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 1 day 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 1 day 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 1 day ago (1 children)

PE pills have never worked for anyone

[–] tedd_deireadh@lemmy.world 1 points 1 day 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 1 day 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 1 points 5 hours ago

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

[–] Dlayknee@lemmy.world 20 points 1 day 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 1 day ago

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

[–] Jackcooper@lemmy.world 36 points 2 days ago* (last edited 2 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 2 days ago

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

[–] Rivalarrival@lemmy.today 4 points 1 day 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 1 day 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 1 day 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 1 day 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.

[–] watson387@sopuli.xyz 80 points 2 days ago* (last edited 2 days ago) (15 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 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.

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[–] adarza@lemmy.ca 43 points 2 days ago* (last edited 2 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 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.”

[–] Fades@lemmy.world 3 points 1 day ago

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

[–] sunzu2@thebrainbin.org 15 points 2 days ago (1 children)

Drugmakers are expected to challenge the proposal.

But has anyone thought about the corporations?

[–] homesweethomeMrL@lemmy.world 8 points 2 days ago

Yeah, that one guy did.

[–] BradleyUffner@lemmy.world 14 points 2 days ago

The stuff that they restricted.

[–] jagged_circle@feddit.nl 2 points 1 day ago
[–] bluGill@fedia.io 7 points 2 days ago (3 children)

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

[–] Drusas@fedia.io 7 points 1 day 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 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 7 points 2 days ago* (last edited 2 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.

[–] Rivalarrival@lemmy.today 2 points 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 11 points 2 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 2 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 1 day ago (2 children)

In my experience, it does more harm than good.

[–] sharkfucker420@lemmy.ml 3 points 1 day 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

[–] Rivalarrival@lemmy.today 1 points 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.

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