Phenylephrine for colds and allergies don’t work, FDA panel says
58 points by johnkpaul 1 year ago | 38 comments- philipkglass 1 year agoThe ever-excellent Derek Lowe has a deep dive on this from a year ago:
"The Uselessness of Phenylephrine"
https://www.science.org/content/blog-post/uselessness-phenyl...
- AussieWog93 1 year agoTo anyone in Australia, apparently you can still get pseudoephedrine over the counter. You just need to explicitly ask for it (brand name is Codral Original) and provide ID so that the chemist can register the sale.
Expect a visit from the AFP if you start hoarding boxes. :)
- kalupa 1 year agopseudoephedrine is still available over the counter in Canada, too.
Despite pressure from the USA, that fact hasn't changed. I literally just bought cold meds with it as an ingredient just yesterday. Not just limited to "store brand" or "generic" versions, either. Name brand Tylenol or Advil "cold".
- BenjiWiebe 1 year agoIt's available over the counter in the USA, too. You do have to show ID.
- BenjiWiebe 1 year ago
- kalupa 1 year ago
- olliej 1 year agoThis is something literally anyone who was forced into the penylephrine based allergy could tell you. Meanwhile banning an effective drug did nothing to lower meth production.
- hn_throwaway_99 1 year agoWhere is pseudoephedrine actually banned? It's available everywhere I know of in the US, you just have to show ID to get it.
- kadoban 1 year agoNot anywhere in the US as far as I know, but even the requirement of showing ID is ridiculous. What has it accomplished? And how many people got tricked into buying the useless stuff that's 10x easier to purchase?
- Shorel 1 year agoI know it is no longer available in Colombia, prescription or not.
- olliej 1 year agoSorry.
"can no longer be bought without advance planning so that you can get to a pharmacy during open hours and have time to stand in line"
e.g. no real hope if you realize allergy nonsense is happening on the way to or from work
- DontchaKnowit 1 year agoDude just buy in bulk and keep it on you. Thats what I do. 96 25mg quick release tablets costs like 6 dollars at walmart.
- wutwutwat 1 year agoLa la la-la la la,
Sing a happy song
- DontchaKnowit 1 year ago
- kadoban 1 year ago
- hn_throwaway_99 1 year ago
- Wowfunhappy 1 year agoIs "Sudafed PE" different than normal Sudafed? I typically take the latter when I have a cold. If it's a placebo, it's a darn effective one!
Edit: Oh I see, my box of Sudafed has a different active ingredient, "pseudoephedrine".
- BenjiWiebe 1 year agoSudafed / pseudoephedrine is the real stuff, the stuff that works. It's also the stuff that you use to make meth.
- olig15 1 year agoIn the UK ‘Sudafed’ (the brand of decongestants) is available off the shelf, but doesn’t contain pseudoephedrine. There is a different ‘Sudafed’ branded coloured box that you can get from behind the counter by asking someone, that does contain pseudoephedrine.
- bennyelv 1 year agoI find it funny that “things you need to cook meth” are such common knowledge among normal people.
Breaking Bad sure had a deep influence!
- RattlesnakeJake 1 year agoIt's more due to the fact that you can only buy it in tiny amounts "because some people use it to make meth." As far as I know, that restriction predated the show by several years at least.
- RattlesnakeJake 1 year ago
- olig15 1 year ago
- BenjiWiebe 1 year ago
- willcipriano 1 year agoDid big phenylephrine's check not clear this year? Why did the FDA approve it previously if it didn't work?
> These products generated nearly $1.8 billion in sales last year alone
A real mystery.
- _moof 1 year agoJust heard about this on the radio. It works as a nasal spray, and was approved back in the 1970s when medical trials were different than they are now (in some way that the radio show guest, a professor of pharmacy, didn't explain). It doesn't work when taken orally because less than 1% of it survives the trip to your nose, and wouldn't pass trials today for the oral route.
- mikecoles 1 year agoA new, prescription-only, medication is likely coming out.
- _moof 1 year ago
- m463 1 year agothat said, my doctor has told me the pseudoephedrine hcl it replaced doesn't really help your cold or allergy, maybe just your symptoms. I don't know the truth/reality of the matter.
- arthur2e5 1 year agoThe issue with phenylephrine is that it does not help the symptom. Pseudoephedrine does not deal with the underlying immune reactions, but it does constrict your nose blood vessels enough to stop the mucosa from stuffing your nose holes.
Having your nose unclogged is very useful on its own, considering otherwise you'd be forced into mouth-breathing, which would lead to more discomfort and potentially worse outcomes like sleep apnea.
- Modified3019 1 year agoThe problem with blood vessel constriction medicines, is the body tends to very quickly adjust to their presence. Things like “decongestant nose sprays” are known for being traps, they work a few days, and then one needs an ever increasing amount to achieve the effect. And if one stops using them, then they’ll be worse off because their blood vessels will over expand again without the chemical present, resulting in congestion even after the original cause is gone. It then takes time to ween off the effect, during which the exact problems you mention occur. Same thing with “redness eye reliever” found in eye drops.
Basically, you shouldn’t use these sorts of things for more than ~2 days, but that is not well communicated with consumers.
- kalupa 1 year agohaving witnessed this escalation in a family member, it's completely the same description I'd have used. I can't imagine how annoying it was to have a constantly stuffy nose, yet the only relief is ever-increasing nasal spray.
- bradknowles 1 year agoThere are now decongestants you can use where you spray it into one nostril one night, then the other nostril on the next night. And you can keep swapping back and forth without running into these "boomerang" problems.
My wife can take them, but I can't because I have high blood pressure.
The thing about decongestants is that they increase your blood pressure, so those of us who are already hypertensive cannot take them.
- kalupa 1 year ago
- Modified3019 1 year ago
- Wowfunhappy 1 year agoThe symptoms are what I want fixed, thank you very much.
It would be one thing if we were discussing chronic pain or some such, but colds are generally temporary. A drug that can make the cold more pleasant is exactly what I want.
- brianaker 1 year agoThe better you feel, the more likely you are to get better sleep.
Good, restive, sleep helps your body heal from most anything while the reverse, a lack of sleep, will always wreck your health.
There is zero nobility, or reason, for people to suffer through a cold.
- DontchaKnowit 1 year agoPsuedoephedrine is super disruptive to sleep. Its a pretty strong cns stimulant. In fact if you have low tolerance you can get pretty zooted off it.
- DontchaKnowit 1 year ago
- perilunar 1 year agoYes, but if people treat the symptoms then carry on with their normal life, they risk spreading the virus to everyone else. Those "Soldier on with Codral" ads were really messed up.
- brianaker 1 year ago
- viraptor 1 year agoIt is expected to just work on the nose/sinus congestion, so yes, it's for managing symptoms. That's very useful though if it lets you sleep.
- jnsie 1 year agoI have a friend who won't take medication (cold meds and otherwise) because they don't treat the illness "only the symptoms". While I understand the distinction I don't understand the lack of desire to treat the symptoms (assuming the meds aren't themselves damaging)
- danparsonson 1 year agoIn at least some cases, the symptoms are part of the body's attempts to fight the sickness - fever for example, which raises body temperature, making it more hostile to the pathogen.
- kadoban 1 year agoTrue, but I have yet to hear any good reason to have a stuffed nose so bad you can't even function or sleep well. Pretty sure that's just the illness helping itself spread.
I don't take meds for fevers, but first thing I do when I'm getting a cold is make sure I still have a box of pseudoephedrene to use. It turns 90% of colds or flus into just a boring few days instead of abject misery.
The other two essentials IMO are an expectorant and a cough suppressant. All separate meds so you can pick and choose (it's also cheaper typically, the boxes of random mixed crap tend to be stupidly expensive).
- kadoban 1 year ago
- danparsonson 1 year ago
- kalupa 1 year agocold medication has, as far as I've personally seen, never claimed to treat the problem, just relieve the symptoms. The marketing definitely deviates from this, though.
- blacksmith_tb 1 year agoSince most colds are caused by viral infections, and we don't have a lot of anti-viral meds... there isn't much to do but wait for your immune system to figure out how to beat the invaders. But no one ever got rich on "return to the mean".
- blacksmith_tb 1 year ago
- arthur2e5 1 year ago
- randombits0 1 year agoGrammar.
- kalupa 1 year agoyou sure bro
- randombits0 1 year agoPhenylephrine for colds and allergies DOESN’T work.
Yes, I’m sure.
- randombits0 1 year ago
- kalupa 1 year ago