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FDA says decongestant in many cold medicines doesn't work. So what does? (apnews.com)

submitted 3 days ago* (last edited 3 days ago) by [email protected] to c/[email protected]

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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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[–] [email protected] 4 points 2 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.

[–] [email protected] 2 points 2 days ago (1 children)

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

[–] [email protected] 3 points 2 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.

[–] [email protected] 3 points 2 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.