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Context for readers from countries where this isn't an issue, or anyone who hasn't followed decongestant news: one of the most effective decongestants is called
by schoen 2y ago
Context for readers from countries where this isn't an issue, or anyone who hasn't followed decongestant news: one of the most effective decongestants is called pseudoephedrine.
https://en.wikipedia.org/wiki/Pseudoephedrine https://en.wikipedia.org/wiki/Pseudoephedrine
In the past this was easily available, with the most popular brand being Sudafed. My parents always told me that one should take Sudafed when flying after having had a cold, in order to avoid severe ear pain from the pressure changes, but people would also obviously take it when not flying, just in order to reduce the discomfort of the congestion itself.
Pseudoephedrine is very effective. It is also used to synthesize the somewhat related illegal drug methamphetamine ("meth"). Historically, meth manufacturers would hire people to buy large amounts of pseudoephedrine pills at pharmacies and supermarkets, then grind them up and synthesize meth from them.
In order to deter this, authorities in the U.S. restricted the availability of pseudoephedrine, while not making it prescription-only, by limiting the amount that people could buy, and requiring buyers to show ID and be put on a registry (which law enforcement could use in investigations). I think this is the only drug that is treated this way. Some people stopped buying pseudoephedrine entirely, either because they were offended by these rules or because they were afraid that they could wrongly be implicated in meth investigations if they appeared to buy it too often.
The pharmaceutical industry produced an alternative called phenylephrine, the substance that this proceeding relates to. Most manufacturers of pseudoephedrine-based drugs, including Sudafed, formulated alternative decongestants using phenylephrine. There are no legal restrictions on phenylephrine drugs; one can buy them anonymously and in any quantity. Customers have complained for years that these are much less effective than the original formulations.
A couple of years ago this regulatory authority started looking into the question of whether phenylephrine is actually completely useless as a decongestant (rather than just much worse than pseudoephedrine). Their preliminary review of studies suggested that it is probably, in fact, useless. This proceeding is now proposing to ban it on the grounds that it's ineffective and so people should not be encouraged to buy and use it as a medicine for purposes for which it doesn't actually work.
(There doesn't seem to be much corresponding initiative to remove or reduce the restrictions on pseudoephedrine.)
- gniv 2y agoI read this and was puzzled, until I realized that you are talking about the pills. The nasal spray is effective, although probably not more effective than a saline solution.
- notpushkin 2y ago> although probably not more effective than a saline solution I guess saline is a baseline against which effectiveness should be measured here, especially since nasal sprays are usually saline plus something. (I guess? Not sure about Sudafed specifically.)
- bottom999mottob 2y agoI'd argue that saline should be the panacea here. I doubt very many people do at-home saline rinses with filtered, sterilized water and a simple mixture of salt and baking soda. Do people really want to spray PFAS water directly into their mucus lining? I bought an Arm and Hammer Saline spray out of curiosity. It smelled awful, and the BPS lined can had an awful smell despite the ingredients being: water, salt, baking soda, and no suspicious preservatives.
- dreamcompiler 2y agoTrue except it is definitely more effective than saline. Phenylephrine nasal spray is not as effective or long-lasting as oxymetazoline, but it's also not as dependency-inducing.
- rrrrrrrrrrrryan 2y agoThe efficacy of the nasal sprays had already been demonstrated when they introduced the pills. Surprisingly, the efficacy of the pills was never properly demonstrated, and now that it's being investigated, they're pulling it from the shelves.
- seattle_spring 2y agoIn my experience phenylephrine is worse than useless. Not only does it do nothing for congestion, but it makes me feel wired in a bad way and unable to sleep for at least 24 hours. I hate phenylephrine.