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.
