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Cold Tablets Deception: Your Medicine Doesn't Work
15 Oct
Summary
- Oral phenylephrine, common in cold tablets, is ineffective for nasal congestion.
- Phenylephrine replaced pseudoephedrine due to illicit drug manufacturing risks.
- Consumers pay for ineffective decongestants, relief likely from other ingredients.
Evidence clearly indicates that common over-the-counter cold and flu tablets containing oral phenylephrine are ineffective for relieving nasal congestion. This ingredient, which narrows nasal blood vessels, fails when swallowed because only a small amount reaches the bloodstream. It replaced pseudoephedrine in many formulations after tightened restrictions on pseudoephedrine sales, stemming from its use in illicit drug manufacturing.
While nasal sprays with phenylephrine can be effective, oral consumption yields little benefit. Recent studies and a US FDA advisory committee review in 2023 concluded oral phenylephrine is not effective at standard doses. The FDA proposed its removal from over-the-counter products in November 2024.
The Australian Therapeutic Goods Administration (TGA) is monitoring the FDA's review but has no immediate plans to reassess oral phenylephrine's efficacy. The primary concern is not safety, but that consumers spend money on products offering minimal relief for nasal congestion. For actual relief, short-term use of decongestant nasal sprays or saline rinses is recommended.
