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Cold Meds Don't Work? Decongestant Under Fire
28 Oct
Summary
- Oral phenylephrine, a common decongestant, performs no better than a placebo.
- Phenylephrine replaced pseudoephedrine due to illicit drug manufacturing concerns.
- US FDA proposed removing oral phenylephrine from over-the-counter cold medicines.
Recent studies indicate that oral phenylephrine, a frequent ingredient in cold and flu medications, is ineffective for relieving nasal congestion. When swallowed, only a minimal amount of the drug reaches the bloodstream, rendering it no more effective than a placebo. This contrasts with nasal sprays, which deliver the decongestant directly where needed.
Historically, phenylephrine replaced pseudoephedrine in many cold medicines. This shift occurred after pseudoephedrine became restricted due to its diversion for illicit drug manufacturing in Australia. While initially considered an adequate substitute, newer research has revealed oral phenylephrine's lack of efficacy.
In 2023, a US FDA advisory committee concluded that oral phenylephrine is ineffective at standard doses. The FDA proposed removing it from over-the-counter sales, a decision Australia's Therapeutic Goods Administration (TGA) is observing. The primary concern is not safety, but that consumers may be paying for a product offering minimal congestion relief.
For effective relief, short-term use of decongestant nasal sprays or saline rinses are recommended. Products containing pseudoephedrine may be available from pharmacists with identification. Rest and hydration remain key to recovering from common viral illnesses.
