Normally when I daydream about time travel I want to do things like go birdwatching in the Pleistocene.
Today I just want to walk into the nearest Walgreens 30 years or so ago (how long has it been exactly?) and buy some Drixoral.
We used to have decongestants that worked, y'all. Even on my sinuses, which have always been my weak spot. I had resistance to almost everything and then Drixoral came along. One pill and I could breath for 12 hours!
A Decongestant in Cold Medicines Is Ineffective. Here’s What to Use Instead.
Here’s what you can use instead.
Cold season just got trickier.
On Tuesday, an advisory committee to the Food and Drug Administration unanimously said that a popular ingredient found in oral cold and allergy decongestants is ineffective.
The F.D.A. will make its own decision on whether to remove medications containing the ingredient, phenylephrine, which is found in products like Sudafed P.E., NyQuil Severe Cold & Flu and Tylenol Cold & Flu Severe. But in the meantime, and as cold and flu season approaches, consumers will need to weigh their options.
If I take a medicine with phenylephrine, am I at risk?
The advisory committee focused on oral medications that contain phenylephrine; nasal sprays with phenylephrine are still considered effective. If you have oral medications with the ingredient, they are not necessarily harmful at their recommended doses, and some may contain other ingredients that can be helpful.
“It’s not a safety issue. It’s an effectiveness issue,” said Dr. Mark Dykewicz, an allergist and immunologist at Saint Louis University School of Medicine.
But you still may want to look for alternatives. “Me, personally, I wouldn’t want myself or my kid to take anything that’s unnecessary and that’s demonstrated ineffective,” said Jennifer Le, a member of the advisory committee and a professor of clinical pharmacy with the Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of California, San Diego.
If I want to relieve congestion, what ingredients should I look for instead?
Pseudoephedrine, which is found in behind-the-counter products like Sudafed, is effective at clearing congestion, Dr. Dykewicz said; just keep in mind that it can come with side effects. Some people taking the medication report trouble sleeping, feeling jittery or elevated blood pressure, he said.
Nasal decongestant sprays like Afrin or those that contain phenylephrine can also offer relief, Dr. Dykewicz said — but you shouldn’t use them for longer than three to five days. After that, you run the risk of rebound congestion: when the mucosal surfaces in your nose swell, making you feel even more clogged up than before. There are some sprays that you can use for longer stretches, without the rebound risk, namely steroid sprays that contain ingredients like fluticasone (Flonase) or triamcinolone (Nasacort), which are available over-the-counter.
If allergies are the source of your congestion, oral antihistamines like Zyrtec, Claritin or Allegra might help. You can pinpoint whether your stuffy nose comes from allergies or a viral infection, like the cold and flu, by paying attention to other symptoms, said Dr. Mark Aronica, an allergy and immunology specialist at the Cleveland Clinic. If you also have a sore throat, fever or body aches, it’s likely something other than allergies.
Can I treat congestion without medication?
In many cases, you can treat a stuffed-up nose by standing in a steamy shower or using a humidifier to help clear your nasal passages, Dr. Le said. A nasal saline spray can also help clear out irritants and mucus trapped in the nose, said Dr. Andrew Lane, director of the Johns Hopkins Sinus Center.
“You can’t do too much saline,” Dr. Lane said.
Neti pots are another useful tool to irrigate your sinuses, Dr. Aronica said, although you should be careful to use sterile or distilled water.
But if congestion is interfering with your ability to get through the day, or if you find yourself suffering for multiple days on end, you may want to seek out other options, Dr. Le suggested.
Will cold medicines containing phenylephrine be off the shelves soon?
The F.D.A. has not issued a final decision, and it could be some time before the agency announces whether it will pull medications that have phenylephrine. “The process will take a lot,” Dr. Le said.
The Uselessness of Phenylephrine 30 MAR 2022 BY DEREK LOWE
Why is oral phenylephrine so useless? It is extensively metabolized, starting in the gut wall. You can find a bioavailability figure of 38% in the literature, but that appears to be the most optimistic number possible, and you can also find studies that show 1% or less. Overall, the Cmax is highly variable patient-to-patient, and the lack of cardiovascular effects at low doses argues for very low systemic effects (and expected low efficacy as a decongestant). The bioavailability increases at higher doses as you apparently saturate out some of the metabolic pathways, but at the 10mg dose typically used for decongestants, you can forget it.
But here in the US, if you go to the drugstore and purchase an over-the-counter nasal decongestant (as a single agent or a combination of drugs that includes a decongestant), you will in every single case be buying phenylephrine. Which does not work. It is found (according to the paper linked above) in 261 different OTC products, and it is a useless bait-and-switch on the consumer in every one of them. I have always told friends and family members to avoid these products if at all possible, and to go back to the pharmacy counter to get something that actually works. This situation obtains, of course, because as mentioned above you can make methamphetamine from pseudoephedrine. There are a number of synthetic procedures for doing this, some of them quite alarming, and several of which can indeed be performed in the barn, garage, basement, or trailer park of your choice - if you can get enough pseudoephedrine. Thus the move to put medications containing this behind the pharmacy counter, with limits on their sale. No more walking in with a duffel bag and buying every single Sudafed package in the store.
But it's quite possible that that era is gone anyway. The Mexican drug cartels have apparently been putting some real effort into process improvements and economies of scale, and I am told that the drug is (sadly) cheaper than it's ever been and available in higher purity than all but the most dedicated basement lab would be able to provide. As that article details, this includes an interesting and concerning increase in the compound's enantiomeric purity over the years. Whatever the current synthesis is - and you can be sure that the DEA knows the details, even if they are understandably not going into them in public - it is strongly skewed towards the more pharmacologically desirable D-methamphetamine. All this means that even if pseudoephedrine were more freely available, it might not be as much of an illegal article of commerce as it was twenty years ago.
But be that as it may: the fact remains that its alleged replacement, phenylephrine, is of no real use and does not deserve its FDA listing. There's no reason to think that it's a safer compound than pseudoephedrine or one with fewer side effects - if you can get enough of it into your blood, you'll probaby have a rather similar profile. The only reason it's sold is to have some alternative to offer consumers, even if it's a worthless one. There have been several attempts over the years to do something about this (here's an earlier one from the authors of the current paper), but absolutely nothing has happened. Perhaps the agency does not wish to be put in the position of having nothing available than can be put out on the open shelves, and perhaps the pharmacies themselves prefer things as they are as well. It's for sure that the companies producing phenylephrine-containing products like the current situation a lot better than the alternative. But for people who actually want to be able to breath for a while as we enter allergy season, wouldn't it be better just to stop pretending and to stop wasting everyone's time and money?
Your understanding of over-the-Counter allergy medication matters when you offen have trouble dealling allergy symptoms.
You’re having trouble with allergy symptoms, then you look forward to getting relieved from Over-the-Counter allergy medication. Once those allergy medications were the only prescription ones, now they are as easy as getting aspirin.
6 Easy Home Remedies That Can Help You Get Rid Of Your Stuffy Nose
6 Easy Home Remedies That Can Help You Get Rid Of Your Stuffy Nose
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Not being able to smell or breathe properly can be extremely frustrating. A person with a stuffy nose would not only be unable to enjoy their food but would also complain of interrupted sleep. While some people take medicines to get rid of the stuffiness, others prefer trying some home remedies first. Here are a few home remedies that can help you deal with your stuffy nose and give you…
Hey friends, as promised here's the recipe for Stefanie' s cold season rub. She credits @herbalistkareem8 youtube's channel for this magical concoction. Ingredients: 100% Essential oil of Oregano 100% Tea Tree Essential Oil 100% Eucalyptus Oil 100% Peppermint Oil Organic Coconut Oil (or any other carrier oil of your choosing) Instructions: The rule of thumb when diluting essential oils (EO) is 12 drops EO to 1 oz carrier oil (CO). Now you may like yours a bit stronger. So you can add more of each essential oil in equal amounts if you'd like a stronger mix. Combine by mixing until you get a uniform texture as shown in the video (provided by Stefanie). Take some in your hands, and rub together to warm the oils and then rub it on the chest, back, under the arms, back of the neck behind the ears, and feet (cover with socks so you don't slip and fall 😊). When applying, rub in a circular motion and enjoy. You'll immediately feel your sinuses open up. This does help to clear up congestion. Stefanie uses it preventatively to ward off the common cold. If you try this recipe, let us know what tweaks you've made and how you liked it. Thanks Stef and @herbalistkareem8! 😍 #commoncoldhacks #prevention #coldseasonrubs #decongestants #CHAIBeauty #CHAIhealth Come back tomorrow, we'll share more great info! Share the love and Invite your friends to like our page! Be healthy and well! ❤Kerry❤ https://www.instagram.com/p/BuWjm1GhkWT/?utm_source=ig_tumblr_share&igshid=17d4mxgp7f1qn
“Do Not Use This Product” Warnings on Decongestants: Which are Safe for A-Fib Patients
“Do Not Use This Product” Warnings on Decongestants: Which are Safe for A-Fib Patients
by Steve Ryan
First published Dec. 2017. [lastupdated format=”F j, Y”]
It’s cough and cold season and millions of cold sufferers are reaching for an over-the-counter (OTC) decongestant capsule or nasal spray to clear a stuffy nose.
As an A-Fib patient, did you notice these over-the-counter decongestants often contain a warning such as:
“Do not use this product if you have heart disease, high blood…
