Here's the latest FDA POWER GRAB OVER YOUR DRUGSTORE:
Americans have been wasting billions a year on cold medicines like Sudafed & Benadryl with the active ingredient phenylephrine, despite conclusive evidence they don't work. But a report published yesterday may finally lead to the removal of these drugs from pharmacy shelves. 1/6 pic.twitter.com/eCv7UlR1dZ
— John Arnold (@JohnArnoldFndtn) September 8, 2023
Ahem. Sorry about that. What I meant to say is that the FDA is close to removing a drug for sale that has been shown in multiple studies to be worthless as a nasal decongestant. Here's a typical result from one of the studies, showing no difference between the drug and a placebo:
This whole episode is an unfortunate side effect of the meth panic from the early aughts. You see, the drugs at issue use phenylephrine as their active ingredient. But why use a worthless ingredient? Because the ingredient that works, pseudoephedrine, can be used in meth labs and was put behind locked pharmacy shelves many years ago. This was enough to significantly reduce (legitimate) consumer demand, so pharma companies shrugged and switched to phenylephrine products that could be put out on open shelves for everyone to see and buy. In 2022, worthless phenylephrine products sold at 5x the rate of pseudoephedrine products that actually work but are a little harder to buy.
By the way, one thing that's interesting is that every one of the recent studies shows that phenylephrine actually does have a positive effect. But so does a sugar pill. The power of taking a pill, any pill, is remarkable. But what the FDA cares about is whether phenylephrine is any better than a sugar pill, and sadly it's not.
So that's the end of the road for phenylephrine unless (a) the FDA caves in to corporate lobbying, or (b) Donald Trump convinces his army of fans that this is yet another example of Deep State corruption erasing your rights—and the FDA caves in to that. Stay tuned.
Tee hee, I use to use these, way back when I was scuba diving and no longer. I guess there was a good reason. There is nothing in them to decongest anything.
The topical decongestant oxymetazoline hydrochloride (originally available only in Afrin but now generic) is very effective temporary relief for nasal congestion. Don't assume that there are no popular OTC medications for congestion.
Pseudoephedrine is still over the counter; it's just a different counter.
Over a counter where one has to register as a possible meth maker…
It’s the counter where the clerk looks at you suspiciously and acts as though you are a criminal. Unless you go to Costco where they ask if you want one or two packs.
Some guys never get over buying their first pack of condoms.
And the amount you're allowed to buy without getting a prescription is limited.
It probably varies by state, but in my state I can only buy one package of 20 12-hour tablets per month, and I have to show ID and sign something.
The annoying thing is that it is hard to tell when the month is up (they don't go by calendar month) and if you are really sick one pack a month is not enough. You can also ask your doctor to prescribe it which will get around the limit.
I find it very hard to believe that there is one ounce less of crystal meth on the street because of these rules.
Where I live, they also substantially reduced the quantity you can buy, effectively tripling the price.
Yeah, the only problem with oxymetazoline is that you can't use it for more than 3 days at a stretch or you're running the risk that your nose gets completely addicted to it. And if that happens you may be congested whenever you aren't using the stuff. Which means either you take it until your septum rots away, or you're condemned to a life of misery.
Yeah, but the rebound effect leaves you worse off when it wears off. So you use it again, and end up with nasal linings swelled shut.
When phenylepherine was first offered as a replacement for pseudoephederine, I tried it, and discovered that it didn't work for me.
Big chain drug stores now put homeopathic "remedies" and "herbal" "supplements" right next to the FDA-approved OTC medications. So selling products that can't be shown to provide the benefits promised is now just part of the American Way.
I'm curious whether or not the marketing was effective: was there sufficient uptick in phenylephrine sales to compensate the loss of pseudoephedrine sales? I know that I never bought any of the newfangled phenylephrine products, having tried some years ago and already knowing that they wouldn't work.
I’m guessing most people didn’t realize there was a change. They were just buying Sudafed.
Yep, I got handed some of these several times and still felt like I was drowning,
It's about time Sudafed PE is worthless and a waste of money and it's so annoying to have to go to the pharmacist to get the real thing.
Back in the day me and my fellow allergy sufferers waiting on the Man used to joke that crank was getting harder to buy on accounta it being a key ingredient in the synthesis of pseudoephedrine.
Still don't know why my allergies got so much worse when I moved from Columbia, MO to Chicago, IL. You'd a thunk they would have gotten better ...
This is the moment for DJ Harangutang to step up and unclog America.
Think of the branding opportunity!
Some kind of snorting powder to Make America Blow Again.
Drain the Swamp!
A nasal douche with his face on it.
I want my Drixoral back!
The graph shows improvement with a placebo pill, but what about no treatment at all? I think that for episodic congestion natural improvement would be expected sooner or later from the time that medication would be used, presumably a fairly intense state of congestion.
In other words for episodic phenomena at least part of placebo effects is probably just due to normal remission, not some actual influence from the placebo.
You're ignoring that the placebo effect has long been known to be physiologically real, i.e. you have objectively measurable improvements.
I always take care to buy the real stuff. But some people aren't "in the know" or don't read the label...
Living with chronic sinus issues for over 45 years, I have tried almost all prescription and OTC remedies. Drixoral was a top shelf, time release tablet loaded with real Sudafed and and an antihistamine. As always, you adjusted to the antihistamine and it became less sleep inducing and less effective over time.
While ENT's generally don't want you to take antihistamines or decongestants, I find it they are still effective if taken intermittently. These folks also tell you not to put a Q-tip in your ear, but most of us don't listen to them.
FYI, Benadryl is not an decongestant, but an antihistamine. For a bad sinus headache, real Sudafed works and so does Benadryl, if Sudafed keeps you up at night.
Also take Sudafed before dental procedures, so I have a fighting chance at breathing. Do need to remind my dentist/oral surgeon that breathing is really not optional.
They can take my Sudafed and Benadryl out of my cold dead hand.
Don't tell them that's an option.
Thanks for pointing out that Benadryl is an antihistamine.Very different in effects than a "decongestant"...
Hmmm, I use Advil Sinus occasionally for headaches and sinus pain from allergies. It works well for me. I use it sparingly because it supposedly raises blood pressure. It might not work for really severe congestion but for swelled sinuses it works fine.
The ibuprofen acts as a pain reliever even if the decongestant element is useless.
This must be the Biden FDA. It's weird when a government agency does its job rather than what corporate lobbyists tell it to do. A lot of people are too young to have ever seen this happen.
As much as I wish he were still with us (and writing great stuff), I'm still annoyed with Mark Kleiman for his role in getting Sudafed pseudo-regulated.
I eat a lot of it, I have chronic sinus trouble. Now I have to put it on my calendar when I can buy more.
I never understood why that seemed like a good idea, other than the "...and this is something" one. Forcing production to Mexico didn't even stop meth kitchen explosions here - we still have idiot tweakers trying to make it domestically, too.
But hey - another jobs program dedicated to making the world slightly worse that people can pretend serves a purpose, I guess.
Kleiman wasn't one of the ones pushing the requirement that pseudoephedrine be available only through a pharmacist. I exchanged emails with him on the subject, both at the time and several years later. Here is what he was writing at the time:
Offhand, I'm not sure what to do about meth. It's a hard enforcement target because, unlike crack, it's typically bought in large multiples of the dose size, so transactions are relatively infrequent. Making pseudoephedrine harder to acquire might have helped slow the geographic spread of the problem, since sudafed is the precursor used in the home "meth labs" that are often the first sources of the drug in a new community. Even today, denying sudafed to the home cookers would have some environmental benefits. But it's hard to imagine that the Mexican drug gangs won't figure out a way to fill any gap in supply created by putting the home labs out of business. Expanding treatment supply where it's scarce compared to treatment demand is certainly worthwhile, but lots of people who need meth treatment aren't actually demanding it. Once meth users hit the criminal justice system, we can try to coerce them into treatment, but in fact probation departments aren't very effective in getting their clients to comply with treatment orders.
https://www.huffpost.com/entry/debunking-the-debunking-t_b_23029
So, how did it get approved in the first place? …
Remember Vix VapoRub? Good times.
But it's non-drowsy!!!
So--short cut to approval because of meth???
Reminds me of a problem awhile back with a night time cold relief medicine--drink this and you get rid of cough, congestion and pain--except it was using a topical decongestant, and people weren't snorting it.
Instead of the meth, we got them rednecks hooked on oxy! Hilarious. Much better result.
Actually, some states required prescriptions. Oregon reverted this law in 2022, so now it's OTC again but not perfectly OTC accessed.
Okay, phenylephrine isn't any good. But what about hydroxychloroquine? Maybe that would work. Or how about shoving ivermectin up your nose? As Trump said, "What have you got to lose?"
An aside:
I strongly believe one thing most doctors got wrong when they claimed vitamin D was curative or at least supportive, was that the vast majority of older people have a severe vitamin D deficiency.
And B12. And magnesium. And likely several other minerals. Full vitamin, mineral, hormone, and thyroid testing (not just TSH) every 5 years should become an AMA standard. Probably several other things as well. To test for deficiencies, toxins, and common parasites, viruses, and conditions. At this point in history waiting until things are emergent or critical is foolish & cruel. oops, I forgot that maximizing corporate profits is the highest objective of all life on the planet.