this post was submitted on 24 Dec 2024
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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.

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[–] weariedfae@sh.itjust.works 24 points 3 days ago (1 children)

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.

[–] Rivalarrival@lemmy.today 4 points 3 days ago (1 children)

PPA was better, but they banned it around 2000.

PE pills have never worked for me, but PE nasal spray works great.

[–] pupbiru@aussie.zone 6 points 3 days ago (1 children)

PE pills have never worked for anyone

[–] tedd_deireadh@lemmy.world 1 points 3 days ago (1 children)

They work great for me! Ex-girlfriend swore by them and convinced me to try them years ago. It's been my go to ever since.

[–] placatedmayhem@lemmy.world 6 points 3 days ago (1 children)

You can thank to phenylephrine's placebo effect for your improvements:

https://pubmed.ncbi.nlm.nih.gov/19230461/

Note: Some people do feel better on placebos than on nothing. It's a quark of the human brain. So, if it's working for you, don't switch. Or, maybe try pseudoephedrine and feel even better...

[–] tedd_deireadh@lemmy.world 2 points 2 days ago

Apologies, I misunderstood PE as the initialism for pseudoephedrine. I agree about phenylephrine being ineffective. I never use it.

[–] watson387@sopuli.xyz 80 points 4 days ago* (last edited 4 days ago) (19 children)

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

[–] CrayonRosary@lemmy.world 22 points 4 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.

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[–] Dlayknee@lemmy.world 19 points 3 days ago (1 children)

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

Homeopathic medicine says what?

[–] malibu43@lemmy.world 3 points 3 days ago

I love this video that explains the potency of homeopathic medicine: https://youtu.be/8HslUzw35mc

[–] Jackcooper@lemmy.world 36 points 4 days ago* (last edited 4 days ago) (1 children)

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.world 11 points 4 days ago

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

[–] adarza@lemmy.ca 43 points 4 days ago* (last edited 4 days ago) (1 children)

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 10 points 3 days 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.”

[–] Rivalarrival@lemmy.today 4 points 3 days ago (1 children)

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.

[–] bunkyprewster@lemmy.world 2 points 3 days ago (1 children)

But that nasal decongestant fucks up your nasal mucosa, leading to worse swelling and congestion over time.

[–] Rivalarrival@lemmy.today 3 points 3 days ago (1 children)

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 3 points 3 days 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.

[–] BradleyUffner@lemmy.world 14 points 4 days ago

The stuff that they restricted.

[–] Fades@lemmy.world 3 points 3 days ago

How about you do something about all of the fucking scams then

[–] bluGill@fedia.io 7 points 4 days ago (3 children)

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

[–] Drusas@fedia.io 7 points 3 days ago

You know that you can stay home and take a decongestant.

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 2 points 4 days 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 7 points 4 days ago* (last edited 4 days ago) (2 children)

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.

[–] MelodiousFunk@slrpnk.net 11 points 4 days ago (1 children)

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.

[–] sharkfucker420@lemmy.ml 6 points 4 days ago (1 children)

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

[–] xylogx@lemmy.world 4 points 3 days ago (2 children)

In my experience, it does more harm than good.

[–] sharkfucker420@lemmy.ml 3 points 3 days ago

I've been able to use it when thinfs are really bad for just one or two days but then I have to stop

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[–] Rivalarrival@lemmy.today 2 points 3 days 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.

[–] jagged_circle@feddit.nl 2 points 4 days ago
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