FDA says common over the counter decongestant phenylephrine does not work in oral form

dantheclamman@lemmy.world to News@lemmy.world – 374 points –
FDA panel says common over-the-counter decongestant doesn’t work
nbcnews.com
94

I think allergy suffers already have known this for years... The stuff that works is locked up because it can be used to make meth...

Yes, it's pseudoephedrine that you want. Somewhat ironic that Sudafed got its brandname from it, but you can't easily get the original version anymore.

Edited: corrected for availibility of the Sudafed - thanks Blue and Cubby.

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A frustrating outcome. I used to buy 14 day packs of allergy meds and sometimes didn’t qualify to buy more two or even four days after I ran out. I don’t know what aspect of their restrictions allow this to happen, but it’s bullshit. Also, good luck if you’re going overseas for a month and need a full supply. I believe a doc can prescribe a larger supply, but I shouldn’t have to pay more money and time for a doc appointment to get that.

One thing I've realized about US healthcare is that it would rather restrict meds from those that need them than to give access to those that would abuse it.

That's definitely what they've done with opioids. You could have your bone sticking out of your arm and they'd call you a drug addict for being surprised when they give you a motrin.

Any backyard chemsit can make meth if they are skilled enough

Nile Red likely has the capability of doing that

Nile Red is more than a backyard chemist lol he has a lab

Probably in the minority here but I didn't know that Benadryl straight up doesn't work as a decongestant. It knocks me the fuck out though, so I wonder if it's effective at making you drowsy as shit and not much else.

The person you replied to was talking about pseudoephedrine, which is marketed as a decongestant. And boy does it get the job done.

Benedryl (diphenhydramine), on the other hand, is an anti-histimine and it absolutely works for allergic reactions. That said, it's also marketed as a sleep aid (take a look at the active chemical in things like "ZZZQuil" or drug store brand "sleep aid," and compare it to the one in Benedryl. Same chemical), and believe me, it works very well for that.

I dunno if I would use it as a decongestant.

Yep I mixed up the ingredients lists. I don't know if I've ever even tried sudafed PE.

Benadryl is one of the stronger sedatives, prescription or not, if I recall correctly (CPhT, lapsed)

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Representatives for the Consumer Healthcare Products Association, a group that represents OTC drug manufacturers, did not offer any new evidence to counter the FDA’s claims that the drug is ineffective during their presentation Monday.

The group instead said that if oral phenylephrine were not available over the counter, it would be a significant burden to consumers.

But it doesn't work! Consumers are literally using something that's no better than the naturopathic bullshit found in the next aisle over!

MAN I hate corporate lobbyists. Outright lying to try and save face.

“It is difficult to get a man to understand something, when his salary depends on his not understanding it.” -Upton Sinclair

It's because the DEA restricted pseudoephedrine, which does work. Duck the war on drugs

Yes, I NEED this shit like 2-3 months of the year due to a severe winter cedar allergy. I can barely function without a strong decongestant and having to show my ID and jump through hoops at the pharmacy to get it instead of just grabbing some off a shelf is so frustrating.

Lol, thinking that the naturopathic shit isnt sitting on the same shelves with almost identical packaging to real medicine.

it would be a significant burden to consumers our share prices

Burden to consumers = burden to our profits for selling useless bullshit

No shit. The fun part is it DOES have side effects. So it doesn't do what it's proclaimed to do, but is a drug. It should be pulled off the shelves.

Super interestingly, in clinical trials it is less effective than the placebo.

Pseudoephedrine definitely works though right?

Yeah man you gotta go to the counter and sign a log book to get the good stuff, thanks methheads. Don't fall for the PE version on the shelves, that's a noob trap.

Yes. I have a few months a year where I have to get some type of decongestant and the most cost effective is generic Pseudoephedrine. It works. My mother bought me phenylephrine a few times when I was younger and it just didn't do anything. Not surprised about this article one bit.

I graduated pharmacy school 8 years ago. This was a thing that was taught in school. This is why you should talk to your pharmacist. Guaifenisin is another 'garbage drug' that does virtually nothing; just drink more water

Guaifenisin seems to clear my chest congestion up pretty quickly. If I'm placeboing myself, then lalalala I'm not listening.

omg are you serious? I always felt like sudafed PE didn't do much but I thought mucinex helped a bunch with sinus congestion. now I'm here not sure if anything is real.

Edit for those interested: "extended-release guaifenesin was found to have no effect on all 3 patient-related outcome markers analyzed as measured by the Daily Cough and Phlegm Diary, Spontaneous Symptom Severity Assessment score, and the Wisconsin Upper Respiratory Symptom Survey."

Edit again with more: "The greatest effects of treatment with guaifenesin/pseudoephedrine were observed for nasal congestion and sinus headache. Time to overall relief was shorter with guaifenesin/pseudoephedrine (P = 0.038). Significantly more patients reported “the medication was helping during the day” on Day 2 with guaifenesin/pseudoephedrine (P = 0.002). Patient assessments of symptom relief showed a significant preference for guaifenesin/pseudoephedrine versus placebo"

I'm with the others. Guaifenisin seems to work pretty well. Even on it's own. And I'm a major skeptic.

Not as well as pseudoephedrine or ibuprofen or acetaminophen, but it's definitely better than dextromethorphan.

I can't even pretend to believe that last one does anything. Well, I think idiots use it to get high in a scary way.

Guaifenisin is definitely not a garbage drug, it's very effective for me in ways that prove it works.

what does it do? I honestly dont know, I havent looked it up.

just to say, you taking it and believing it has an effect is not proof. large, well regulated, double blind studies are proof.

if you take it and it does something for you thats good and all you need to know, but it aint proof.

thats reaaaal similar to people who took Ivermectin when they had covid who recovered from covid and say "thats proof Ivermectin cures covid"

It thins out mucus. The fact that it works very well for me is absolutely proof that it works. I started taking it on recommendation from my doctor. Please explain to me how this is at all analagous to people taking horse ivermectin after doctors denied giving them a prescription?

Edit to add: guaifenisin is the main ingredient in Mucinex, to those who aren't familiar

lots of doctors gave, and are still giving out ivermeticin on prescription. just the ones who ignore the clinical evidence.

look I'm not saying it doesnt seem to work for you. I'm saying one person taking any med and seeing results is not "proof", other than for yourself, but thats really all you need to worry about so it doesnt matter.

Guaifenisin aka Mucinex is an FDA approved drug. Maybe you should look it up since you clearly don't know anything about it? Or just take the word of a stranger on the Internet who says they went to pharmacy school eight years ago

hey, I wasnt taking anyone's word for anything. I was only saying one person's experience isn't proof, and I stand by that.

I do owe you an apology though, it was late at night and I misunderstood- I confused guaifenisin with phenylephrine, so we were talking about different things which was totally my fault

I take guaifenisn to combat dry sinuses, and it's helpful there for me. But I'm not sure I've seen a difference in on-label use.

Unfortunately I deal with frequent nosebleeds and sinus headaches from dryness, and there aren't a lot of options that work well for me

It’s crazy that enough people think this crap works that it’s a billion dollar industry…

I’m near certain that the companies that sell this useless crap are quite aware of how useless it is.

Placebo effect is a real thing. Plus, if it just clears up a bit on its own, you might contribute it to the medicine.

My NP told me to avoid this stuff and just hand over my Photo ID at the back to get the real pseudoephedrine.

Yup, the good stuff is always that 20mg-30mg psedoephedraline they give you the third degree over buying. Worth it.

I keep both the 4 hour and the 12 hour time-released versions at home. There's no substitute. I'll gladly spend a few extra minutes at the pharmacy counter to obtain it.

not a huge fan of the 12 hour ones, but take them myself at times. Still, it just seems, at least to me that the 4 hour doses just work better.

Maybe I'm a lightweight, but pseudoephedrine makes me feel weird. I can't put my finger on it, but maybe a bit jittery and kind of cold. Also hyper - like I'll want to do chores when I take it

Works better than anything else for my colds, but it also makes me feel odd so I avoid it unless I'm feeling super trash.

It's basically watered down meth. It's no joke! That said, it doesn't make me feel bad at all but everyone's different and it is a powerful drug.

You know what's weird? I get severe sinus headaches and regular pseudoenepherine sudafed doesn't help at all, but these phelylephrine ones do. I'll even tell my wife "the little reds, not the whites". Weird.

Have you tried a migraine formulation for that? It sounds like you're actually benefiting from the systemic effects (vasoconstriction) instead of the reduced mucous production. A formulation would include caffeine that also has vasoconstriction in case this is removed from the market.

The real pseudoephedrines are also little red pills, at least where I am on the US East Coast.

Weird, here in my area of California the OTC ones are the reds, you have to go to the pharmacist for the white ones.

In my area both are red unless you get the 12-hour controlled-release caplets, those are white. It's probably just different factories.

It depends on the dosage. The 4hr pseudoephedrine are red. The 12hr are white.

I forget but wasn't it also advertised to have a painkilling effect? Maybe the thing it's doing for you isn't the decongestant but that?

In my area the red ones are the pseudophedrine ones. Never seen the white ones, I just go to the counter because I am not making meth.

The power of placebo! It's the nicest part about placebo too. The more you believe it the more your body does too.

I actually doubt that. Phenylephrine does have systemic effects that might be beneficial for migraines. That's not what it was decided to not be effective in with the FDA and not what folks generally use it for. Pseudoephedrine isn't really that effective for migraines itself.

Nah, the drug is still a bio-active drug. It DOES do things, just doesn't help most with the prescribed symptoms because its mechanism of effect is different.

No.... You just spend more money on things that don't work while convincing yourself that it does.

When I had COVID and got really severe congestion, it was some of the worst sinus pain I've ever had in my life. I was at the point where I was trying to use a baby nasal bulb to relieve some pressure. The phenylephrine helped me a lot more than any other medication I was trying, including nasal sprays. I also take other sinus medications though, so I wonder if it's a case of a medication not working well unless it's used in conjunction with other things?

I guess it's possible I experienced a placebo effect, but it seems weird it would do it when nothing else was.

This is not new news, in original studies it never outperformed placebo and has cardiovascular health risks. It's simply never worked, it's not a secret, it's just preferred by governments that your access to pseudoephedrine is limited so this was rushed onto shelves

I could have guessed that. Pseudophedrine works great. You just have to ask for it behind the counter because of the whole meth thing.

I got two sinus infections back to back this year and got to learn it the hard way. The doctor was like: "No, you gotta get the REAL stuff!"

This explains why this weekend taking this shit did nothing at all for me

I'm with you that it doesn't work.

Pseudoephedrine, however, does work.

Just sign your live away and get the real stuff.

Yeah they said it like decades ago. Theres never been evidence it works.

Not sure why the Lemmy headline says "pill form" -- the article says "oral form" does not work.

So if you're reading this and wondering about pill vs liquid, then you're missing the actual message.

And in other news water is just dihydrogen monoxide

Um, I've heard that's actually wrong

Hydroxic acid actually sounds worse and completely not like plain water at all. I'm going to start using that one...

It's not really accurate though because it's not an acid. Something like hydrogen hydroxide might be better because it implies it's a base without outright saying it. Though hydroxic acid does still sound worse.

Does chemistry have a naming convention for something that should be there but isn't? If so, you could add a bunch of scary sounding elements to it, like a chemical name for leadless lead water.

I rely on pharmaceuticals for multiple problems, and they are very effective, but my god we are being scammed by pharmaceutical companies in so many ways.

It works to make meth.

Which is probably what most of it is used for.

edit: My mistake. Thanks for the corrections.

They’re talking about the stuff on the shelf, not the good stuff that’s locked up because it actually works.

Yeah, someone else also corrected me.

Thanks though, it was a throw away comment anyway.

Wrong one.

pseudoephedrine is the meth-making one, and usually the one you now have to ask a pharmacist for.

Phenylephrine is the one they used to replace it, which many people knew didn't work and complained about it.

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