he said. Instead, they tell the patients behind the counter to prescribe pseudoephedrine, a more effective nasal decongestant, or other medications if the nasal congestion is caused by allergies.
Medications containing phenylephrine often contain other active ingredients, so don’t throw away your medicine just yet. Here’s what you need to know about finding a nasal decongestant for cold, flu and virus season.
What is phenylephrine?
Phenylephrine is a decongestant that works by restricting blood vessels in the nose. It is found in common medications such as Sudafed PE (not regular Sudafed), Theraflu, Tylenol Sinus, Advil Congestion, and NyQuil severe cold and flu products. These are medications that don’t require a prescription and are easily available over the counter and are usually intended to treat nasal congestion as well as other symptoms of colds and flu.
Phenylephrine’s more effective cousin: pseudoephedrine
There’s another oral nasal decongestant that works similarly, pseudoephedrine, which studies have shown for some time to be more effective than phenylephrine, says pharmacist and pharmacy editor Dr. Stacia Woodcock. . Good R.
“The idea that phenylephrine doesn’t work is not new to most medical professionals,” Woodcock said in an email. “Pseudoephedrine (Sudafed) has been clearly the superior nasal decongestant for quite some time.”
However, pseudoephedrine face more restrictions Because it is also the main ingredient used in the production of methamphetamine. This means that Sudafed PE containing phenylephrine is available over the counter, but to purchase regular Sudafed PE containing pseudoephedrine you will likely need to ask a pharmacist and show identification. Masu. There is also a limit to the quantity that can be purchased at one time. (Another name for pseudoephedrine The drug contains a 12-hour chilled maximum strength. )
As a result of the restrictions on pseudoephedrine, “most cough and cold medicine manufacturers turned to phenylephrine to replace pseudoephedrine in their OTC products,” Woodcock said. “This allows you to make purchases even when your pharmacy is closed, you have reached your monthly limit for pseudoephedrine products, or you do not have the necessary identification to make a purchase.”
Pseudoephedrine is considered safe for most adults when taken as directed, but it also constricts blood vessels and acts like a stimulant. It is recommended that you consult your doctor before taking nasal decongestants (especially pseudoephedrine) in the following cases: have a certain health condition For example, if you have high blood pressure, heart problems, glaucoma, diabetes, or are pregnant or breastfeeding. Certain antidepressants, monoamine oxidase inhibitors (MAOIs), may also interact with pseudoephedrine and phenylephrine.
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Sudafed PE is a drug containing phenylephrine that can be obtained without consulting a pharmacist. (“PE” stands for phenylephrine.) Regular Sudafed contains pseudoephedrine, which Rutledge says is the best choice if you’re looking for an effective nasal decongestant. However, you should consult your pharmacist.
Sudafed is just one of many brand names for medications containing phenylephrine.
don’t throw medicine
Oral nasal decongestants containing phenylephrine have been on the market for decades.And according to research information According to a report compiled by the Consumer Healthcare Products Association for an FDA meeting, many people say they are satisfied with products containing phenylephrine and find benefits.
Woodcock and Rutledge said if you want to use a product containing phenylephrine or feel it helps, it’s okay to continue using it. Especially since you’re likely still benefiting from the other ingredients in the drug. Nyquil contains phenylephrine, which relieves nasal congestion; Contains ingredients Reducing fever and pain and suppressing cough can reduce symptoms and provide relief during the worst stages of illness. The same is true for other drugs containing phenylephrine.
Beyond the effectiveness of other ingredients, Rutledge says, don’t overlook the fact that people who are hoping for symptom relief from a drug are more likely to get that effect. He called this dynamic duo effect on phenylephrine “the power of the placebo and the power of the other ingredients.”
The FDA committee considered evidence suggesting that phenylephrine itself is equivalent to a placebo, a “dummy” drug used to test the effectiveness of something. But there are many facets to the placebo effect, Rutledge says.
“It has been shown time and time again that if you believe something works, there is a subjectively measurable benefit,” he points out, adding that if patients believe what their doctors say, It added that outcomes and treatment follow-through were better.
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Alternatives to oral nasal decongestants
nasal spray Contains phenylephrine According to Woodcock, these are still considered effective decongestants because they go directly to the source of congestion and are well absorbed by the body. May also include oxymetazoline. But nasal sprays come with a “huge caveat,” she says.you can If you don’t use the spray for just a few days, you risk “rebound nasal congestion”“It’s difficult to get rid of and can last up to a year.
And if you want an effective oral decongestant, ask for pseudoephedrine, Rutledge said.general side effects This may include trembling and restlessness.
If your nasal congestion is caused by allergies, Rutledge says you may need to target your symptoms a little differently. Nasal inhaled steroids like Flonase “actually block the immune response in the nose rather than treating the symptoms, making them suitable for long-term use in allergy patients,” he said.
Antihistamines are also used by people with allergies, but it’s important to know that antihistamines are not medicines to clear nasal congestion, Rutledge said. They work by blocking the effects of histamine, which the body releases in response to allergies. That’s why one simple test to determine if you have an allergy or virus is to see if your symptoms improve when you take an antihistamine.
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