5 ms·

I feel like anyone who has tried a PE drug knew they didn’t work. I’ve wondered for a solid decade why they existed. I’ll happily wait in the tweaker line for m

I feel like anyone who has tried a PE drug knew they didn’t work. I’ve wondered for a solid decade why they existed. I’ll happily wait in the tweaker line for my pseudo.

prmph 3y ago
They hitched a profitable ride on the placebo effect bandwagon
Scubabear68 3y ago
It literally did nothing at all. Before I started using Flonase for my congestion, real Sudafed was the only thing that would work when I had to fly. If I forgot, take off and landing would be miserable because my ears wouldn’t pop.
- hunter2_ 3y ago
  You probably know given your username, but Sudafed is also great for diving to avoid barotrauma (MEBT). Just need to ensure it's not less than the 12 hour formulation, lest it wear off at depth.
  - mattmaroon 3y ago
    A year ago I had an eardrum suddenly and randomly rupture (probably due to an infection I never felt before it happened) and after it healed a bit, my ENT told me that I should take it before a flight just to be sure to open the eustachian tubes. Oddly a few days later I overheard pilots in the airport lounge talking about times their eardrum ruptured due to a cold or something. It’s an injury that’s not uncommon for them. Now I pop one before a fight every time just to be safe. If you’ve never had an eardrum rupture let’s just say it isn’t fun.
    - Nursie 3y ago
      My eardrum rupture was amazing. Would recommend :) Not so much “fun” as “blessed relief”. I picked up some sort of nasty flu in Mexico in about 2005, and my eustachian tubes got blocked for a few weeks, resulting in an ear infection with pressure building up behind the eardrum in one of my ears. When that drum finally burst I felt so much better. It was a sharp pain, and it was a bit gross, but so much better… Pseudoephedrine did nothing for me (it usually works great) and it took a a course of co-amoxiclav to finally clear up the infection.
      - mattmaroon 3y ago
        Ah, my pressure buildup happened in a few hours and it did suck. The rupture was more scary (literally hearing my ear explode) than painful, but the process after was really awful. I could barely stand at one point and even a year later I have bad tinnitus and some (thankfully minor) hearing loss.
HumblyTossed 3y ago
> I’ll happily wait in the tweaker line for my pseudo. HA! Indeed! I got a three pack from Costco. Should last a while.
- dylan604 3y ago
  How much paperwork and what forms of ID were required to buy that much at one time? It sounds like a sarcastic question, but it is a serious one. The last time I was prescribed a codeine based cough syrup, my signature was required enough times to make me compare to financing a car/house.
  - eli 3y ago
    It's the same process for any amount up to the limit.
    - dylan604 3y ago
      and that process is????
      - patch_cable 3y ago
        In Washington state at least I just have to let them scan my drivers license.
      - eli 3y ago
        It depends where you live, but usually ID check + signature
  - sixothree 3y ago
    I don't think that's allowed where I live. But hey. We have gun shows every other month and a strangely coincidental amount of gun deaths. But at least I'm protected from dealing with colds.
  - HumblyTossed 3y ago
    Just had to show my driver's license. And I didn't want to buy that much, that's just how they sell it at my Costco. Bundled in three's.
toast0 3y ago
I seem to recall reading something that said there is an effective does of phenylephrine, if you take it by itself, 2x the dose works, but if you take it with other meds, it might be ok by itself. Something about the stomach acid neutralizing it. Might help to take it with food too.
- kstrauser 3y ago
  What you’re probably thinking of is topical (is that the right word here?) phenylephrine. If you snort it, like as a nasal spray, and it soaks directly into the inflamed nasal tissue, then it has an effect. Swallowing it does not. Analogy: you wouldn’t eat hemorrhoid cream.
  - toast0 3y ago
    Well there's this report [1] from 2007 that suggests a 25 mg dose works significantly better than the 10mg dose generally available. I'm pretty sure that's not the report I'm recollecting, but it was easy to find. Possibly a digested version of this report from 2015 [2] which found The relative bioavailability of phenylephrine 10 mg was doubled (Fbio 2.11, 95%CI 1.89, 2.31) when combined with acetaminophen 1000 mg, while the absorption half-time was reduced by 50 %. When combined with 500 mg of acetaminophen, bioavailability increased by 64 % (Fbio 1.64). Phenylephrine 5 mg in combination with acetaminophen 1000 mg produced a phenylephrine plasma time-concentration profile similar to that seen with phenylephrine 10 mg administered alone. Combining information from the first and second reports, the generally available 10 mg dose isn't very effective, but increasing to 25 mg is much more effective --- and you can double the absorption of 10 mg phenylephrine by also taking 1000 mg of acetaminophen the recommended adult dose of 'extra strength' Tylenol in the US). So take double the dose or with something else (tested specifically with acetaminophen, but anecdotally, seems to also work with ibuprofen), and it may work much better than alone. Given that it's been much easier to obtain phenylephrine than more effective decongestants, it's useful to know what you can try to make it work, if that's all you have. [1] https://pubmed.ncbi.nlm.nih.gov/17264159/ https://pubmed.ncbi.nlm.nih.gov/17264159/ [2] https://pubmed.ncbi.nlm.nih.gov/25475358/ https://pubmed.ncbi.nlm.nih.gov/25475358/
zbrozek 3y ago
It's long past time to remove that regulatory friction. Instead, it's spread to other drugs. My wife got a cold last week and sent me off to get some other non-pseudo drug. Despite being on the shelf, unlocked, it triggered a driver's license scan at checkout. Very dystopian.
- tptacek 3y ago
  It doesn't seem dystopian to me at all. I get carded when I buy alcohol; in fact, I got declined recently buying alcohol, because my license had expired, but would not have been for Sudafed, where the ID is just there to rate limit purchases. This is a very old, recurrent HN debate.
  - alright2565 3y ago
    But you don't have your identity logged with the government when you buy alcohol. They just verify the age and forget all the information on your ID immediately.
    - tptacek 3y ago
      They're not rate-limiting my purchases of alcohol; they are rate-limiting my purchases of Sudafed. That's the only reason they need my ID for it. Meanwhile, the data they're theoretically collecting is useless. Everybody gets colds.
  - vasco 3y ago
    > I got declined recently buying alcohol, because my license had expired Were they under the impression you might get younger when you renew your license or was this some kind of automated machine that auto-denies without any recourse?
    - School-Cotton 3y ago
      > some kind of automated machine that auto-denies without any recourse? This describes a lot of bureaucratically-minded humans, fwiw.

I feel like anyone who has tried a PE drug knew they didn’t work. I’ve wondered for a solid decade why they existed. I’ll happily wait in the tweaker line for my pseudo.

prmph 3y ago

They hitched a profitable ride on the placebo effect bandwagon

Scubabear68 3y ago

It literally did nothing at all. Before I started using Flonase for my congestion, real Sudafed was the only thing that would work when I had to fly. If I forgot, take off and landing would be miserable because my ears wouldn’t pop.

hunter2_ 3y ago
You probably know given your username, but Sudafed is also great for diving to avoid barotrauma (MEBT). Just need to ensure it's not less than the 12 hour formulation, lest it wear off at depth.
- mattmaroon 3y ago
  A year ago I had an eardrum suddenly and randomly rupture (probably due to an infection I never felt before it happened) and after it healed a bit, my ENT told me that I should take it before a flight just to be sure to open the eustachian tubes. Oddly a few days later I overheard pilots in the airport lounge talking about times their eardrum ruptured due to a cold or something. It’s an injury that’s not uncommon for them. Now I pop one before a fight every time just to be safe. If you’ve never had an eardrum rupture let’s just say it isn’t fun.
  - Nursie 3y ago
    My eardrum rupture was amazing. Would recommend :) Not so much “fun” as “blessed relief”. I picked up some sort of nasty flu in Mexico in about 2005, and my eustachian tubes got blocked for a few weeks, resulting in an ear infection with pressure building up behind the eardrum in one of my ears. When that drum finally burst I felt so much better. It was a sharp pain, and it was a bit gross, but so much better… Pseudoephedrine did nothing for me (it usually works great) and it took a a course of co-amoxiclav to finally clear up the infection.
    - mattmaroon 3y ago
      Ah, my pressure buildup happened in a few hours and it did suck. The rupture was more scary (literally hearing my ear explode) than painful, but the process after was really awful. I could barely stand at one point and even a year later I have bad tinnitus and some (thankfully minor) hearing loss.

HumblyTossed 3y ago

> I’ll happily wait in the tweaker line for my pseudo. HA! Indeed! I got a three pack from Costco. Should last a while.

dylan604 3y ago
How much paperwork and what forms of ID were required to buy that much at one time? It sounds like a sarcastic question, but it is a serious one. The last time I was prescribed a codeine based cough syrup, my signature was required enough times to make me compare to financing a car/house.
- eli 3y ago
  It's the same process for any amount up to the limit.
  - dylan604 3y ago
    and that process is????
    - patch_cable 3y ago
      In Washington state at least I just have to let them scan my drivers license.
    - eli 3y ago
      It depends where you live, but usually ID check + signature
- sixothree 3y ago
  I don't think that's allowed where I live. But hey. We have gun shows every other month and a strangely coincidental amount of gun deaths. But at least I'm protected from dealing with colds.
- HumblyTossed 3y ago
  Just had to show my driver's license. And I didn't want to buy that much, that's just how they sell it at my Costco. Bundled in three's.

toast0 3y ago

I seem to recall reading something that said there is an effective does of phenylephrine, if you take it by itself, 2x the dose works, but if you take it with other meds, it might be ok by itself. Something about the stomach acid neutralizing it. Might help to take it with food too.

kstrauser 3y ago
What you’re probably thinking of is topical (is that the right word here?) phenylephrine. If you snort it, like as a nasal spray, and it soaks directly into the inflamed nasal tissue, then it has an effect. Swallowing it does not. Analogy: you wouldn’t eat hemorrhoid cream.
- toast0 3y ago
  Well there's this report [1] from 2007 that suggests a 25 mg dose works significantly better than the 10mg dose generally available. I'm pretty sure that's not the report I'm recollecting, but it was easy to find. Possibly a digested version of this report from 2015 [2] which found The relative bioavailability of phenylephrine 10 mg was doubled (Fbio 2.11, 95%CI 1.89, 2.31) when combined with acetaminophen 1000 mg, while the absorption half-time was reduced by 50 %. When combined with 500 mg of acetaminophen, bioavailability increased by 64 % (Fbio 1.64). Phenylephrine 5 mg in combination with acetaminophen 1000 mg produced a phenylephrine plasma time-concentration profile similar to that seen with phenylephrine 10 mg administered alone. Combining information from the first and second reports, the generally available 10 mg dose isn't very effective, but increasing to 25 mg is much more effective --- and you can double the absorption of 10 mg phenylephrine by also taking 1000 mg of acetaminophen the recommended adult dose of 'extra strength' Tylenol in the US). So take double the dose or with something else (tested specifically with acetaminophen, but anecdotally, seems to also work with ibuprofen), and it may work much better than alone. Given that it's been much easier to obtain phenylephrine than more effective decongestants, it's useful to know what you can try to make it work, if that's all you have. [1] https://pubmed.ncbi.nlm.nih.gov/17264159/ https://pubmed.ncbi.nlm.nih.gov/17264159/ [2] https://pubmed.ncbi.nlm.nih.gov/25475358/ https://pubmed.ncbi.nlm.nih.gov/25475358/

zbrozek 3y ago

It's long past time to remove that regulatory friction. Instead, it's spread to other drugs. My wife got a cold last week and sent me off to get some other non-pseudo drug. Despite being on the shelf, unlocked, it triggered a driver's license scan at checkout. Very dystopian.

tptacek 3y ago
It doesn't seem dystopian to me at all. I get carded when I buy alcohol; in fact, I got declined recently buying alcohol, because my license had expired, but would not have been for Sudafed, where the ID is just there to rate limit purchases. This is a very old, recurrent HN debate.
- alright2565 3y ago
  But you don't have your identity logged with the government when you buy alcohol. They just verify the age and forget all the information on your ID immediately.
  - tptacek 3y ago
    They're not rate-limiting my purchases of alcohol; they are rate-limiting my purchases of Sudafed. That's the only reason they need my ID for it. Meanwhile, the data they're theoretically collecting is useless. Everybody gets colds.
- vasco 3y ago
  > I got declined recently buying alcohol, because my license had expired Were they under the impression you might get younger when you renew your license or was this some kind of automated machine that auto-denies without any recourse?
  - School-Cotton 3y ago
    > some kind of automated machine that auto-denies without any recourse? This describes a lot of bureaucratically-minded humans, fwiw.