Perusing the aisles of any drugstore invariably leads you to an array of over-the-counter medicines housing the decongestant phenylephrine. Presented as a catch-all solution for cold and flu symptoms, this ingredient has recently been deemed ineffective by a Food and Drug Administration (FDA) advisory committee.
Widespread in many cold and flu meds, including popular choices such as Sudafed PE, Benadryl Allergy D Plus Sinus, and Vicks DayQuil Cold and Flu Relief, it’s essential to know your alternatives to this fallible component.
An Emphasis on Efficacy: Pseudoephedrine
Pseudoephedrine, a prevalent decongestant in Sudafed, has been lauded for its effectiveness in helping people with stuffy noses enjoy easier breathing, asserts Dr. Maryann Amirshahi, a medical toxicologist and professor of emergency medicine at Georgetown University School of Medicine.
Unlike your standard over-the-counter medication, pseudoephedrine is procured “behind the counter,” meaning it doesn’t necessitate a prescription but is only available upon request. It was repositioned behind the counter in 2006 to ward off individuals seeking to utilize it for methamphetamine production.
Electing pseudoephedrine as an alternative in place of the ineffectual ingredient, phenylephrine, saw an uptick in its popularity. Renowned pharmacist Mike Koelzer explains that pharmacists are aware of phenylephrine’s limitations and consistently recommend alternatives such as pseudoephedrine. Still, pseudoephedrine does have side effects like dizziness, nervousness, sleep disruptions, and possible elevation of blood pressure— a significant concern for individuals with heart conditions.
Nasal Sprays: An Effective Option to Phenylephrine
Many people opt for medications in pill form, but nasal sprays have proven equally effective. Dr. Vin Gupta, a pulmonologist and affiliate faculty member at the University of Washington, strongly recommends corticosteroid nasal sprays like Flonase for individuals unable to take pseudoephedrine.
Phenylephrine is considered effective when used in nasal sprays, according to Dr. Wynne Armand. The FDA recently focused on the effectiveness of oral phenylephrine, sparking studies demonstrating that excessive amounts of the drug are broken down before it reaches the nose, thus hindering its ability to relieve congestion. When administered via a nasal spray, it’s delivered directly where it is needed. However, one must exercise caution not to use decongestant nasal sprays for more than three days, as they may lead to rebound congestion.
Oxymetazoline, frequently present in over-the-counter nasal sprays such as Afrin and Zicam, is also considered an effective substitute. Yet, similar to phenylephrine nasal sprays, prolonged use of oxymetazoline sprays can also lead to rebound congestion.
The Lure of Antihistamines
Dr. Purvi Parikh, the national spokesperson for the Allergy & Asthma Network, usually desists from recommending pseudoephedrine to her patients, considering the side effects it has on blood pressure. Rather, she suggests oral antihistamines like Zyrtec, Allegra, and Claritin.
Commonly used for allergies and hives, these oral antihistamines can also come to the rescue for nasal congestion. They tackle congestion differently than decongestants, which reduce the swelling of blood vessels in the nasal passages. Antihistamines also lower swelling and irritation in the nasal passages, but they manage this by blocking the body’s chemicals responsible for such reactions.
Pediatric Concerns: Remedies for Stuffy Noses in Children
Dealing with a stuffy nose is more challenging for children due to their smaller nasal passageways. On these grounds, the industry has limited options for treating child congestion. The FDA advises against administering any cold and flu medication containing decongestants or antihistamines to children under two due to dangerous side effects and urges caution for children aged between two to four.
To aid with initial child congestion, a bulb syringe can be used to retrieve mucus from a child’s mouth and nose. Pain relief can be offered through Children’s Tylenol and Advil if decongestants aren’t suitable.
In a fast-paced health industry, it’s critical to stay updated on effective medicines to tackle life’s inconveniences. As the debate continues on phenylephrine’s effectiveness, it’s reassuring to know that there are proven alternatives available to help relieve nasal congestion.
